Peyronie’s disease

Alternative names


Definition
Peyronie’s disease is an abnormal bend in the penis that occurs during erection. This condition may cause problems with penetration and pain associated with intercourse.

Causes, incidence, and risk factors

In Peyronie’s disease (curvature of the penis), fibrous tissue develops on the tunica albuginea (the lining of the erectile bodies of the penis). The cause of fibrosis is not known.

The condition occurs in about 388 of 100,000 men. The fibrous tissue causes a bend to develop during erection that is painful and can make intercourse difficult or impossible. The condition is relatively uncommon and affects men between 40 and 60 years and older.

An association has been noted with Dupuytren’s contracture, a cord-like thickening across the palm of one or both hands causing the 4th and 5th fingers to pull in toward the palm. This is a fairly common disorder of white men over 50 years old. However, only 1 to 2% of individuals with Dupuytren’s contracture develop curvature of the penis.

Other risk factors have not been identified. Also, there is an association with HLA B27 antigen cross-reactivity. A person with this condition has a particular type of immune cell marker that indicates the condition may be inherited.

Symptoms

     
  • Painful erection  
  • Observable bend in the penis with erection  
  • Observable narrowing of the diameter of the penis with erection  
  • Thick band of hard tissue within the penis

Signs and tests

Physical examination is sufficient to diagnose curvature of the penis. The hard plaques can be felt with or without erection. It may be necessary to use injectable medications to induce an erection for proper evaluation of the penile curvature.

The patient may also provide pictures of the erect penis for evaluation by the physician. Ultrasound of the penis may demonstrate the lesions in the penis, but is not necessary.

Treatment

Symptoms may be decreased somewhat with radiation therapy or corticosteroid injections into the fibrous band of tissue. Verapamil, an oral medication used for high blood pressure, has recently been shown to improve the disease, and has been approved for use in treating Peyronie’s.

If medical therapy fails and intercourse is not possible because of the curvature of the penis, surgery may be performed to correct the curvature. Because of the risk that this procedure will cause impotence, it is only performed if intercourse is impossible.

Expectations (prognosis)

The condition is typically progressive and leads to inability to have intercourse. The disease is also associated with development of impotence.

Complications

The condition may make intercourse difficult, painful, or impossible. Surgical correction may also lead to impotence.

Calling your health care provider

Call your health care provider if symptoms indicating curvature of the penis occur, particularly if erections are painful.

Johns Hopkins patient information

Last revised: December 2, 2012
by Arthur A. Poghosian, M.D.

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