What is Peyronie’s Disease?
Peyronie’s disease is an abnormal bend of the penis occurring during an erection. The bend develops by plaque accumulating in an area of tissue on the penis. It is estimated that Peyronie’s disease occurs in approximately 1 – 5 percent of men.
Peyronie’s disease is an acquired physical deformity of the penis. It is most often caused by a plaque or scar tissue in the fibrous coating of the penile erectile bodies that causes a curvature or a constriction of erections. When erect, most men with Peyronie’s curve upwards, right or left. Few curve downwards. Some men will notice their penis has a hinge defect, an hourglass deformity or have a severe narrowing of the penis as it extends outward. It is a psychologically traumatic condition that lowers men’s self-esteem, inhibits normal sexual function and frequently stresses relationships. There is no direct cause for Peyronie’s. Most men develop the condition spontaneously while a few men will remember a physically traumatic sexual experience that caused the penis to bend forcibly and often painfully. Francois Gigot de la Peyronie was a court physician for King Louis XV of France in the 1700s. He first wrote about the condition and as such, it has carried his name for the last 300 years.
What Causes Peyronie’s Disease?
The cause of Peyronie's disease is unclear. For some men, plaque develops following a trauma causing bleeding inside the penis. The trauma may not be noticeable at the time. In other cases, the disease may be genetically linked or inherited.
In severe cases of Peyronie’s disease, hardened plaque reduces the flexibility of the penis, causing pain and forcing it to bend during an erection. While the pain may decrease over time, the bend in the penis remains. Milder forms of Peyronie’s disease can resolve on their own without permanent bending.
Peyronie's Disease: Diagnosis
The patient usually makes the diagnosis of Peyronie’s when he notices his penis develops a curve with erections. Peyronie’s disease may be diagnosed during a physical exam where a physician will feel the hardened tissue. A biopsy may also be performed on tissue in the affected area to confirm the diagnosis.
What to expect when diagnosed with Peyronie’s Disease
Some men will develop overnight severe curvature, and some men will take months to develop the deformity. It can be painful, especially in the first few months of development.
Specialists divide Peyronie’s disease into 2 categories: acute and chronic. The acute phase can last up to a couple of years but most men evolve into the chronic phase in the first year or so after noticing the curvature. Along with curvature, most men will notice loss of penile length that can sometimes be dramatic. Some men claim losing up to ½ of their former erect penis length. Penile shortening occurs because the thick fibers of the penis are usually elastic and stretch with blood flow and men find themselves with a smaller erect penis.
Severity of Peyronie’s depends on how bothered a man is by this condition. Some men have a bend of over 90 degrees and are unable to penetrate their partner. Some men have a much less severe bend, but are so bothered by the changed appearance of their penis that they avoid sex. If they don’t have a partner, they hesitate to find one, afraid to divulge their condition.
Over the last 15 years, erectile dysfunction (ED) has become a household word. Celebrity spokesmen proclaimed their ED on national television and normalized the condition. This empowered a generation of men to seek treatment. Peyronie’s disease has no celebrity spokesman. It is a disease, for the most part, suffered in silence. Many physicians don’t know much about the condition and therefore can’t guide their patients toward a treatment option. Thankfully, the physicians at UCLA Health-The Men’s Clinic are some of the most experienced and well-known Peyronie’s Disease experts in the world.
If you or someone you know suffers from Peyronie’s Disease, be confident that urologists at UCLA Health-The Men’s Clinic will perform a complete evaluation. The evaluation consists of a series of questions exploring how long the man has noticed the condition and how much does it bother or hinder him. Physical exam will focus on the penis where most often, the doctor will palpate a thickened plaque, usually on the dorsum, or top, of the penis. It may or may not be tender. Peyronie’s specialists will usually get an ultrasound of the penis to evaluate the blood flow to the penis, induce an erection to measure the degree of curvature and note if there is calcification within the plaque. Treatment will depend on duration and severity of the disease.
Peyronie’s disease can be successfully treated. At UCLA Health—The Men’s Clinic, physicians are trained to Peyronie’s Disease and have a number of options available. Typically, the pain associated with the disease only occurs with an erection and is usually mild. If intercourse is satisfactory then no treatment may be needed. If treatment is needed, there are several treatment options available for Peyronie’s disease:
As mentioned before, the key to choosing a surgical approach is to determine which is best for the individual. Since the surgeons at the UCLA Men’s Clinic are experienced in all surgical techniques, you can be sure you will have the best possible surgery unique to the severity of your Peyronie’s condition.
Medical Therapies: Surgery will not be recommended for all men with Peyronie’s disease, however. There are conservative approaches that may be a better option, especially in the early stages of the condition. Medical therapies may also be effective and will be discussed at your office visit.
More about Peyronie’s Disease treatment options >
Dr. Mills and the team at The Men’s Clinic - UCLA Health are at the forefront of treating Peyronie’s disease. Dr. Mills was a principal investigator for Auxilium Pharmaceuticals’ late-stage study of Xiaflex in 2011 and 2012. This injectable medication was recently approved by the U.S. Food and Drug Administration and Dr. Mills is a national leader in using Xiaflex. Xiaflex is the first drug to be approved by the FDA for the treatment of Peyronie's disease.
Board-certified urologists staff The Men’s Clinic at UCLA and you can be assured you are getting an experienced physician performing your evaluation and procedure in a relaxed and comfortable environment. For more information and to schedule an appointment, please call the UCLA Urology Appointment line at (310) 794-7700.