When you get an erection, arteries bring blood to the spongy tissue in your penis. The blood fills this tissue and makes your penis hard.
Failure to get an erection that is hard enough for sexual intercourse is called erectile dysfunction (ED), or impotence.
Sometimes the process doesn’t work the way it should. Damaged arteries, blood vessels, and nerves can prevent or obstruct blood flow to your penis. In a few cases, a psychological problem may interfere with erection.
One physical problem than can cause incomplete erection and erectile dysfunction is Peyronie’s disease, often called penile curvature.
A man with Peyronie’s disease has hardened or “calcified” tissues in his penis. These tissues are called plaque. The hardening is in the tunica abluginea. This is the sheath surrounding the spongy tissue in the penis. The hardening often causes pain and curvature, usually during erection.
3% of men may have Peyronie’s disease
The condition usually occurs between age 45 and 60. The average age is 50, but it can occur in men as young as 18.
Nearly 3% of all men may have Peyronie’s disease. Doctors think that many men with Peyronie’s disease do not look for help because the symptoms are mild or they are too embarrassed.
A total of 20 patients with Peyronie’s disease, including 15 with erectile failure and 5 with normal potency, underwent evaluation with dynamic xenon washout and infusion cavernosography. Abnormal drainage from the cavernous body was found in 13 of the 15 patients with erectile failure and in none of the 5 potent patients (p less than 0.01), indicating that this condition seems to be the underlying pathological mechanism leading to erectile impotence in patients with Peyronie’s disease.
Metz P, Ebbeh?j J, Uhrenholdt A, Wagner G.
Peyronie’s disease has three main symptoms:
* Lumps in the penis
* Curvature or “angulation” of the penis during erection
These symptoms are not all present in every case. The symptoms may also vary in severity.
Peyronie’s disease may start with pain in your erect penis. At this point, you may feel firm lumps in the shaft of your penis. Usually, these lumps are the small areas of plaque forming in the shaft.
As the plaques develop, you will see a bending of your penis during erections. In severe cases, the bending can make sex impossible or uncomfortable for you and your partner. It can also cause worry and anxiety. This in turn can lead to erectile dysfunction.
Doctors don’t know all of the causes of Peyronie’s disease. Sudden cases often are caused by trauma to the penis, such as injury or extremely vigorous sexual activity.
There may be a genetic link. There also is evidence that blood vessels may be involved.
What is Peyronie’s disease?
Peyronie’s disease is a big name for a curve in the penis. (Peyronie’s is said this way: pay-rone-ees.) It can be painful at times, most often during sex. In some men, Peyronie’s disease is a mild problem without symptoms. Other men with Peyronie’s disease may have pain during erection or erections that aren’t hard enough for sex.
What causes Peyronie’s disease?
Scar tissue under the skin of the penis causes the curve. No one knows why the scar tissue starts. Some men with Peyronie’s disease have had a penis injury that causes scar tissue. The scar feels like a ridge or a row of tiny bumps. The scar can keep getting worse during the first few years, making the penis curve more and more. You might notice this more during an erection. After a few years, the scar usually stops getting worse, but it doesn’t go away.
What can I do about the curve in my penis?
We can’t cure Peyronie’s disease. Medicines like Potaba or vitamin E help some men. Potaba is a prescription medicine. Your doctor will tell you about it. If you take vitamin E, don’t take more than your doctor tells you. Too much vitamin E won’t help your penis. Too much vitamin E or Potaba can hurt your liver. Potaba can also make you nauseous or take away your appetite.
If you think you have Peyronie’s disease
If you feel pain or abnormal lumps in your penis, see a urologist immediately.
Many men with Peyronie’s disease do not need any treatment. The disease sometimes clears up by itself, although it may take several years. Other men, however, do need treatment.
There are a variety of treatments available. You should work with your doctor to decide the best treatment for you.
There is help for ED caused by Peyronie’s disease
Erectile dysfunction is different from Peyronie’s disease. The disease can lead to physical or psychological impotence. If it does, many treatments for ED are available.
Treatments include drugs such as Viagra, penile implants, vacuum erection devices, injection therapy, and urethral suppositories.
Penile implants can be extremely effective for treating Peyronie’s disease and also provide the best alternative for maximum spontaneity during sex.
Implants have been enhanced and perfected over a period of 29 years. Nearly 300,000 men have had a penile implant. Clinical studies show a very high degree of satisfaction with penile implants.
< 0.001). Although patients with Peyronie's disease may suffer impotence due to arterial occlusive disease, our results indicate that the principal cause of impotence in this patient population is veno-occlusive dysfunction.
Lopez JA, Jarow JP.
Department of Urology, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina.
PMID: 8267684 [PubMed - indexed for MEDLINE]
The best treatment for erectile dysfunction depends on many things. These include a man’s health and personal and physical tolerance for the treatment. Work with your doctor (usually a urologist specializing in the treatment of ED) and your partner to determine the best treatment for you.