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Peyronie's disease(ED) : Causes, Types, Symptoms, Diagnosis ,Treatment , Risk factors , Complications , Prevention

 What Is Peyronie’s Disease(ED) ?

Erectile dysfunction (ED) is a circumstance wherein someone with a penis has trouble getting or keeping an erection. It can cause troubles within the bedroom for people of every age. One uncommon form of ED, known as Peyronie’s disease, results in a bend inside the penis that may make an erection painful.

While a curved erection doesn’t usually suggest a problem, human beings who have Peyronie’s ailment may additionally have problems having intercourse. This regularly reasons tension and pain. Keep studying to understand more about Peyronie’s ailment.

Peyronie's ailment is a problem resulting from scar tissue, referred to as plaque, that paperwork in the penis. It can result in a dishonest, in preference to straight, erect penis.

Most guys with Peyronie's disorder can nonetheless have intercourse. But for some, it could be painful and cause erectile dysfunction.

Depending on the signs,  you can choose observation, clinical or surgical remedies.

What Is Peyronie’s Disease(ED)


Explanation of medical terms and concept Peyronie's disease(ED)

Peyronie's (pay-roe-NEEZ) ailment is a noncancerous circumstance as a consequence of fibrous scar tissue that develops on the penis and causes curved, painful erections. Penises range in shape and length, and having a curved erection isn't always a motive for concern. But Peyronie's ailment causes a sizable bend or ache in some men.

This can save you you from having sex or would possibly make it hard to get or hold an erection (erectile dysfunction). For many guys, Peyronie's sickness additionally causes pressure and tension. Penile shortening is some other common issue.

Peyronie's ailment hardly ever is going away on its own. In maximum guys with Peyronie's ailment, the situation will stay as is or get worse. Early treatment quickly after growing the situation may preserve it from getting worse or even enhance symptoms. Even if you've had the condition for some time, remedy can also help improve bothersome symptoms, which includes pain, curvature and penile shortening.

Peyronie’s disease also called a curvature of the penis is a condition where scar tissue builds up in one area of the penis causing it to bend and sometimes shrink Most men with Peyronie’s disease develop painless nodules (small firm lumps) on the penis shaft The condition is not contagious or life-threatening and does not affect sexual function In some cases however an erection can be painful for both partners.

Peyronie’s disease is a condition in which the scar tissue is formed in the penis due to injury or infection When this scar tissue hardens it can cause painful erections and may be seen as a lump or plaque on the shaft of the penis There are no complications with urination ejaculation or fertility.

Symptoms Peyronie's disease(ED)

The number one symptom of Peyronie’s ailment is curvature inside the penis. You may sense scar tissue (a plaque) underneath the skin of the penis.Peyronie's disorder symptoms and signs would possibly appear  or increase steadily. The maximum commonplace signs and symptoms and signs and symptoms consist of:

  • Scar tissue. The scar tissue related to Peyronie's disease — referred to as plaque however distinct from plaque which can increase in blood vessels — can be felt below the skin of the penis as flat lumps or a band of difficult tissue.

  • A significant bend to the penis. Your penis may curve upward or downward or bend to one facet.

  • Erection problems. Peyronie's disease might motivate issues with getting or keeping an erection (erectile disorder). But, frequently men file erectile dysfunction before the start of Peyronie's disorder signs.

  • Shortening of the penis. Your penis may become shorter as a result of Peyronie's disorder.

  • Pain. You might have penile pain, with or without an erection.

  • Other penile deformity. In some guys with Peyronie's sickness, the erect penis might have narrowing, indentations or maybe an hourglass-like appearance, with a tight, narrow band around the shaft.

The curvature and penile shortening associated with Peyronie's ailment may regularly get worse. At some point, however, the circumstance generally stabilizes after three to three hundred and sixty five days or so.

Pain all through erections usually improves within one to 2 years, however the scar tissue, penile shortening and curvature frequently continue to be. In a few men, each the curvature and pain related to Peyronie's ailment enhance without treatment.

When to see a doctor

See your medical doctor as soon as feasible once you notice signs or symptoms of Peyronie's sickness. Early treatment offers you the first-class danger to improve the situation — or prevent it from getting worse. If you've had the circumstance for some time, you may desire to see a health practitioner if the ache, curvature, period or other deformities bother you or your companion.

