Peyronie’s disease is a curvature of the penis, it is acquired and manifests itself with an erection. Scar inelastic fibrous tissue appears in the protein membrane and cavernous tissue. This leads to pain during erection, increased penis tension, causes erection dysfunction, and often makes coitus impossible.
The content of the article:
Causes of Peyronie’s disease
Symptoms of Peyronie’s disease
Treatment of Peyronie’s disease
Peyronie ‘s disease
The disease is not very rare. About 7% of the male population of the planet are exposed to this disease. At risk are men aged 25 to 60 years, that is, during the period of greatest sexual activity. There are three degrees of severity of Peyronie ‘s disease:
1 degree: deviation angle up to 30 degrees;
2 degree: the angle of deviation is 30 — 60 degrees;
3 degree: the angle of deviation is more than 60 degrees.
Causes of Peyronie’s disease
The origin of Peyronie’s disease is not 100% clear. Most experts, since the second half of the 19th century, agree that seals in the protein shell on cavernous bodies most often occur as a result of small hematomas that resolve. Microtraumas appear due to the increased load on the penis during erection, its kinks during coitus. Therefore, the best prevention of Peyronie’s disease is to avoid injuries and excessive loads.
Experts note the existence of a hereditary predisposition to this disease. Fibrous plaques can appear as a result of inflammatory disease, immune disorders, vascular problems. Favorable conditions for the onset of the disease are created by diabetes mellitus, disorders in connective tissues, metabolic diseases, vascular problems, vitamin E deficiency.
Symptoms of Peyronie’s disease
Curvature of the penis is the most pronounced, but not the only symptom of Peyronie’s disease. The curvature varies depending on the angle and direction of deflection. The most common deviation is no more than 60 degrees. Most often there is a deviation in the direction up to the trunk. Less often there are facts of deviation downwards, to the left and right sides.
In addition to the direct deviation of the penis from its axis during erection, the following signs of Peyronie’s disease are observed:
When feeling, the plaque on the protein shell is palpated well;
The process of erection is often accompanied by severe pain;
The length of the penis decreases with an erection, and the erection becomes weaker.
Severe painful sensations, as a rule, occur during the acute period of the disease (its duration is from six months to a year). At this time, due to plaques, blood microcirculation worsens, blood vessels degenerate, fibrin falls out, and calcium salts are deposited. Deformation occurs at the site of the plaque. During the acute period, plaques in the protein shells on cavernous tissues do not have a stable shape and size, their active formation occurs.
After an acute period, a chronic one occurs. It is characterized by a decrease or complete disappearance of painful sensations. The plaques stop growing, the deformation begins to intensify.
Timely referral to an andrologist is important. At the diagnostic stage, patient surveys, anamnesis, probing, ultrasound, MRI, CT, consultations of a urologist and andrologist, as well as a wide range of laboratory diagnostics are used.
Treatment of Peyronie’s disease
There are two types of treatment for Peyronie ‘s disease:
Medical therapeutic treatment;
Surgical treatment of Peyronie’s disease.
Medication and topical treatment are used only at the very initial stages. In the acute period, drug therapy is practically not used. During treatment, medications such as vitamin E, drugs that reduce collagen synthesis, reduce the activity of fibroblasts, immunomodulatory and anti-inflammatory drugs, etc. are prescribed. The drugs are most often taken orally, but sometimes they are injected in a jet.
In the therapeutic treatment of the disease, shock wave procedures, a combination of ultrasound and magnetolaser therapy are prescribed. Such procedures are used only when there is not much pronounced deformation (the angle of deviation is no more than 45 degrees).
Treatment of Peyronie’s disease shows the greatest effect during surgery. This method allows you to remove the seal in the tissue, correct the deformation and almost completely eliminate the disease.
The choice of surgical intervention is certainly carried out by a doctor, but the following facts are indications for this method of treatment:
The duration of the disease is at least 1 year;
Plaques do not grow and do not change shape for at least 3 months;
The impossibility of coitus.
First of all, patients are offered Nesbit surgery, which was developed to correct birth defects, but is also successfully used in the treatment of Peyronie’s disease. This operation and its various modifications are based on shortening the penis by 1-2 cm and are carried out only with sufficient length, maintaining an erection. Among the risks and disadvantages of such a technique, there is a violation of the integrity of the protein shell, the appearance of scars in the cavernous bodies, which may cause an erection, etc.
Most often, for the treatment of Peyronie’s disease, plication techniques are used, which are based on invasion of the protein envelope, in which the cavernous bodies are not opened. This method involves the imposition of non-absorbable seams.
With a strong deviation of the penis (the angle of deviation is greater than 45 degrees), insufficient length, surgical dissection or excision of plaques is used. With this method, the fibrous tissue is dissected, and the defect is filled with synthetic or natural material. The best results are shown by the use of the patient’s own tissues directly.
With a strong curvature of the penis and erectile dysfunction, prosthetics are necessary. The choice of prostheses is large. The most effective are hydraulic three-component prostheses.
The choice of the method of surgical intervention is carried out by a specialist, taking into account the wishes of the patient, the specifics of the individual case and the material equipment of the medical institution.
