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Peyronie’s Disease or “bent penis” produces pain and bending of the penis during the erection. In more severe cases, Peyronie’s disease can lead to erectile dysfunction. The disease often affects young men and, if untreated, can have a negative impact upon a man’s physical and psychological well-being.
Peyronie’s disease is caused by scar tissue that is deposited onto the corpora cavernosa of the penis. The corpora cavernosa are two long cylinders that run the full length of the penis. These cylinders fill with blood during the erection. When scar is deposited onto the corpora, the penis bends in the direction of the scar. Sometimes the scar is accompanied by inflammation which produces a painful erection. In severe cases, the scar prevents the corpora from filling and this leads to erectile dysfunction.
Many researchers believe that the disease results from trauma to the penis. Genetics also plays a role. Peyronie’s disease is associated with Dupuytren’s contracture – a condition that causes scarring and contracture of the hand.
Common symptoms of Peyronie’s disease include:
- Bending of the erect penis
- Painful erections
- Erectile dysfunction
- Anxiety and depression
The natural history of this disease in unpredictable. In most cases, the disease is mild and can be controlled with conservative treatments. It is important for the patient to understand that the majority of men with this condition will have a normal sex life with proper treatment.
There are a number of treatment options when it comes to Peyronie’s disease, including observation, medical treatments, and surgical treatments.
Mild cases may require no treatment other than reassurance.
There are many oral medications for this condition. Studies show that the results of these treatments are mixed and inconsistent. Medications prescribed for Peyronie’s disease include vitamin E, potassium amino-benzoate - Potaba, tamoxifen, colchicine, and carnitine. These drugs are most effective when prescribed during the early stages of the disease – when the patient is experiencing pain and inflammation.
If oral medications do not work, penile injections are the next step. The medicines that are most commonly used for injection include verapamil, interferon, or collagenase –Xiaflex. These meds are injected directly into the scar tissue of the penis.
Surgical treatments are reserved for men with Peyronie’s who have complete erectile dysfunction. The two most common surgical operations include:
• Plaque removal followed by insertion of a graft
• