Peyronie's disease is a condition when the shape of the penis bend due to the formation of scar tissue along the shaft of the penis. Change the shape of this penis cause pain and will be clearly visible when erect.
Every man has a penis of different sizes and shapes. In some men, a slightly curved penis during an erection is normal. However, in Peyronie's disease, the curvature of the penis is quite significant and causes problems.
Peyronie's disease is common and can affect men of all ages. However, most of the sufferers are middle-aged men.
Causes of Peyronie's Disease
It is not known exactly what causes Peyronie's disease. However, experts suspect that one of the triggers for this condition is penile injury that occurs repeatedly, for example due to sports or sexual intercourse.
Injury to the penis can result in bleeding and swelling within the penis. Actually, this injury can heal normally. However, in people with Peyronie's disease, scar tissue forms which develops into plaques during the healing process.
Scar tissue and plaque are tough and not as elastic as other tissues in the penis. When the penis is erect, this tissue does not expand and instead holds the penis. As a result, the penis is erect in a bent position and feels painful.
In some cases, Peyronie's disease develops gradually without injury. Therefore, it is still being investigated whether Peyronie's disease is also related to genetic factors or other diseases.
Peyronie's Disease Risk Factors
There are a number of factors that can trigger the formation of scar tissue on the penis when an injury occurs, namely:
- Aged 50 years and over
- Have a family member with Peyronie's disease
- Experience Dupuytren's contracture, which is a condition when hard tissue forms under the palm of the hand, causing the fingers to bend inward
- Have had surgery or radiation therapy to treat prostate cancer
- Have a history of hip injury
- Suffering from erectile dysfunction, diabetes, high blood pressure, or high cholesterol
- Suffering from an autoimmune disease, such as Sjögren Syndrome
- Have a habit of smoking or consuming alcoholic beverages
- Taking certain drugs, such as hypertension drugs, anticonvulsant drugs, and interferons
Symptom PPeyronie's disease
When erect, normally the penis will tighten, straighten, and enlarge. However, in people with Peyronie's disease, the penis can't have an erection perfectly because the part of the penis that has scar tissue can't stretch.
Symptoms of Peyronie's disease can appear suddenly or develop gradually, including:
- Npenis pain
Penile pain is most felt when erect. However, some people with Peyronie's disease also complain of penile pain when not having an erection.
- Scar tissueor plaque under the skin layer of the penis
Scar tissue or plaque under the skin of the penis can feel like a lump or solid line to the touch.
- A crooked or deformed penis shapeThe penis can curve up, down, or sideways. In some cases, scar tissue can cause the shaft of an erect penis to look like it's bound with rubber or even to resemble an hourglass shape.
- Short penis
Peyronie's disease can cause the penis to shorten.
- Erectile dysfunction
People with Peyronie's disease can have difficulty getting an erection or maintaining an erection. Usually, these complaints come before the symptoms of Peyronie's disease appear.
Based on the phase of symptoms experienced by the patient, Peyronie's disease is divided into two phases, namely:
acute phase
The acute phase is the initial phase of symptoms appearing which is characterized by pain and significant changes in the shape or length of the penis. Generally, these symptoms last for 2–4 weeks. However, in some cases, symptoms can last up to 1 year or more.
Chronic phase
The chronic phase is characterized by the disappearance of pain and the absence of further changes in the shape or length of the penis. Usually, the disease enters a chronic phase 3–12 months after the initial symptoms appear.
When to go to the doctor
Immediately consult a doctor if you experience symptoms of Peyronie's disease. Although there are patients who can recover on their own, but this condition generally requires medical treatment. With early treatment, symptoms can subside and do not get worse.
If you've had Peyronie's for a long time and don't have any problems, see a doctor if the shape and size of the penis and pain in the penis are causing problems during sex.
Diagnosis PPeyronie's disease
To diagnose Peyronie's disease, the doctor will ask about the symptoms experienced, the medications being taken, as well as the patient's medical history, especially a history of injury to the penis before the patient experienced symptoms of Peyronie's disease.
After that, the doctor will perform a physical examination by palpating the scar tissue on the patient's penis. If necessary, the doctor will inject a special drug first into the penis to have an erection. That way, doctors can find out what abnormalities occur when the patient's penis is erect.