Causes Peyronie's disease(ED)

According to the Mayo Clinic, the reason for Peyronie's disorder is essentially unknown. However, studies indicate that the situation may additionally expand after trauma to the penis, such as bending or hitting. This can cause bleeding and next scar tissue buildup.

While injury may be the reason for the situation in some cases, the National Kidney and Urologic Diseases Clearinghouse (NKUDC)Trusted Source notes that regularly the circumstance arises without a traumatic event.

The reason for Peyronie's disorder isn't completely understood, but a variety of things appear to be involved.

It's a notion Peyronie's disease normally effects from repeated harm to the penis. For example, the penis is probably broken at some stage in sex, athletic activity or as the result of an coincidence. However, most usually, no unique trauma to the penis is recalled.

During the recovery manner after injury to the penis, scar tissue paperwork in a disorganized way. This can result in a nodule you may sense or improvement of curvature.

Each facet of the penis consists of a sponge-like tube (corpus cavernosum) that consists of many tiny blood vessels. Each of the corpora cavernosa is encased in a sheath of elastic tissue known as the tunica albuginea (TOO-nih-kuh al-BYOO-JIN-e-uh), which stretches throughout an erection.

When you turn out to be sexually aroused, blood flow to those chambers increases. As the chambers fill with blood, the penis expands, straightens and stiffens into an erection.

In Peyronie's sickness, whilst the penis becomes erect, the location with the scar tissue would not stretch, and the penis bends or becomes disfigured and in all likelihood painful.

In some guys, Peyronie's ailment comes on step by step and would not seem to be related to any damage. Researchers are investigating whether Peyronie's disease is probably connected to an inherited trait or positive fitness conditions.

Risk factors Peyronie's disease(ED)

Genetics and age seem to play a role in Peyronie’s sickness. The condition may be genetic and run in families, giving some humans a genetic predisposition.

Tissue modifications cause less difficult injury and slower recuperation as human beings become older. This puts them at more risk for growing the condition.

Those with a connective tissue disease known as Dupuytren’s contracture have a better chance of growing Peyronie’s disease. Dupuytren’s contracture is a thickening in the hand that makes your hands pull inward.

Minor harm to the penis would not usually cause Peyronie's sickness. However, different factors can make a contribution to poor wound restoration and scar tissue buildup that could play a function in Peyronie's disorder. These include:

  • Heredity. If a member of the family has Peyronie's disorder, you've got an accelerated danger of the condition.

  • Connective tissue disorders. Men who have certain connective tissue disorders seem to have an expanded danger of developing Peyronie's disorder. For example, a number of men who have Peyronie's disease even have a cordlike thickening throughout the palm that causes the hands to tug inward (Dupuytren's contracture).

  • Age. Peyronie's sickness can occur in men of any age, but the prevalence of the circumstance will increase with age, particularly for men in their 50s and 60s. Curvature in more youthful guys is a great deal much less frequently due to Peyronie's sickness and is extra usually called congenital penile curvature. A small quantity of curvature in more youthful men is everyday and not concerning.

Other elements — inclusive of positive health situations, smoking and some styles of prostate surgical procedure — might be related to Peyronie's ailment.

Complications

In addition to the tension or pressure the circumstance may additionally purpose you — and possibly your associate — different headaches may also rise up. Difficulty achieving or preserving an erection makes it difficult to have sexual sex.


If intercourse isn’t possible, you may be unable to conceive a baby. Seek support out of your healthcare team, which may additionally consist of your medical doctor, and a mental counselor, to help you face those complicated issues.

Complications of Peyronie's disease might include:

  • Inability to have sexual intercourse

  • Difficulty achieving or maintaining an erection (erectile dysfunction)

  • Anxiety or stress about sexual abilities or the appearance of your penis

  • Stress on your relationship with your sexual partner

  • Difficulty fathering a child, because intercourse is difficult or impossible

  • Reduced penis length

  • Penile pain

Diagnosis Peyronie's disease(ED)

Tell your health practitioner approximately anything, which includes an injury, that passed off before the signs started.

