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Penile curvature (Peyronie’s)


What is penile curvature or Peyronie's disease?

Penile curvature, also known as Peyronie’s disease, is a urological disorder characterized by abnormal curvature of the penis during erection due to the formation of scar tissue in the erectile tissue of the penis.

Although it is not considered a serious medical condition, it can significantly affect the quality of life and sexual health of those who suffer from it.

Is Peyronie's disease common?

From an epidemiological perspective, Peyronie’s disease is estimated to affect between 3% and 9% of men, but the actual prevalence may be higher as many cases may go unreported or undiagnosed due to embarrassment or lack of diagnosis. medical consultation. This condition tends to occur most frequently in middle-aged men, between 40 and 60 years old, although it can occur in younger or older men.

What are the causes of Peyronie's disease?

It has been suggested that certain medical conditions and risk factors may increase the likelihood of developing Peyronie’s disease. Among them:

– traumatic injuries to the penis

– previous genital surgeries

– genetic predisposition

– diseases such as Dupuytren’s disease (which causes similar contractures and fibrosis in the hands),

– diabetes

– arterial hypertension

– smoke

What symptoms does Peyronie's disease cause?

Peyronie’s disease not only manifests itself with the curvature of the penis, but it can also be accompanied by symptoms such as pain during erection, loss of penile length, difficulty maintaining satisfactory sexual relations and psychological problems related to self-esteem and image. . bodily.

How is Peyronie's disease diagnosed?

The diagnosis of Peyronie’s disease is usually based on clinical evaluation and the patient’s medical history, complemented by imaging tests such as ultrasound to evaluate the erectile tissue and determine the degree of curvature and plaques of scar tissue.

Understanding the epidemiology and possible causes of penile curvature is essential to help patients seek appropriate medical guidance and make informed decisions about available treatment options. Providing accurate and understandable information on this topic can significantly contribute to the awareness and care of those affected by Peyronie’s disease. This is the main objective of this website. Peyronie’s?

Phases of the disease:

Peyronie’s disease is generally divided into 2 phases that reflect the progression and changes in the state of penile tissue:

1. Acute or inflammatory phase: In this initial stage, the formation of scar tissue is experienced, usually after an injury or trauma. The most characteristic thing is that during erections pain occurs, along with the formation of plaques or nodules in the erectile tissue.

2. Chronic or stable phase:

After the acute phase, the pain may decrease, but the curvature of the penis becomes more evident. Here, the scar tissue plaques are stabilized and a curvature is observed during erection. These phases can vary in their duration and severity in each individual affected by Peyronie’s disease. Management and treatment may be different at each stage to address the specific symptoms and progression of the condition.

How is Peyronie's disease treated?

Example of a vacuum device for penile traction.

Treatment for Peyronie’s disease varies depending on the severity of the symptoms and the stage of the disease. In general, these are the different treatment options:

1. Observation and follow-up: In mild cases where the symptoms do not significantly affect sexual life, a regular observation and follow-up approach can be opted for to monitor the progression of the disease.

2. Oral drugs and/or local injections: Medications such as vitamin E, colchicine, verapamil can be administered to help reduce pain, curvature and plaque formation. These medications focus on mitigating symptoms and slowing the progression of the disease. They can rarely reverse the curvature.

Local injection treatment for Peyronie’s disease involves directly applying certain medications to plaques of scar tissue on the penis. This approach seeks to reduce curvature, pain and improve erectile function. The two main types of injections used are:

1. Verapamil: These medications are injected directly into plaques of scar tissue. These drugs are believed to help break down or reduce collagen formation in the affected tissue, thereby decreasing stiffness and curvature.

2. Xiaflex* (collagenase): This newest treatment involves injecting Xiaflex, an enzyme that breaks down collagen, directly into Peyronie’s patches. This can help soften and reduce plaques of scar tissue, which can decrease the curvature of the penis. * The Xiaflex is not available in Spain from January 2020 until further notice.

These procedures should be performed in doctors’ offices by an experienced urologist. Multiple injection sessions over a specific period of time may be required to achieve the desired results. As with any treatment, there are potential risks, such as localized pain, bruising, or adverse reactions, so it is essential to discuss the possible benefits and risks with a medical professional before undergoing this type of treatment.

3. Shock wave therapy: This option uses low-intensity waves to break up plaques of scar tissue. Although it is still under investigation, it has been used in some cases to treat Peyronie’s disease.

4. Traction devices or extenders: These devices are used to apply traction to the penis in order to stretch the tissue and correct the curvature. Its use is not simple and should always be done under medical supervision.

5. Surgery: . In severe cases or when other treatments have been unsuccessful, the surgical option should be considered. Surgical techniques vary from correction of curvature to removal or repair of scar tissue.

Each treatment has its own advantages, disadvantages and possible risks. Choosing the appropriate treatment depends on medical evaluation, severity of symptoms, and individual patient preferences. Therefore, it is essential to discuss with a urology specialist to determine the most appropriate approach for each particular situation.

What is surgery for Peyronie's Disease like?

Surgery to treat Peyronie’s disease is considered in advanced cases and/or when symptoms significantly interfere with sexual function. Basically there are 3 surgical options:

1. Penile plication: This procedure is used to correct the curvature of the penis. It involves “countertraction” of the tissue on the opposite side of the Peyronie’s plate to straighten the penis during erection.

2. Plaque incision/excision and tissue graft: In cases where the disease has caused significant length loss or severe deformities, the fibrotic plaque can be incised or removed and a tissue graft (usually taken from another area of the body) may be used. or synthetic material) to correct the curvature and restore the natural shape of the penis.

3. Penile prosthesis implants: In serious situations in which conventional treatments have failed and there is also associated erectile dysfunction, the placement of penile prosthesis implants can be considered. These devices are surgically inserted into the penis to help achieve and maintain a proper erection.

It is important to note that surgery for Peyronie’s disease carries risks such as loss of sensation, decreased penile length, or the possible appearance of new scar plaques. Therefore, it should be carefully considered in conjunction with an experienced urologist, who will determine the best surgical option based on each patient’s specific condition.

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