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Male and Female Urology
Alek Mishail, MD
Diplomate of American Board of Urology
Peyronie’s disease is a wound-healing disorder of the penis. It occurs when an injury to penile tissue causes a scarring process that goes beyond the normal healing process resulting in change of penile curvature, shape, size and length. Also, excess buildup of collagen in the penis leads to the formation of scar-like material called plaques.
Peyronie'sDisease usually occurs in 2 phases — the acute (or active) phase and the chronic (or stable) phase.
This phase can last up to about 12-18 months during which most of the changes in the penis occur. Plaques begin to form, causing changes in the shape of the erect penis. As plaques develop, curvature typically worsens. Erections become painful, and pain may occur even without an erection, due to inflammation in the tissue surrounding the developing plaque.
For most patients, this phase begins within 12-18 months after initial symptoms appear. At this time, the main signs of the disease — the plaque and penile curvature — become stabilized. However, they are also not likely to improve. Penile pain usually diminishes during the chronic phase, but erectile dysfunction may develop or worsen. Men will notice their erections are not as adequate as they used to be. The penile curvature may still worsen, even in the absence of painful symptoms.
Nonsurgical options may be attempted to treat Peyronie’s disease.
These options include— medications, penile injections (i.e. Xiaflex), and external devices — with varying results.
Surgery is performed in men with Peyronie’s disease in the stable phase, and is usually appropriate for patients that have difficulties with intercourse due to pain, discomfort, inability to penetrate due to severe curvature, or due to presence of extensive plaques. The surgical technique may involve one or a combination of the following approaches:
The goal of treatment is to restore penile shape, function, and sexual satisfaction to the patient and patient's partner.