Peyronie’s disease is an accumulation of scar tissue within the penis shaft. This inflammation may be associated with an injury to the penis, but no clear information exists on its origin. The scar tissue within the shaft often causes the penis to curve and can make erection and intercourse difficult and painful. The disease often goes into a type of spontaneous remission, and some individuals are able to resume sexual activity, although there may be scarring, which results in problems with erection.
Treatment for Peyronie’s Disease. If Peyronie’s disease is treated early, ultrasound, heat application, and anti-inflammatory drugs may help reduce scar formation. There have been reports that potassium para-aminobenzoate (POTABA) may be helpful. Vitamin E has also been tried but does not seem to be very useful. Studies are suggesting that the calcium channel blocker verapamil may be helpful. One study used verapamil and the steroid dexamethasone administered through a special skin patch. More than 80% of patients reported a definite improvement in penile rigidity. Extracorporal shock wave therapy, particularly with verapamil, has also been used with some success. In severe cases of scarring, the only treatment is surgery to straighten the penis and reduce the curve. Penile implants may also be beneficial.
Priapism is a sustained, painful, and unwanted erection that occurs despite a lack of sexual stimulation. Generally, priapism results when the smooth muscle tissue remains relaxed so that a constant flow of blood into the vessels of the penis occurs with no leakage back out. The development of priapism has been associated with urinary stones, certain medications, neurologic disorders, and, more recently, with self-injection therapy used for impotence.
Treatment of Priapism. If priapism occurs, applying ice for ten-minute periods to the inner thigh may help reduce blood flow. Erections that last four hours or longer require emergency care.
American Urological Association
Revision date: June 20, 2011
Last revised: by Jorge P. Ribeiro, MD