Peyronie’s Disease (PD)
Abnormal curvature of the penis.
PD is estimated to affect more than 1 in 10 men.
What is PD?
Peyronie’s Disease is a connective tissue disorder of the penis causing curvature, reduction in penile length and sexual dysfunction affecting up to over a million men in the United States.
It is caused by an abnormal buildup of scar tissue under the skin (a plaque) in the thick wall of the erectile body of the penis called the tunica albuginea. Scar formation can occur from both injury (one you may not even notice) or from autoimmune disorders.
It begins with an acute or active phase that can last up to 18 months during which the penis starts to curve, the plaque site may be painful even without erection or you may only have pain with erections. When a patient presents during the active phase, the chance curvature will improve on its own is 20 percent, 40 percent will stabilize and another 40 percent will continue to progress.
The disease enters the chronic phase when the curvature no longer gets worse and pain at the plaque lessens or goes away entirely. Erectile dysfunction may develop or get worse during this time.
Treatment options.
Many options exist for the treatment of Peyronie’s disease.
Active Phase
During the active phase of the disease, we recommend a combination of oral medications to help maximize erection strength to prevent additional injury and reduce inflammation at the site of the plaque. Once you have entered the chronic phase, there are a number of possible interventions.
Xiaflex®
XIAFLEX® (collagenase clostridium histolyticum) is the only nonsurgical treatment option for men with Peyronie's disease approved by the FDA. Treatment involves a series of injections in the office and gentle stretching exercises at home. Enzymes within the injections break down and soften the plaque and have been proven to help reduce erectile curvature.
Plication
Plication is an outpatient (no hospital stay) surgical procedure where permanent sutures are placed on the opposite side of the curvature to straighten the penis. It is a reliable, quick surgery with excellent results, though you may see a small amount of reduced penile length.
Incision/Excision and Graft
Plaque incision or excision and grafting is a more involved surgical procedure during which the plaque is incised or removed creating a defect in the tunica albuginea which is repaired with a graft, or patch, such as cadaveric pericardium. It has a high success rate of reversing penile curvature from PD, but has the highest risk of new or worsening erectile dysfunction and a small risk of temporary or permanent nerve damage.
Penile Implant
For men with both severe erectile dysfunction and PD, penile implants are an excellent solution allowing for reliable, on-demand erections and correction of penile curvature.
Traction Devices
Traction devices are minimally invasive, may help reduce curvature and regain lost penile length, but require a significant time investment. Devices, such as RestoreX®, work by bending and stretching your penis against the curvature caused by PD.
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