The Men’s Clinic at UCLA is a world leader in Peyronie’s Disease (PyD) management and research. Dr. Jesse Mills was a principal investigator in the Phase III clinical trial to achieve FDA approval for collagenase clostridium histolyticum (Xiaflex.), an injectable medication used to treat Peyronie’s disease. Since that time, Dr. Mills continues to be a world expert in administering Xiaflex and trains physicians form all over the world on how to effectively administer the drug.
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.
No one knows how a man gets PyD. About 80% of men have no clue why their penis became curved or deformed. The other 20% remember an injury during intercourse. PyD can be genetic. Fathers and sons, brothers may all have a genetic risk. It’s not something most men talk about and even may be more difficult for brothers or dads to discuss their condition with each other.
Men most often make the diagnosis themselves. Physicians can confirm the diagnosis with a physical exam. Some physicians will perform x-rays and ultrasounds of the penis to get more information on the scar tissue. At The Men’s Clinic at UCLA, all men receive a thorough history, physical exam and penile duplex ultrasound to get the most accurate diagnosis possible to provide individualized therapy.
Some men with PyD will develop overnight severe curvature or bending of the penis, 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 two (2) categories: acute and chronic. The acute phase of Peyronie’s disease 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 or bending, 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 lose their usually elasticity and ability to stretch with blood flow and, therefore, men find themselves with a smaller erect penis.
Severity of Peyronie’s disease 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 change in 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 several 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.
If you or someone you know suffers from Peyronie’s disease, be confident that The Men’s Clinic at UCLA will treat you. Dr. Mills and his associates lead the world in PyD management and research. Dr. Mills is one of the largest volume Xiaflex injectors since its FDA approval in 2013.
Dr. Mills frequently states the penis chooses the treatment. In other words, there are many treatments for PyD, from medical management, intralesional therapy like Xiaflex, or surgical therapies. The severity of the curvature and severity of a patient’s bother determine the best course of treatment.
There are three categories of surgery used at UCLA to treat Peyronie's Disease:
Surgery is not recommended for all men with PyD. There are medications that have shown some efficacy in treating the acute phase of Peyronie’s. There are no FDA approved pills for treating PyD so keep in mind, the oral therapies Dr. Mills may recommend are off label. Off label medicines that Dr. Mills recommends are generally safe and effective and FDA approved for other conditions.
Dr. Jesse Mills and the team at The Men’s Clinic - UCLA Health are at the forefront of treating Peyronie’s disease, both surgically and medically. Dr. Mills was a principal investigator for Auxilium Pharmaceuticals’ late-stage study of XIAFLEX in 2011 and 2012. XIAFLEX is an FDA-approved injectable medication used to treat adult men with Peyronie’s disease who have plaque that can be felt and a visible curve in their penis. XIAFLEX, after injected into the tissue, works to help weaken and break down the plaque. Dr. Mills is a national leader in using XIAFLEX, and it is the first drug to be approved by the U.S. Food and Drug Administration (FDA) for the treatment of Peyronie's disease.
More about Peyronie’s Disease treatment options at UCLA >
For more information and to schedule an appointment, please call the UCLA Urology Appointment line at (310) 794-7700.