WHAT IS PEYRONIE'S DISEASE?

Peyronie's disease consists of hard, fibrous tissue, called plaques, developing within the penile shaft. The plaques are hard, thickened and stiff areas, actually a kind of internal scarring. In this fibroid tissue also calcium compounds can accumulate, making the plaques even harder.

The Peyronie's disease is also called cavernositis, and also sometimes plastic induration. There is probably a chronic inflammation process that leads to this scarring.

The thickened area has less blood flow than normal penile tissue, and do not fill with blood and swell as the normal spongy areas in the inside of the penis. Therefore the penis swells more at the opposite side, and gets a curvature towards the side containing the plaques when erected.

If the plaques are found at several places, more complex deformations will develop. The abnormal bending, twisting or swelling within the penis, often also lead to painful erections.

Any man from the age of 18 and upwards can develop Peyronie's disease. The average age of men suffering from Peyronie`s disease is 50.

THE SYMPTOMS AND CONSEQUENCES OF THE CONDITION

The three main characteristics of cavernositis are:

• One or more small hard lumps underneath the skin, or a continuous hard, stiff and thickened area.

• Abnormal bent or crooked penis when erect. All penises have some curvature, but by this disease, the penile bend increases, and one may get a very curved penis. The penis may be bent as a banana or in an angular fashion. The penile bending is most often up, but may be down, to the left side, to right or sloping.

-The bending is usually to the same side as that of the hard thickened area when the penis is erected.

-The hard areas in the erected penis may look like bumps, making the penis irregular.

• Sometimes the penis bends greatly enough to make sexual intercourse difficult, or impossible.

• Pain during erections caused by the pressure from the hard areas in the penis, or from the stretched skin at the opposite side of the penis.

• One may not notice the bend immediately, as it tends to develop over one to three months and later than the hardness and stiffness of the indurations.

• The plastic induration may progress and cause impotence. Sometimes the Peyroni's disease will clear up by itself, but this may take several years.

THE CAUSES OF PEYRONIE'S DISEASE

The exact cause of the induration is unknown. It's not a sign of an underlying serious condition, and it is not a sexually transmitted infection. It is possible that the disease can begin with an inflammation in the penile tissue. An inflammation may be caused by an allergic or auto-immune reaction. Although the Peyronie's disease is not an infection, an initial infection can damage the penile tissue and cause an inflammation that develops into Peyronie's disease. Men having the inflammatory condition called Systemic Lupus Erytematosus more often get Peyronie's disease.

Vitamin E deficiency seems to be a contributing factor in causing the disease. Diabetes may cause damage of blood vessels, and if this damage occurs in the erectile bodies of the penis, Peyronie's disease can develop. Peyronie's disease is sometimes a side effect of the drug Inderal (propanolol) used against high blood pressure.

Sometimes a physical injury to the penis that causes internal bleeding, or a series of such injuries, is the initial cause. A habit of violent sexual activity may cause such injuries. It is thought that some men may have a genetic disposition to the condition.

Plastic induration of the penis is not a cancer, and cannot cause cancer, however a lump or deformation in your genitals that develops, must be examined.

TREATMENT OG PEYRONIE'S DISEASE

Not all men with Payronie's disease require treatment. The disease sometimes go away by itself. If the condition is pronounced, it is also difficult to find a remedy that can cure every sign of the disease, but several methods can take away most penis changes associated with Peyronie's. Here is a survey of treatment methods used today.

Tamoxifen - In its early stages of the disease a medication called Tamoxifen has been shown to prevent the formation of the fibrous plaque by Peyronie's disease. This drug is also used in the treatment of breast cancer, but the two conditions are not related.

Vitamin E and B - Vitamin E and B is sometimes effective in easing the pain and as a treatment for the penile deformity by Peyronie's disease.

Verapamil - Verapamil, often used in the treatment of high blood pressure, has been shown to decrease the size of the plaque and decrease the pain when injected directly into the plaque, and thus also improve the penis shape distortion by peyronie's disease.

Shock wave therapy - Extracorporeal shock wave therapy, or ESWT, a new treatment, is being used in some hospitals for the Peyronie's disease. Although the initial results of this new approach to treat Peyronie's disease have been promising, the long-term outcome is still undetermined.

Surgery - This is sometimes considered if Payroni's disease has lasted for a year or more and it hasn't progressed or regressed for at least three months. By the Nesbitt procedure one removes tissue opposite to the curve to straighten the penis. Another procedure involves putting a graft or part of a vein within the fibrous plaque to lengthen this area. In certain cases of Pyrenees disease, surgical insertion of a penile prosthesis (implant) is recommended.

Radiation therapy - This treatment modality has been tried, but the results are unpredictable and sometimes the opposite of the intended one.

Traction devices - On the market, you can buy mechanical devices to use on the penis some time daily that gently pull upon the penile tissue to straighten out the penis, and thus mending the penis from the curvature caused by Peyronie's disease.

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