What are causes and effects of Peyronie's disease? Can Peyronie's disease go away on its own?

Peyronie's disease, a non-cancerous condition that causes unpleasant, curved erections, is brought on by fibrous scar tissue that develops on the penis. The presence of a curved erection is not always caused for concern because penises come in a variety of sizes and forms. However, Peyronie's illness might cause extreme bending or discomfort in certain men.

As a result, you might find it challenging to get or keep an erection or be unable to engage in sexual activity (erectile dysfunction). Many men also experience tension and anxiety as a result of Peyronie's disease. Another common concern is penis shortening.

Symptoms

 Signs and symptoms of Peyronie's disease might emerge suddenly or develop gradually. The most typical warning signs and symptoms are:

 ·      skin scars. Plaque, a type of scar tissue linked with Peyronie's disease that is distinct from the plaque that can accumulate in blood vessels, can be felt as flat lumps or a ring of hard tissue under the skin of the penis.

·       considerable penis flexion. Your penis may have an upward, downward, or sideways curvature.

·      Erection issues  Peyronie's illness may make it difficult to achieve or sustain an erection (erectile dysfunction). However, erectile dysfunction is frequently reported by males prior to the onset of Peyronie's disease symptoms. Reduction in penis length. Peyronie's illness may cause your penis to shrink in size.

·      Pain. With or without having an erection, you could experience penile pain. a different penile defect. The erect penis in some Peyronie's disease patients may appear narrowed, indented, or even hourglass-shaped, with a tight, thin ring encircling the shaft.

·       Peyronie's disease-related penile shortening and curvature may gradually get worse. But after around three to twelve months, the problem usually stabilizes.

Typically, erection-related pain subsides in one to two years, but scar tissue, penile shortening, and curvature persist. often persist. In some male patients, Peyronie's disease-related discomfort and curvature both get better on their own.

Whenever to visit a doctor

As soon as you observe any Peyronie disease symptoms or signs, make an appointment with your physician. The best opportunity to improve the condition or stop it from growing worse is with early therapy. If the discomfort, curvature, length, or other deformities annoy you or your spouse and you've had the disease for some time, you might want to consult a doctor.

Although the exact origin of Peyronie's disease is unknown, several variables seem to be involved.

Peyronie's disease is believed to often originate from repetitive harm to the penis. For instance, the penis might be hurt when having intercourse, exercising, or in an accident. But the majority of the time, no particular trauma to the penis is remembered.

After a penile injury, unorganized scar tissue grows during the healing process. This may result in the growth of a nodule that you may feel or a curvature.

The corpus cavernosum, which is located on each side of the penis, resembles a sponge and is filled with numerous tiny blood veins. The tunica albuginea (TOO-NIH-Kuh al-BYOO-JIN-e-uh), an elastic tissue sheath that extends across each corpora cavernosa, surrounds each of them when one is erection.

The amount of blood flowing to these chambers rises as you become sexually stimulated. The penis enlarges, straightens, and stiffens into an erection as the blood-filled chambers do.

When the penis grows erect in Peyronie's disease, the area with the scar tissue doesn't stretch, causing the penis to bend or become deformed and potentially painful.

Peyronie's disease appears to develop gradually in some males and has no apparent connection to an injury. The possibility of an inherited trait or certain medical problems being connected to Peyronie's disease is being looked into by researchers.

Risk elements

Peyronie's disease is not always brought on by minor penile injuries. However, a number of reasons may be responsible for inadequate wound healing and the accumulation of scar tissue, which may be related to Peyronie's disease. These consist of:

Heredity. You are more likely to develop Peyronie's disease if a family member does.

diseases of connective tissue. Peyronie's disease appears to be more likely to affect men with specific connective tissue problems. For instance, some men with Peyronie's disease also have Dupuytren's contracture, which is a cord-like thickening across the palm that causes the fingers to pull inward.

Age. Peyronie's disease can affect males of any age, although it is more common in older men, particularly those in their 50s and 60s. Younger men tend to have congenital penile curvature, which is less frequently caused by Peyronie's disease. In younger males, a slight amount of curvature is typical and unproblematic.

other elements, such as Peyronie's disease may be related to smoking, certain kinds of prostate surgery, and various medical disorders.