You’ll get an exam wherein your medical doctor will feel the hardened tissue because of the sickness during an examination. It’s now not constantly essential, however if the penis needs to be erect for the examination, the doctor would inject a medicine to make that manifest.

There’s a hazard you may need to get an X-ray or ultrasound of the penis.

It’s rare, however, in some cases where the physician's exam does not verify Peyronie's disorder, or if the condition develops unexpectedly, your medical doctor can also do a biopsy. That includes putting off a bit of tissue from the affected region for lab exams.

A bodily examination is frequently enough to become aware of the presence of scar tissue in the penis and diagnose Peyronie's disorder. Rarely, other situations cause comparable signs and symptoms and want to be ruled out.

Tests to diagnose Peyronie's disease and recognize exactly what's causing your symptoms may encompass the subsequent:

  • Physical exam. Your health practitioner will sense (palpate) your penis when it is not erect, to identify the region and amount of scar tissue. He or she may additionally measure the period of your penis. If the condition continues to worsen, this preliminary dimension helps determine whether or not the penis has shortened.
    Your medical doctor may ask you to bring in photos of your erect penis taken at home. This can determine the degree of curvature, vicinity of scar tissue or different details that would assist become aware of the fine remedy technique.

  • Other tests. Your physician might order an ultrasound or different assessments to have a look at your penis while it's erect. Before trying out, you will likely obtain an injection without delay into the penis that reasons it to become erect.
    Ultrasound is the most commonly used, take a look at for penis abnormalities. Ultrasound checks use sound waves to produce images of soft tissues. These tests can show the presence of scar tissue, blood waft to the penis and other abnormalities.

Treatment Peyronie's disease(ED)

There’s no cure for Peyronie’s ailment, but it’s treatable and may work on its own. Though it can be tempting to request medicinal drugs right away, many medical doctors choose the “watchful waiting” method if your signs aren’t excessive.

Treatment suggestions for Peyronie's sickness depend on how lengthy it's been because you commenced having signs and symptoms.

  • Acute phase. You have penile ache or changes in curvature or duration or a deformity of the penis. The acute phase happens early inside the ailment and may ultimately be two to four weeks but every so often lasts for as much as a yr or longer.

  • Chronic phase. Your signs and symptoms are stable, and you haven't any penile ache or adjustments in curvature, duration or deformity of the penis. The persistent phase occurs later within the ailment and typically takes place around three to 365 days after symptoms start.

For the acute phase of the disease, treatments range from:

  • Recommended. When used early within the sickness system, penile traction therapy prevents period loss and minimizes the quantity of curvature that happens.

  • Optional. Medical and injection treatment options are non-compulsory on this phase, with a few more powerful than others.

  • Not recommended. Surgery is not recommended until the disease stabilizes, to avoid the need for repeat surgical procedure.

For the continual phase of the disorder, numerous capacity remedies are to be had. They may be finished by myself or in aggregate:

  • Watchful waiting

  • Injection treatments

  • Traction therapy

  • Surgery

Oral medicinal drugs aren't encouraged inside the chronic section, as they have not been proven to be effective at this stage of the disorder. Shock wave therapy, stem cells and platelet-wealthy plasma also haven't been shown to be powerful in human research.

Medications

A number of oral medications were attempted to treat Peyronie's disease, however they have not been shown to be effective continually and aren't as powerful as surgery.

In a few guys, capsules injected immediately into the penis might reduce curvature and pain associated with Peyronie's disorder. Depending on the therapy, you are probably given a nearby anesthetic to save you pain in the course of the injections.

If you have got any such treatments, you'll probably receive a couple of injections over several months. Injection medications will also be used in combination with oral capsules or traction treatment plans.

Medications include:

  • Collagenase. The most effective FDA-authorized medication for Peyronie's ailment is collagenase clostridium histolyticum (Xiaflex). This remedy has been approved for use in person men with slight to severe curvatures and a palpable nodule.
    This remedy has been proven to enhance curvature and bothersome signs and symptoms associated with Peyronie's ailment. The remedy works with the aid of breaking down the buildup of collagen that causes penile curvature. Collagenase seems to be extra powerful whilst used in conjunction with "modeling," that is forcible bending of the penis in the contrary path of the bend.