Further examination that may be done is ultrasound or X-rays of the penis. The doctor may also perform a biopsy (tissue sampling) of the flexed penis for examination in a laboratory.
Peyronie's Disease Treatment
If the patient's symptoms are mild, do not worsen and do not interfere with sexual activity, treatment may not be necessary. In some cases, Peyronie's disease may even go away on its own.
However, in the vast majority of cases, Peyronie's disease needs to be treated by a doctor. The treatment method will be adjusted to the phase experienced by the patient, namely:
acute phase
In the acute phase, the recommended treatment method is penile traction therapy to prevent penis shortening and reduce penile curvature. Doctors can also give medicines either in oral or injectable form.
Chronic phase
In chronic Peyronie's disease, the doctor will monitor the patient's condition and only take treatment if complaints arise. If the patient requires treatment, the doctor will give the drug in the form of an injection, perform traction therapy, or perform a surgical procedure.
The following is an explanation of the treatment methods that can be used to treat Peyronie's disease:
Drugs
There are no oral medications known to be effective for treating Peyronie's disease. However, medications such as ibuprofen or mefenamic acid can be used to relieve pain in acute Peyronie's disease.
In addition, there are several types of oral medications that can help prevent the development of Peyronie's disease, such as:
- Pentoxifylline to improve blood flow
- Colchicine to reduce swelling
- Potassium amino-benzoate to reduce plaque on the penis
On the other hand, injectable drugs are known to be more effective than oral drugs. This injection can be combined with oral medication and penile traction therapy. Some types of drugs that can be used are:
- Collagenase, to break down scar tissue and plaque
- Interferon, to reduce scar tissue on the penis
- Verapamil, to inhibit the production of collagen which is the main component in scar tissue
Penile traction therapy
Penile traction therapy aims to stretch the penis using a mechanical device that can be operated by the patient himself. This therapy can improve the size, curvature, and shape of the penis. Depending on the type of device used, penile traction therapy can last from 30 minutes to 3–8 hours per day.
In the acute phase, this therapy has been shown to restore penile length. While in the chronic phase, penile traction therapy can be used in conjunction with other treatment methods or after surgical procedures to provide better results.
Operation
Surgery is performed on severe Peyronie's disease, for example, which makes the patient unable to have sex. This procedure is usually performed on patients who have had this disease for more than 9 months. The patient should also be ensured that there is no increase in penile curvature for at least 3 months.
There are several surgical methods that can be performed to improve the condition of the penis in Peyronie's disease. The choice of this method depends on the patient's condition, the location of the scar tissue in the penis, and the severity of the symptoms of this penile disease.
If the curvature of the penis is severe enough, the patient may need a skin graft on the penis. Meanwhile, penile implants can be done in Peyronie's disease accompanied by erectile dysfunction.
Depending on the type of surgery performed, the patient can go home the same day or be asked to be hospitalized. After that, the doctor will ask the patient to rest for a few days before returning to activities. Generally, patients should not have sex until 4–8 weeks after surgery.
Other therapy
Other therapies that can be used to treat Peyronie's disease are radiotherapy and shock wave therapy.shockwave therapy) which is known as ESWT. However, research is still needed on the effectiveness and possible side effects of this therapy.
Complications of Peyronie's Disease
Peyronie's disease can cause the following complications:
- Inability to have intercourse
- Difficult to get offspring
- Impotence
- Anxiety about sexual ability or the appearance of the penis
- Stress due to disturbances in sexual relations
- Permanently shortened penis
- Prolonged pain in the penis
Peyronie's Disease Prevention
It is not known exactly how to prevent Peyronie's disease. However, this condition can be avoided by being careful during sexual intercourse, for example by providing sufficient lubricant to the penis and avoiding positions that can increase the risk of penile injury or penile fracture.
If you often cycle or do other activities that put a lot of friction or pressure on the penis area, it is recommended to use special pants that can reduce the risk of penile injury.
The use of male tonic for people with erectile dysfunction can also prevent Peyronie's disease. This is because an incomplete erection during sex can increase the risk of penile injury. Even so, strong drugs should be used according to the advice of a doctor.