Peyronie’s disease is an abnormal curvature and shortening of the penis during an erection. This is caused by scarring of the tunica albuginea of the corpora cavernosa.
_ Peyronie’s disease occurs in approximately 1% of men.
_ It is commonly seen between the ages of 45 and 60 yr.
_ Specific cause is unknown. It is believed that scar tissue forms on either the dorsal or ventral midline surface of the penile shaft. The scar restricts expansion at the involved site, causing the penis to bend or curve in one direction.
_ The precipitating factor appears to be trauma from repetitive microvascular injury caused by vigorous sexual intercourse, accidents, or prior surgeries (e.g., transurethral or radical prostatectomy, cystoscopy).
_ Painful erections
_ Tenderness over the scar tissue area
_ Erectile dysfunction
_ Curvature of the erected penis interfering with penetration
_ Dupuytren’s contracture is a commonly associated finding in patients with Peyronie’s disease
History and physical examination alone will usually establish the diagnosis of Peyronie’s disease.
There are no specific blood tests to diagnose Peyronie’s disease.
_ A conservative approach of reassurance and observation is taken at first because the disease process may be self-limiting.
_ Acute treatment
- Vitamin E 400 mg bid.
- Paraaminobenzoic acid 12 g/day.
- Colchicine 0.6 mg bid for 2 to 3 wk.
- Fexofenadine 60 mg bid for 3 mo.
- Steroid injection into the scar tissue.
- Collagenase injection into the scar tissue.
- Radiation to the scar tissue area.
- Extracorporeal shockwave therapy (ESWT)