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In certain conditions a layer of benign fibrous tissue develops under the skin of the penis. When erection occurs, this layer of tissue cannot stretch as well as the normal penile tissue, thus causing the penis to curve. Thiis can can make erection painful and sexual intercourse difficult. This is known as Peyronie's disease.
The side and degree to which the penis curves on erection would depend on the area and extent of the fibrous tissue formation. If the scar tissue forms on the upper side of the penis, on erection the penis will curve upwards. Similarly, if the fibrous tissue is on the lower side, the curvature will be downward. If there is fibrous tissue formation on both sides, the penis will appear irregular or indented on erection.
The signs and symptoms of Peyronie's disease include :
Conditions that are thought to cause Peyronie's disease are :
Diagnosis of this condition is made on physical examination of the penis. In some cases the hard fibrous tissue may be felt without an erection, but in others in may be necessary to induce an erection ( by injecting medication into the penis ) for proper examination. Ultrasound of the penis may also be helpful in diagnosis.
Peyronie's disease can make sexual intercourse painful, difficult or even impossible. This leads to anxiety and stress which can have an effect on the relationship between the two partners. It is important to be aware of this disease and its course so that its symptoms can be managed effectively. The course of this disease varies from man to man and in some cases there may be some resolution of the symptoms without treatment. In mild cases, the doctor may advice monitoring the disease by serial examinations to see the progression of the fibrous tissue formation, penile curvature and erectile function.
Treatment options available are surgical or nonsurgical.
Oral medications may be useful in the early stages of the disease.
Drugs such as collagenase, calcium channel blockers or interferons can be injected into into the fibrous tissue lesion on the penis.. This works by breaking down the fibrous tissue and promoting healing with normal tissue. Multiple injections may be needed over a period of months. The success of these injections varies from person to person and may depend on the extent of the lesion.
Surgical treatment may needed if other options do not help and symptoms have persisted for more than a year. Surgery may help restore normal erection, though it may cause partial loss of erection or shortening of an erect penis.
Common surgical methods include :