  • Verapamil. This is a drug commonly used to deal with high blood strain. It appears to disrupt the production of collagen, a protein that is probably a key element inside the formation of Peyronie's ailment scar tissue. The drug is properly tolerated and can lessen ache, too.

  • Interferon. This is a type of protein that appears to disrupt the manufacturing of fibrous tissue and assist ruin it down. One placebo-controlled trial confirmed development of the usage of this therapy over placebo. Interferon additionally has been shown to lessen penile ache in men with Peyronie's ailment.

Traction therapy

Penile traction remedy includes stretching the penis with a self-applied mechanical device for a period of time to improve penile duration, curvature and deformity.

Depending on the specific device, traction remedy may additionally want to be worn for as little as 30 minutes to as much as 3 to eight hours a day to obtain advantages. The effectiveness of treatment can also rely upon the precise device used.

Traction remedy is usually recommended in the early phase of Peyronie's ailment. It's the handiest treatment shown to enhance penile period. Traction remedy can also be used within the persistent phase of the disease, combined with other treatments or after surgery for a higher outcome.

Surgery

Your medical doctor may advocate surgical procedure if the deformity of your penis is intense, sufficiently bothersome or prevents you from having sex. Surgery generally isn't always advocated until you've had the circumstance for nine to 365 days and the curvature of your penis stops increasing and stabilizes for at least three to 6 months.

Common surgical methods encompass:

  • Suturing (plicating) the unaffected side. A variety of methods may be used to suture (plicate) the longer side of the penis — the side without scar tissue. This results in a straightening of the penis, even though that is frequently limited to less excessive curvatures.
    Several application strategies can be used, commonly resulting in similar success charges depending on physician experience and choice.

  • Incision or excision and grafting. With this type of surgical operation, the doctor makes one or extra cuts inside the scar tissue, allowing the sheath to stretch out and the penis to straighten. The healthcare professional might do away with a number of the scar tissue.
    A piece of tissue (graft) is often sewn into place to cover the holes inside the tunica albuginea. The graft might be tissue from your very own frame, human or animal tissue, or a synthetic fabric.
    This method is usually utilized in guys with extra-excessive curvature or deformity, consisting of indentations. This system is related to more risks of worsening erectile function whilst in comparison with the plication strategies.

  • Penile implants. Surgically positioned penile implants are inserted into the spongy tissue that fills with blood at some point of an erection. The implants might be semirigid — manually bent down most of the time and bent upward for sexual intercourse.
    Another type of implant is inflated with a pump implanted inside the scrotum. Penile implants might be considered when you have Peyronie's disorder and erectile dysfunction.
    When the implants are installed location, the surgeon may perform extra processes to improve the curvature if needed.

The kind of surgical treatment used will depend upon your circumstance. Your doctor will take into account the area of scar tissue, the severity of your signs and symptoms and different elements. If you are uncircumcised, your health practitioner would possibly advise a circumcision at some point of surgery.

Depending on the form of surgical treatment you have got, you might be capable of going home from the health center the same day or you would possibly want to stay in a single day. Your health practitioner will suggest to you on how long you must wait earlier than going again to paintings — normally, a few days. After surgery for Peyronie's disorder, you'll want to wait four to 8 weeks earlier than sexual pastime.

Other treatments

A method referred to as iontophoresis uses an electric powered current to manage a combination of verapamil and a steroid noninvasively through the pores and skin. Available studies have proven conflicting results on penile curvature and erectile characteristics.

Several non drug treatments for Peyronie's disorder are being investigated, however proof is limited on how properly they work and feasible facet results. These consist of using excessive sound waves to break up scar tissue (surprise wave remedy), stem cells, platelet-wealthy plasma and radiation remedy.

Coping and support

Peyronie's ailment can be a source of giant tension and create strain between you and your sexual companion.

Here are a few tips for dealing with Peyronie's ailment:

  • Explain to your companion what Peyronie's disorder is and how it influences your potential to have intercourse.

  • Let your partner understand the way you experience about the advent of your penis and your capacity to have sex.

  • Talk to your partner about how the two of you can maintain sexual and physical intimacy.