Complications

Peyronie's disease complications include the following:

being unable to engage in sexual activity

trouble getting or keeping an erection (erectile dysfunction)

Stress or worry about one's sexual prowess or penis appearance

Stress affecting your sexual partner relationship

Having a kid is difficult because having sexual relations is difficult or impossible.

shortening of the penis

Penile discomfort

Peyronie's disease stages

The acute phase and the chronic phase of Peyronie's disease are frequently distinguished from one another. The bent/curved penis could make intercourse difficult during either period. You might also have ED.

Phase Acute: The acute phase typically lasts 5 to 7 months but, in unusual circumstances, can last up to 18 months. During this period, plaques develop in the penis, the bending or curving of the penis gets worse, and your penis may become hard and cause you pain.

Chronic Phase: During the chronic phase, the plaque stops expanding and the penis stops bending. Usually, at this point, any pain associated with an erection that existed during the acute phase would have subsided.

Other Elements

Not all men who experience minor penile injuries get Peyronie's disease. Because of this, the majority of studies assume that Peyronie's disease plaque formation must have genetic or environmental causes. Peyronie's disease is more likely to affect men who have specific connective tissue illnesses (such as Dupuytren's contractures or tympanosclerosis) or who have a close relative who has the condition. Peyronie's disease may also be brought on by certain health conditions, such as excessive blood sugar, tobacco use, or prior pelvic trauma.

Diagnosis

With just a physical examination, your doctor may be able to determine whether you have Peyronie's disease. Whether the penis is stiff or not, the hard plaques are most frequently felt. Your doctor may inject a medication into your penis to make it stiff and may take images to study to see how the penis curves. Dynamic ultrasonography, which employs sound waves to create an image of what is inside your body, is sometimes used to detect calcium buildup, locate plaque, and visualize blood flow in the penis.

Treatment

About 13 out of 100 times, Peyronie's disease resolves on its own without treatment. The majority of medical professionals advise delaying surgery for the first 12 months after the condition is first diagnosed. Men who have few plaques, little penile curvature, little pain, and no sex-related issues may not require to be handled. There are numerous options if you require medical attention.

Oral drugs
Men who are severely afflicted by the condition during the acute period may benefit from drug therapy. Because long-term studies have not demonstrated a strong benefit, the majority of society's guidelines do not advocate oral medications.

oral vitamin E

Antioxidant vitamin E is well-liked due to its minor side effects and affordable price. Vitamin E supplementation may help reduce plaque size and straighten the penis, according to research from as long back as 1948. However, the majority of these research did not contrast vitamin E users with those who did not use it (a control group). Several vitamin E studies that included a control group imply that Vitamin E is not more effective than a placebo. (A placebo is a "sugar pill" that contains no active ingredients.)

Amino-benzoic acid potassium

It has been demonstrated in small experiments using placebo controls that the vitamin B complex reduces plaque size but not the curve. Sadly, it is expensive, and patients must take 24 pills every day for three to six months. Many men discontinue taking it since it can potentially cause gastric problems.

Tamoxifen

Desmoid tumors, which resemble the plaques in Peyronie's disease, have been treated with this non-steroidal, anti-estrogen medication. The few controlled studies that have been conducted on this medication haven't demonstrated that tamoxifen is more effective than a placebo.

Colchicine

Colchicine, an anti-swelling drug, has been demonstrated to be only marginally useful in a few uncontrolled, short studies. When taking colchicine, many individuals experience gastrointestinal issues and cease taking the medication. Its superiority to placebo has not been established.

Carnitine

Antioxidant medication called carnitine reduces edema to speed up the healing of wounds. Studies done without controls reveal some advantages. However, a recent controlled trial failed to demonstrate that it is more effective than a placebo.

Penile Injections

Higher doses of medication are delivered to the plaque when it is injected directly into it as opposed to when it is taken orally. For males with early Peyronie's disease or those who are unsure whether they want surgery, plaque injection is frequently employed. Before the shot, the skin is frequently numbed to lessen discomfort.

