Peyronie’s Disease Overview

Peyronie’s disease Treatment is a noncancerous condition caused by fibrous scar tissue that develops on the penis and sometimes causes a curved, painful erection.

and a curved erection isn’t necessarily a cause for concern. But Peyronie causes significant curvature or pain in some men.

This may prevent you from having sexual intercourse or make it difficult to maintain or maintain an erection (erectile dysfunction). For many men, Peyronie also causes stress and anxiety. Penile shortening is another concern.

Sometimes Peyronie goes away with a simple treatment. In most men with Peyronie, the condition will remain or worsen.

Early treatment soon after the condition develops may prevent symptoms from getting worse or even improve symptoms.

Even if you’ve had this medical condition for some time, treatment may help improve bothersome symptoms, such as pain, curvature, and shortening of the penis.

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Peyronie’s Disease Symptoms:

Peyronie’s disease symptoms and signs may appear suddenly or develop gradually. The most common signs and symptoms of the disease include:

Sc scar tissue The scar tissue associated with Peyronie — plaques, but different from plaques that can build up in blood vessels — can be seen under the skin of the penis as flat lumps or bands of hard tissue.

Large penis curve. The penis may curve up, down, or curve to one side.

Erection problems. Peyronie may cause problems getting or keeping an erection (erectile dysfunction). However, men often report erectile dysfunction before the onset of Peyronie’s disease symptoms.

Shortening of the penis. Your penis may become shorter as a result of Peyronie’s disease.

the pain. You may have penile pain, with or without an erection.

Another malformation of the penis. In some men with Peyronie’s disease treatment, the erect penis may be narrow, hollow, or even have an hourglass-like appearance, with a narrow taut band around the shaft of the penis.

The curvature and shortening of the penis associated with Peyronie’s disease treatment may worsen. However, at some point, the condition usually stabilizes after three months to 12 months or so.

Pain during an erection usually improves within one to two years, but scar tissue, shortening of the penis, and curvature often remain.

The penile curvature and pain associated with Peyronie’s disease treatment may improve without treatment in some men.

Causes of Peyronie’s disease and penile curvature

Congenital penile curvature:

It is the result of abnormal overgrowth of one surface of the penis and not the others.

For example, if the top surface grows more than the bottom, this results in a downward curve.

This is sometimes due to a genetic defect, but this defect is not necessarily passed down through the generations, it is not necessarily passed from father to son but may appear sporadically in some members of the family.

Acquired penile curvature:

Acquired penile curvature is when the curvature of the penis is new to you, meaning that you distinctly remember the penis being straight in an erect position and then starting to curl.  

This is usually the result of Peyronie’s Disease, a fibrosis that occurs in the white tunica albuginea layer that encapsulates the internal erectile cylinders of the penis, corpora cavernosa.

Peyronie’s fibrosis is the ossification of the tissue so that instead of being stretchy and easy to stretch, it becomes stiff. For example, if Peyronie’s fibrosis occurs on the upper surface of the penis, it prevents this surface from stretching while the lower surface stretches freely, the penis curves upwards, and so on.

The fibrotic body caused by Peyronie’s disease is called a Peyronie’s layer and is often palpable by hand. Peyronie’s disease also causes shortened penis length, often accompanied by erectile dysfunction. 

Diabetes is a contributing factor to Peyronie’s disease, as well as improper sexual positions, especially the cowboy position. Another cause of acquired erectile dysfunction is repeated localized injections into the penis to treat erectile dysfunction, such as Trimix injections.

 

 

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Peyronie’s Disease Treatment

The treatment of penile curvature has become an easy matter with excellent results. The treatment of penile curvature depends on its cause (congenital or acquired curvature in the so-called Peyronie’s disease) and depends on its degree and direction of curvature, the degree of erection, and whether the curvature is accompanied by erectile dysfunction or not.

For cases with early stages of Peyronie’s disease, it can be treated without surgery and that would be by using PRP treatment sessions

As the Platelet-Rich Plasma (PRP) Injections. In recent years, doctors have learned that the body can heal itself. Platelet-rich plasma therapy can be very easy and effective for Peyronie’s disease treatment.

However, in some other cases when it’s not new to the body and mostly it can come with pain during the erection, in this case, it’s unlikely to see good results with any non-surgical treatment methods, therefore we need to go to the surgery which can fix the problem.

One of the most common side effects of time is erectile dysfunction, in some cases it can be a good idea to do a penile implant surgery as it will solve the two problems together for a lifetime with issues in the future.

Otherwise, if the patient does not suffer from erectile dysfunction, it is possible to treat Peyronie’s curvature only surgically in the first instance, and here we will list some techniques for you.

Peyronie’s penile plication Surgery (16-Dot Technique)

Since penile curvature is the result of an overgrowth of one side of the penis and not the other, the surgery to repair penile curvature with the Plication of the penis relies on shortening the longer side to match the shorter side, leveling them out, and straightening the penis.

The shorter side is the normal side, so the length is usually within the normal range sufficient for intercourse, especially in mild to moderate degrees of penile curvature

The Peyronie’s penile plication is the easiest and simplest curvature repair technique

The only downside to this technique is a shortening of the penis length by approximately 1 cm. Therefore, it is recommended that penile curvature repair with traction surgery in mild to moderate cases of congenital penile curvature be performed as early as possible to avoid a more severe decrease in length in cases of severe penile curvature.

Peyronie’s penile plication surgery to repair the curvature of the penis has a high success rate of approximately 95%. Some shortening occurs but the final length does not deviate from the normal range of length in cases of mild to moderate crookedness.

There may be a partial decrease in the sensitivity of the penis, which returns to normal in most cases after several months. Rarely, 5-10% may experience a partial regression of the curvature, which rarely needs to be re-surgery.

This technique is performed in less than an hour in the operating theatre, and the patient can be discharged from the hospital unaccompanied and can move normally on the same day. It is recommended to avoid sexual intercourse for at least three months after surgery.

How to perform penile curvature repair surgery with Peyronie’s penile plication

Classically, the skin of the penis is opened in the same line as the circumcision surgery so that it is closed, and there is no scar or sign of previous penile surgery.

After the skin is opened, it is gently stretched to expose the two erectile cylinders at the point of curvature. A suture is inserted along the longer side at this point as shown in the drawing

When the suture is tightened, the points shown converge, shortening the longer side to equal the shorter side, straightening the penis. The erection angle is assessed during surgery to determine if more tensioning stitches are needed to achieve full straightening.

This technique is called the 16-dot Technique, There are other options such as opening the inner shell of the erection cylinders where the thread enters, so that when the thread is tightened, the small openings converge and adhere to each other and fuse, which are older techniques such as Nesbit Technique

However, it has been shown that there is no need for such openings as the success rates of both techniques are close to 90%, and There is no risk of erectile dysfunction after this technique.