Peyronie’s Disease

Peyronies disease was first described in the 1600s by a French surgeon (Francois de la Peyronie). Peyronies disease is characterized by a firm lump, curvature or narrowing of the penis and pain with erection. Often the result of trauma and injury to the corpora cavernosa, many men do not remember an injury or inciting event. The problem may be short lived and an annoyance, or the curvature can be severe and limit sexual activity to a degree that causes men to seek treatment.

Fortunately options exist for treatment.

Conservative treatment (observation and monitoring) is reasonable for many men. The pain dissipates with time. The curvature and palpable mass in the penis may never go away but for many men the degree of curvature is simply cosmetic. The penis will still get rigid enough for intercourse and the degree of curvature is not limiting for sexual activity.

For men needing treatment due to severity of curvature most often the next step is an ultrasound of the erect penis to evaluate the lump (often referred to as “plaque” but should not be confused with the type of plaque that develops in the arteries of the heart), degree of curvature, and blood flow to the penis.

Men who are candidates for Xiaflex injections based on their ultrasound should consider this option.

Men who fail Xiaflex injections or who are not candidates for the procedures should consider a Nesbit Plication, Penile Grafting procedures, or a penile implant

A Nesbit plication procedure corrects the curvature by placing suture on the penis opposite of the peyronies plaque to restrict expansion of the penis equal and opposite to the Peyronies disease. This procedure works very well to correct the curvature but because the Peyronies disease and the suture restrict expansion of the corporal bodies the penis will lose overall length of the erection.

An alternative to a plication is an excision or a grafting of the peyronies plaque. Although these procedures have the ability to restore length and girth to a man’s erections, the procedures are technically difficult and have a higher rate of complications.

Men with erectile dysfunction who are not able to achieve and maintain a quality erection should consider a penile implant procedure to correct both the curvature of the penis as well as the rigidity of the penis. You can lean about penile implants HERE.