Injections of verapamil

Typically, verapamil is used to treat elevated blood pressure Verapamil injection may be effective for treating penile pain and curvature, according to certain research. Verapamil seems to be a reliable, affordable choice for treating Peyronie's disease. To demonstrate how effectively it works, more controlled research are required.

infusions of interferon

The body produces interferon, a protein that aids in reducing swelling. It has been demonstrated to aid in the management of scarring, possibly by reducing the rate at which scar tissue develops and producing an enzyme that breaks down the scar tissue. Injections of interferon were tested extensively for Peyronie's disease and were found to be potentially beneficial.

injections of collagenase

The body produces collagenase, which dissolves some types of scar tissue. Collagenase injections into plaques have been demonstrated in studies to be effective in treating Peyronie's disease. The FDA has officially given this medication approval in the US for the treatment of males with penises that are more than 30 degrees curved.

Other Therapies

Researchers are looking for further Peyronie's disease therapies. However, there isn't enough evidence to date to support their efficacy.

Stretching the penis every day for at least six months, according to some modest studies, may help it regain its length and curvature.

It is also being researched how to treat the penis with ultrasound, radiation, shockwaves, heat, and verapamil on the skin. Most of them are unproven, and specialists in the field do not advise using them.

Peyronie's disease surgery

Men with more severe, incapacitating penile abnormalities that interfere with intercourse are the only ones who undergo surgery. most medical care Until the plaque and curvature have stopped becoming worse and the patient has exhibited no worsening for at least 9 to 12 months, doctors advise delaying surgery.

Before doing surgery, your doctor may inject medication into your penis to make it hard so they may examine the blood flow while utilizing ultrasonography to view the inside of the penis. These tests assist in determining what is occurring inside your penis, such as whether you also have ED, so your doctor can choose the best form of surgery for you.

Surgery can treat Peyronie's disease in one of three ways:

reducing the length of the side of the penis opposite the plaque and lengthening the curved side If a man has Peyronie's disease and erectile dysfunction, the surgeon should no longer insert a prosthetic device inside the penis.

Surgery to Reduce Penis Length on the Side Next to the Plaque or Curve

This kind of surgery can be performed by either folding the tissue and drawing it together with surgical thread or by cutting out little bits of tissue on the outside of the curve and stitching them closed. The procedure is typically risk-free, simple for the surgeon to do, and low-risk (such as bleeding or making ED worse). This kind of surgery has the potential to shorten the penis. Men who have a lengthy penis, mild to moderate penile curvature, and no ED should benefit more from this operation.

The operation to Increase the length of the curved side of the penis.

When the shaft has grown extremely thin, the plaque has been calcified, or the penile curve is severe, this type of surgery is performed. To release tension, the surgeon slices the plaque; he or peyronies device she may also remove some of the plaque. A graft is then used to fill the empty spot. In most situations, this operation won't significantly shorten the penis. However, it is more difficult for the surgeon to perform and there is a chance it could exacerbate ED. Men who can obtain erections strong enough for sex and who have severe deformities are frequently the only ones for whom this operation is advised.

Devices to Replace the Penis

A balloon pump or inside, flexible silicone rods For men with moderate-to-severe ED and Peyronie's disease, the penis is a promising alternative. This will usually straighten the penis and enable it to stiffen up enough for intercourse. If the device doesn't straighten the penis enough, the surgeon may cut the plaque and use a graft to cover the opening or model the plaque against the stiff prosthesis to further straighten it.

After therapy

To aid in the healing process, a mild pressure dressing is frequently kept on the penis for 24 to 48 hours following surgery. When you wake up, there can still be a catheter in the bladder that was inserted during surgery through the penis end. Frequently, the tube is removed if leaving that day, in the recovery room, or upon release the following morning. In addition to pain relievers, you might be prescribed antibiotics to take for a few days in order to reduce the chance of infection and help with swelling. After surgery, you should wait at least 6 weeks before having sexual activity.