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A reader recently mentioned Peyronie’s disease to me, and I had never come across it before. Whenever I encounter something new, I love diving in to learn all about it. So, here’s my deep dive into the unwelcome curve of Peyronie’s disease. A disease named after François de la Peyronie, a French surgeon who first described the condition in the 18th century. He was the one who observed and documented the abnormal and sometimes painful curvature of the penis that some men experience. While Peyronie didn’t have an uncomfortable curve of his own, it was named after him because he was the first to formally describe and document it. He was treating a patient with this condition and noticed the abnormal curvature of the penis, which led to… science!
What is Peyronie’s Disease
Peyronie’s disease is a condition that causes a noticeable curvature or bend in the penis due to the formation of fibrous scar tissue (plaques) within the penile shaft. This can lead to pain, discomfort, and even erectile dysfunction. While minor penile curvature is normal, Peyronie’s disease is a medical condition that can worsen over time if not treated (so get it treated).
What Causes Peyronie’s Disease?
The exact cause of Peyronie’s disease isn’t always clear, but there are several contributing factors:
Penile Trauma or Injury – The most widely accepted cause is repeated microtrauma or a significant injury to the penis, often during sex, sports, or accidents. This can lead to internal bleeding and scar tissue formation.
Genetics – If a close relative has Peyronie’s disease or Dupuytren’s contracture (a similar condition affecting the hands), there’s a higher likelihood of developing it.
Connective Tissue Disorders – Men with conditions like Dupuytren’s contracture or plantar fibromatosis may be at greater risk.
Autoimmune Response – Some researchers believe that Peyronie’s may result from an abnormal immune response, where the body mistakenly attacks its own tissue.
Age-Related Changes – While Peyronie’s can happen at any age, it’s more common in men over 40, as the penis becomes less elastic and more prone to injury over time.
Certain Medications – While not directly proven to cause Peyronie’s, some medications, like beta-blockers used for high blood pressure, have been linked to increased risk.
Understanding these causes can help with prevention and early intervention, especially if you notice any unusual changes.
How to Detect Peyronie’s Disease
Early detection is important in managing and potentially reversing Peyronie’s disease. Some initial warning signs include:
Unexplained lumps or hard plaques – Small, palpable nodules or bands under the penile skin, typically located along the shaft.
Pain during erections – Even in the absence of visible curvature, pain while erect can indicate underlying scar tissue development.
Changes in shape or curvature – A sudden or progressive bending, indentations, or narrowing (hourglass deformity) of the penis, especially during erection.
Shortening of the penis – A noticeable loss in penile length due to tissue contraction.
Weaker erections – Reduced erectile firmness can occur as the plaques interfere with normal blood flow.
Men should routinely inspect for changes in their penis, especially after an injury or trauma, which can sometimes trigger Peyronie’s disease.
What Does Peyronie’s Disease Look Like?
A significant curve – The penis may bend upward, downward, or to the side, depending on plaque location.
Indentations or hourglass shape – Some men notice areas of narrowing, creating an uneven or pinched appearance.
Visible plaques – In some cases, hardened scar tissue may be noticeable under the skin.
Shortened penile length – Loss of elasticity in the affected area can result in a visibly shorter penis.
The Risks of Not Treating Peyronie’s Disease
Progressive curvature – Without treatment, the bend can become more severe, making sexual activity painful or impossible.
Erectile dysfunction (ED) – As plaque stiffens and affects blood flow, it can lead to persistent erection issues.
Psychological distress – Many men with PD experience anxiety, depression, and lowered self-esteem due to the changes in their sexual function and appearance.
Penile shrinkage – The condition can result in irreversible loss of length, making early intervention crucial.
Is Peyronie’s Disease More Common in Circumcised or Uncircumcised Men?
There is no conclusive evidence to suggest that circumcision significantly increases or decreases the risk of developing Peyronie’s disease. However, some studies indicate that uncircumcised men may have slightly lower risks due to increased penile flexibility. Conversely, circumcised men may experience more direct trauma to the penis during intercourse, which is a potential risk factor for PD.
Treatment Options for Peyronie’s Disease
Fortunately, Peyronie’s disease can be managed and, in some cases, improved with the right approach. Treatments include:
Non-Surgical Treatments
Oral Medications
- Pentoxifylline: May help slow the progression of plaque formation.
- Potassium para-aminobenzoate (Potaba): Can reduce plaque size in some cases.
- Collagenase Clostridium histolyticum (Xiaflex): FDA-approved for breaking down plaque in moderate to severe cases.
Topical and Injectable Treatments
- Verapamil injections – Help to break down scar tissue and reduce curvature.
- Xiaflex injections – Target and weaken the plaque to restore a more natural shape.
Shockwave Therapy (ESWT)
- Low-intensity shockwave therapy is being studied as a non-invasive way to break down scar tissue and improve blood flow.
Traction Therapy
- Devices like penile traction therapy (PTT) can help stretch the penis and prevent further curvature. When used early, this method may improve penile length and shape.
Lifestyle Adjustments
- Managing conditions like diabetes, hypertension, and heart disease can improve circulation and slow PD progression.
- Avoiding trauma to the penis, especially during vigorous sex, can prevent further damage.
Surgical Treatments
For severe cases that cause significant pain or functional impairment, surgical intervention may be necessary:
Plication Surgery – Involves stitching the opposite side of the plaque to straighten the penis.
Plaque Excision and Grafting – Removes or reduces plaque and replaces the affected tissue with graft material.
Penile Implants – For men experiencing severe erectile dysfunction, inflatable or semi-rigid implants can restore function and correct curvature.
You Can Fix the Curve of Peyronie’s Disease
Peyronie’s disease is a manageable condition when caught early. If you notice any changes in your penile shape, pain, or function, seeking medical advice sooner rather than later can prevent complications and preserve your sexual health. Whether through non-invasive treatments or surgery, there are multiple ways to restore confidence and intimacy.
Evolving Your Conversation
- Have you or your partner ever noticed changes in penile shape that might indicate early Peyronie’s disease?
- How do you approach difficult or sensitive health topics with your partner?
- What concerns would you have about seeking treatment for a condition like this?
- Do you think circumcision or lack thereof plays a major role in male sexual health beyond Peyronie’s disease?
- If you or your partner were experiencing symptoms of PD, how would you support each other emotionally and physically?