  • Talk to a mental health provider who specializes in family relations and sexual matters.

Preparing for your appointment

If you have got Peyronie's sickness signs and symptoms, you're likely to begin by seeing your own family medical doctor or fashionable practitioner. You is probably noted a specialist in male sexual disorders (urologist). If it's feasible, encourage your accomplice to wait for the appointment with you.

Preparing for your appointment will help you make the first-rate use of your time.

What you can do

Make a list beforehand of time that you may share together with your health practitioner. Your list ought to include:

  • Symptoms You're experiencing, such as any that would appear unrelated to Peyronie's sickness

  • Key personal information, including any major stresses or recent life changes

  • Medications that you're taking, including any vitamins or supplements

  • History of injury to the penis

  • Family history of Peyronie's disease, if any

  • Questions to ask your doctor

List questions for your medical doctor from most vital to least crucial in case time runs out. You would possibly need to ask some of the following questions:

  • What tests will I need?

  • What treatment do you recommend?

  • Can you tell if symptoms are likely to worsen or improve?

  • Are there any brochures or other printed material that I can take home with me? What websites do you recommend?

In addition to the questions you've organized to ask your medical doctor, don't hesitate to invite questions during your appointment.

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being prepared to reply to them may reserve time to go over any factors you want to talk about similarly. Your health practitioner might ask:

  • When did you first word a curve on your penis or scar tissue beneath the pores and skin of your penis?

  • Has the curvature of your penis worsened over time?

  • Do you have pain during erections, and if so, has it gotten worse or improved over time?

  • Do you recall having an injury to your penis?

  • Do your symptoms limit your ability to have sex?

Your physician may also ask you to complete a survey, along with the International Index of Erectile Function, to assist pick out how the condition influences your capacity to have sex.

General summary

Peyronie’s disease is a condition in which scar tissue develops under the skin of the penis causing it to develop into a curved shape The cause of peyronie’s disease is not known; however there are several risk factors that may increase the chance of developing this condition These include advancing age smoking and taking certain medications As well as having pain during an erection men with peyronie’s disease may notice that their erections are shorter than before and they may have difficulty achieving an erection.

Can Peyronie's disease heal itself?

Peyronie's disease is a disorder that causes the penis to curve. The curved shape of the penis is called a "penile plaque." It can make it difficult for men to perform sexual activities and often makes it painful to have sex In many cases Peyronie's disease will go away on its own But in some cases it may not improve without treatment.

What happens if Peyronie\'s disease is left untreated?

If you do not take care of a Peyronie’s disease you may permanently damage your penis The scar tissue that forms can cause the penis to curve when erect and it is impossible to repair the curvature without medical intervention Because this condition is progressive the symptoms will only get worse over time if it is left untreated.

Can Viagra help with Peyronie's disease?

Peyronie's disease is a condition that causes the penis to develop scar tissue which can result in painful erections The use of Viagra has been shown to reduce the frequency and severity of these painful erections by increasing blood flow In fact there have been studies where patients who took Viagra experienced an 80 percent improvement in their symptoms While it is not a cure taking this drug may make it easier for you to engage in sexual activity.

Is Vitamin E Good for Peyronie disease?

Vitamin E is a fat-soluble nutrient that has antioxidant properties As an antioxidant it helps protect cells from the damage caused by free radicals Free radicals are molecules that cause damage to cells and tissues when they interact with them While vitamin E has proven benefits for other conditions it hasn't been shown to be effective in treating Peyronie's disease However since vitamin E does help with scar tissue formation it may be helpful for those who have developed a fibrotic plaque or penile shortening after suffering from Peyronie's.

What is the most effective treatment for Peyronie's disease?

The most effective treatment for Peyronie\'s disease is still unclear Conservative treatments such as penile plaque massage vitamin E therapy and oral pentoxifylline are not known to be effective Oral papaverine has been reported to be of marginal benefit; however a placebo effect cannot be ruled out More recently the anti-inflammatory drug verapamil has been tested Verapamil seems to improve the degree of curvature and pain associated with the disease However it is currently not approved by the FDA for this use It also has many side effects including tachycardia hypotension and constipation The drugs mexiletine and sildenafil have also been tested.

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