Treatment of Peyronie's disease

What is Peyronie's disease?

Peyronie’s disease is a disorder in which scar tissue, called fibrous plaque, forms in the penis. The plaque accumulates, specifically, in a thick, elastic membrane called the tunica albuginea, which surrounds the corpora cavernosa of the penis, the structures that during erection fill with blood upon sexual arousal and make the penis rigid. To understand the mechanism that generates this fibrous plaque enveloping the corpus cavernosum, we can imagine what would happen if we add a strip of zeal around a sausage-shaped balloon and try to inflate it (it will deform and bend).

As the plaque enlarges, the penis curves or bends, which can cause painful erections (in the first few months, although later the pain tends to disappear spontaneously, but the curvature does not). The curvature in the penis can make sexual intercourse painful, difficult or impossible. Peyronie’s disease begins with inflammatory changes and may develop into a fully calcified lesion. In addition, some men with Peyronie’s disease may have erectile dysfunction.

This disease produces, like all the unknown, a great emotional alteration of the patient: the anatomy of the penis is altered, the quality of sexual intercourse deteriorates, the perception of one’s own corporeality is disturbed and, consequently, anxiety, anguish, depression…

IT IS NOT A CONTAGIOUS DISEASE NOR IS IT CAUSED BY ANY KNOWN COMMUNICABLE DISEASE. IT IS NOT THE PATIENT'S FAULT. AND IT HAS SOLUTIONS. IT IS IMPORTANT THAT IT BE TREATED BY A UROLOGIST WITH EXPERIENCE IN THIS PROBLEM.

How do we treat Peyronie's disease?

The goal of Dr. Lledó’s treatments is to reduce pain, correct the curvature and restore and maintain the ability to have sexual intercourse.

Men with small plaques, minimal penile curvature, absence of pain and satisfactory sexual function may benefit from periodic monitoring, penile traction exercises and drugs that facilitate maintaining an adequate erection. Peyronie’s disease can lead to a shortening of penile length, so consistency in treatment is essential.

In some cases, Peyronie’s disease can self-limit without treatment, although it must always be supervised by the urologist. On the other hand, if you have symptoms, specific treatment will be necessary.

If you need a specialist in the treatment of Peyronie's disease, we can help you.

Non-surgical treatments

As experts in urology and treatment of Peyronie’s disease, Dr. Lledó’s team only works with those medications that have shown some scientific evidence.

We have medications that can be injected directly into the plaques, such as verapamil, interferon alpha 2b, steroids or collagenase (Xiaflex). To date, collagenase is the most widely used and proven effective drug specifically approved for Peyronie’s disease. However, it is essential that the specialist carefully explain the possibilities so that expectations are appropriate. Collagenase can help break up scar tissue and decrease plaque size and curvature.

If your case needs it, we will perform Peyronie’s disease triggered.

Corrective surgery for Peyronie's disease

Corrective surgery is indicated in those cases in which the symptoms of Peyronie’s disease have not improved with pharmacological treatment or medical therapies, maintaining deformities, incurvation and/or shortening that make penetration during intercourse impossible or difficult, also altering the perception of the patient’s own body image.

In order for the patient’s results and expectations to be realistic, we always explain extensively the various options, as well as their possible consequences.

As specialists in reconstructive urology, we recommend waiting a year or more from the onset of symptoms or a verified stability in penile curvature for at least 3 months before surgery because the course of Peyronie’s disease is different in each man.

To treat Peyronie’s disease by means of a corporoplasty, Dr. Lledó will perform a surgical approach by which the incurvation is corrected with incisions of the plate or removal of the same and fill the space created with a biocompatible graft (acellular porcine dermis) or the patient’s own tissue (oral mucosa).

This type of procedure can straighten the penis, help regain lost length and improve the quality of erection produced by Peyronie’s disease. However, some men may experience slight alteration in the sensitivity of the glans penis, usually reversible, after the procedure.

With this surgery, the doctor will remove or pinch off a piece of the tunica albuginea on the side of the penis opposite the plaque to help straighten the penis.

This procedure is less likely to cause side effects such as numbness or erectile dysfunction. However, plication cannot restore pre-Peyronie’s disease penile length or girth, causing a shortening of the penis.

As experts in penile implants, we consider this option in cases where the patient has Peyronie’s disease and erectile dysfunction.

Why trust us to help you treat Peyronie's disease?

Main symptoms of Peyronie's disease

The symptoms of Peyronie’s disease may develop slowly and usually progress over the first 12 months. In many cases, the pain decreases over time, although the curve in the penis may remain.

Hard lumps on one or more sides of the penis.
Pain during intercourse or during an erection.
Incurvation in the penis with or without erection, as well as areas of narrowing or shortening in the penis.
Erectile dysfunction, inability to achieve a rigid erection.

What factors influence the likelihood of developing the disease?

The following factors can increase a man’s likelihood of developing Peyronie’s disease:

Excessively vigorous sexual or non-sexual activities that cause microscopic lesions on the penis.

Certain connective tissue diseases and autoimmune disorders: Dupuytren’s disease, systemic lupus erythematosus, Sjögren’s syndrome, Behcet’s syndrome.

Also in patients with family history of Peyronie’s disease.

What are the consequences of Peyronie's disease?

The consequences of Peyronie’s disease may include not only the inability to have sexual intercourse, but also erectile dysfunction. Some patients experience anxiety, depressive symptoms or significant stress due to the inability to have satisfactory sexual intercourse and/or the appearance of the penis. In addition, the relationship with a partner may be significantly altered by this disorder.

Would you like to contact Dr. Lledó? Specialist in treating complex cases of reconstructive urology.