Tuesday, February 22, 2005

Peyronies Disease and Treatment

Peyronie’s disease is the formation of hardened tissue called fibrosis in the penis that causes pain, curvature, and distortion, mainly during erection. The penis consists of two columns of erectile tissue forming the corpora cavernosa; firstly, the corpus spongiosum, which contains the urethra that carries urine and semen from the body; and secondly, the tunica albuginea sheath that surrounds the erectile tissue. In Peyronie’s disease, fibrous scar tissue also called plaque forms in the tunica albuginea.

A study published in 1995 by the National Institutes of Health, reported that Peyronie’s disease occurs in about 1% of men. It is most common between the ages of 45 and 60, but also occurs in young and elderly men. The true percentage may be higher because some men are reluctant to seek medical attention for the condition and may not report cases with mild symptoms.

The cause of Peyronie’s disease is unknown. Cases that develop suddenly are often caused by trauma to the penis like invasive penile procedure, injury, or extremely vigorous sexual activity.

Some cases may be caused by an inherited abnormality of the human leukocyte antigen B27 (HLA-B27), suggesting a possible genetic link. Also, Peyronie’s occurs more frequently in men where other family members have the condition or a connective tissue disorder (e.g., systemic lupus erythematosus). Some patients with Peyronie’s disease also develop hardened tissue in other parts of the body such as the hand (e.g., Dupuytren’s contracture) or the foot.
Diabetes, which can lead to blood vessel disease, is also considered a risk factor. Peyronie’s disease has also been linked with vitamin E deficiency.

Peyronie’s disease can vary in severity, and may develop suddenly or over time. Symptoms include the following:

- Hardened tissue (plaque) in the penis
- Pain during erection
- Curve in the penis during erection
- Distortion of the penis (e.g., indentation, shortening)
- Plaque usually develops on the top of the shaft, causing the penis to bend upward during erection, but it may occur on the bottom, causing a downward bend. If plaque develops on the top and the bottom, indentations and shortening may occur. In about 13% of cases, plaque does not cause severe pain or curvature, and the condition resolves on its own.
- In severe cases, pain and curvature result in erectile dysfunction (impotence). If there are several areas of plaque, incomplete erection may occur.

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