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Peyronie's disease?



Peyronie's disease?
Peyronie’s disease is characterised by the formation of hard, fibrous lumps on the penis. The lumps or plaques are first evident as swellings on the upper or lower portion of the penis, which later develop into hard scars that may cause curvature of the shaft of the penis. In most cases, these scars may not be painful and heal by themselves in a few months. In severe cases, they become painful and prevent full erection of the penis due to reduced flexibility.
If the plaque forms on the upper portion of the shaft, the penis bends upwards and if the lump is on the lower portion, the curvature is downwards. The disease occurs more commonly in middle aged men, but can occur at all ages.

How is it caused?

The exact cause of the disease is not known. Sometimes it occurs due to an infection. In most cases, it is caused by injury to the penis. The soft erectile tissue of the penis may be injured because of which internal bleeding takes place. This results in scarring over a period of time to form the plaque. Repeated injury to the penis may worsen the condition.

What are the symptoms?

Men with Peyronie’s disease usually seek medical help because of painful erections and difficulty in sexual intercourse. There may be associated symptoms like:

Lumps in the penis which may be felt while it is soft and flaccid.
Mild discomfort or a dull pain may be felt in some parts of the penis before any lump is detected. This is when the infection or trauma has already taken place, but the hardening has not occurred.
Bending or curvature of the penis when erect.

How is it diagnosed?

The disease is detected first by the patient himself. The doctor confirms the diagnosis by a thorough physical examination. All the predisposing symptoms are taken into account while making the diagnosis.

What is the treatment?

Sometimes the lumps may dissolve on their own or with other treatments like vitamin supplements (which help to dissolve the lump) may be given. The patient may be given painkillers to reduce discomfort. However, these treatments may not be effective. Surgery is the only long term and the most effective treatment for the condition.

In this, the hardened plaque is removed and the area is covered by a patch of skin graft. In another procedure, called the Nesbit procedure, some tissue from the side of the penis opposite to the side with the plaque, is removed. This helps in balancing out the curvature of the penis.