About Peyronie's disease
Peyronie's disease, sometimes referred to as a curved penis, is a benign but disabling condition. It occurs when scar tissue develops in the penis, probably from minor trauma. Peyronie's disease affects about 10% of men in the US.
Peyronie's disease symptoms
The onset and progression of Peyronie's disease varies. In some patients, it comes on rapidly and may become severe in a matter of days; in others, the progression is slower.
There is no proven association between Peyronie's disease and cancer of the penis.
Symptoms of Peyronie's disease
- Pain in the area of the scar tissue early in disease progression
- Pain with erections later in the progression
- Pain near the area of scar tissue without an erection
- Difficulty voiding, especially in the morning
- Changes in firmness of erections
- Erectile dysfunction (ED), which can cause impotency
Peyronie's disease treatment options
In many patients, the scar tissue that characterizes Peyronie's disease softens on its own, and the penis straightens over time. Most patients are put on vitamin E supplements, which is the only treatment for Peyronie's disease that consistently helps relieve the disease.
On average, one out of three patients eventually requires surgery to resolve Peyronie’s disease. There are several Peyronie's disease surgery options. One with which we have had good results (92% success rate) involves cutting out the scar tissue and replacing it with skin grafts. This procedure may be combined with another approach in which the tissue opposite the curvature is surgically tightened.
Patients with severe problems with erectile function may need a prosthesis in addition to removal of the scar tissue and skin grafts. Some patients with severe curvature require two operations as part of their Peyronie's disease treatment: one to correct the curved penis and a second operation to implant the prosthesis.
Duplex doppler ultrasound
Patients who are considered for Peyronie's disease surgery undergo a blood flow study of the penis to determine if there is an underlying abnormality or medical condition, including:
- Venous leak: Blood leaks out through the scar tissue
- Arteriosclerotic changes: The arteries that bring blood to the penis harden, restricting blood flow
The blood flow study is conducted with an ultrasound of the penis. This technique uses a special Doppler ultrasound device to assess the blood flow into and out of the penis.
The blood flow test is especially useful in patients with Peyronie's disease, because it not only assesses how much blood flow is present but how much bending there is and the presence of other lesions.