Peyronie's disease

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Peyronie's Disease

 

Definition

Peyronie's disease is a condition characterized by a bent penis.

Description

The cause of Peyronie's disease is unknown and the disease is often difficult to treat. For some reason, a thick scar develops in the penis and bends it. Almost a third of patients with Peyronie's disease also have similar contracting scars on their hands, a disease called Dupuytren's contractures. Some cases are associated with diabetes, and others appear after prostate surgery. Because prostate surgery always requires a catheter in the bladder, there is some suspicion that catheters can cause the scarring. However, many cases of Peyronie's disease arise without any use of a catheter. There is also a congenital form of penile deviation, again with no known cause. Most of the scars are located in the mid-line, therefore most of the angulations are either up or down.

Causes and symptoms

Peyronie's disease occurs in about 1% of men, most of them between 45-60 years old. Although there is no good research data to back it up, the suspicion exists that Peyronie's disease is the result of injury. If not a catheter, then sudden, forceful bending during sexual intercourse could easily tear the supporting tissues and lead to scarring.
The symptom is bending of an erect penis, sometimes with pain. It often interferes with sexual intercourse. Erectile failure associated with the angulation often precedes it.

Treatment

Attempts have been made to reduce the angulation with injections of cortisone-like drugs directly into the scar, but they are rarely successful. Surgery seems to be the better answer. After the scar is removed, plastic repair of the penis is attempted, often with a graft of tissue from somewhere else on the body. The Nesbit procedure is one of the more successful methods of doing this. The other surgical approach is to implant a penile prosthesis that overcomes the angulation mechanically. Results with these procedures are reported to be 60-80% satisfactory, including the return of orgasm.

Prognosis

Sometimes the condition disappears spontaneously. A careful look for other causes of impotence should be done before surgery.

Resources

Books

Jordan, Gerald H., et al. "Surgery of the Penis and Urethra." In Campbell's Urology, edited by Patrick C. Walsh, et al. Philadelphia: W. B. Saunders Co., 1998.

Key terms

Catheter — A flexible tube placed into a body vessel or cavity.
Congenital — Present at birth.
Plastic surgery — The restoring and reshaping of the skin and its appendages to improve their function and appearance.
Prostate — A gland that surrounds the outlet to the male bladder.
Prosthesis — Artificial substitute for a body part.
Gale Encyclopedia of Medicine. Copyright 2008 The Gale Group, Inc. All rights reserved.

Peyronie's disease

 [pa-ron-ēz´]
a self-limiting disease of the penis that causes hardening of the corpora cavernosa, resulting in painful chordee and penile curvature.
Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.

Peyronie’s disease

A type of superficial fibromatosis characterised by hypocellular dense fibrous tissue within the fascial sheath of one or both corpora cavernosa, leading to penile shaft curvature, painful erection, penile deformity, penile shortening with and without erection, focal penile induration, and, in many, erectile dysfunction. It is most common in men age 40 to 60 and may be associated with Dupuytren’s contracture, trauma, diabetes, gout, Paget’s disease, and urethral instrumentation.
Segen's Medical Dictionary. © 2012 Farlex, Inc. All rights reserved.

Peyronie's disease

Curvature of penis, penile fibromatosis Urology A condition characterized by unilateral fibrotic nodules within the fascial sheath of one or both corpora cavernosa, leading to penile shaft curvature and painful erection. Cf Erectile dysfunction.
McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.

Peyronie's disease

A disorder of the penis in which the organ is bent at an angle when erect. This is the effect of local thickening and indistensibility of the fibrous tissue sheath. The thickening may extend into the erectile tissue and the condition is liable to interfere with sexual intercourse. The cause is unknown and the treatment difficult. Corticosteroid injections may help and surgical removal of the thickened areas may be tried. (Francois de la Peyronie, 1678–1747, French surgeon).
Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005
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