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Peyronie's disease is characterized by a plaque, or hard lump, that forms on the penis. It may develop on the upper or lower side of the penis in layers containing erectile tissue. The penis contains balloon-like blood vessels that fill with blood to cause an erection. Scar tissue forming in the balloons cannot stretch as much as the balloons do, so the erected penis bends toward the side with a scar.
Peyronie's disease was first described in 1743 as a form of impotence. Impotence is recognized as one factor associated with the Peyronie's disease, but is not always present. Men most likely to suffer Peyronie's disease often have high blood pressure and high blood cholesterol and uric acid levels, which weaken blood vessel walls.
Causes & Development
The plaque often begins as a localized inflammation that may develop into a hardened scar. Generally, when the disease heals within a year or so, the plaque does not advance beyond that initial inflammatory phase. When the disease lasts for years, the plaque often becomes a tough fibrous tissue, and calcium deposits may form.
Treatment & Prevention
Men with Peyronie's disease are usually told to live with it unless the erection becomes painful or the bend is so great that the man cannot engage in sexual relations. In general, the goal of treatment is to keep the patient with Peyronie's disease sexually active.
The most favorable nonsurgical treatment for Peyronie's involves injecting medication directly into the plaque in the attempt to soften the hardened tissue and decrease the pain and curvature. Injection medications include steroids, collagenase, verapamil and interferon. It is not yet clear which of these substances works best, although collagenase and verapamil appear the most promising at this time.
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Conditions that suggest Peyronie's Disease:
Recommendations and treatments for Peyronie's Disease: | | | | | Surgery/Invasive |  Surgery | If the bend in the penis is so severe that intercourse is impossible, surgery may be recommended. The scarring plaque that causes the bend may need to be removed or cut to straighten the penis, but this usually affects the quality of erections. A penile implant may be inserted to improve erections.
Peyronie's disease often occurs in a mild form that heals without treatment in 6-15 months. It is not clear why this occurs without intervention. However, once a plaque has calcified, it is unlikely to resolve and surgery is the only solution. Because the cause of Peyronie's disease is still unknown and all of its symptoms may lessen or disappear in some individuals, many experts recommend that a man wait 1 to 2 years before considering surgery. |
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Vitamins |
 Vitamin Paba| | PABA has been suggested for diseases in which abnormal fibrous tissue is involved, such as Peyronie's disease. However, no double-blind studies have been performed. [Tech Urol 3: pp.135-9, 1997] |
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KEY | | Proven definite or direct link | | | May do some good | | | Likely to help |
GLOSSARY
Calcium
The body's most abundant mineral. Its primary function is to help build and maintain bones and teeth. The body also needs calcium to carry nerve signals, keep the heart functioning, contract muscles, clot blood and maintain healthy skin. Calcium helps control blood acid-alkaline balance, plays a role in cell division, muscle growth and iron utilization, activates certain enzymes, and helps transport nutrients through cell membranes. Calcium also forms a cellular cement called ground substance that helps hold cells and tissues together.
Cholesterol
A waxy, fat-like substance manufactured in the liver and found in all tissues, it facilitates the transport and absorption of fatty acids. In foods, only animal products contain cholesterol. An excess of cholesterol in the bloodstream can contribute to the development of atherosclerosis.
Fibrous Tissue
The tissue that forms tendons and ligaments.
Interferon
A protein formed by the cells of the immune system in the presence of a virus, etc. It prevents viral reproduction, and is capable of protecting noninfected cells from viral infection. Several kinds of interferon exist including alpha, beta, and gamma.
Para Aminobenzoic Acid (PABA)
May be considered part of the B-complex vitamins. As a coenzyme, PABA functions in the breakdown and utilization of proteins and in the formation of red blood cells.
Peyronie's Disease
A disorder in which one or more small areas of plaque (fibrous tissue) develop in the penis. This abnormality causes painful erections and difficulty with intercourse. A man may experience a mild aching in a specific area of the penis well before any lump or plaque can be felt. The areas usually develop on the upper side of the penis but are sometimes found on the underside. The plaque may be painless, but the ability of the penis to become erect can be affected. The penis may be curved when erect, with resulting pain. As time goes on, the plaque may spread, causing more bending of the penis or discomfort.
Scar Tissue
Fibrous tissue replacing normal tissues destroyed by injury or disease.
Steroid (Steroids)
Any of a large number of hormonal substances with a similar basic chemical structure containing a 17-carbon 14-ring system and including the sterols and various hormones and glycosides.
Uric Acid (Hyperuricemia)
The final end product of certain native or dietary proteins, especially the nucleoproteins found in the nucleus of cells. Unlike the much smaller nitrogenous waste product urea, which is mostly recycled to form many amino acids, uric acid is an unrecycleable metabolite that must be excreted: nucleoprotein to purine to uric acid to the outside in the urine or the sweat. Hyperuricemia: Having elevated blood uric acid, either from a rapid rate of cell breakdown and synthesis (such as might occur from fasting, heavy training, trauma or any number of major diseases), a high consumption of organ meats, glandular supplements or spirulina, or the inability (usually hereditary) to excrete uric acid in the urine as fast as it is produced, even though production itself is not elevated.
Last updated: Apr 13, 2008
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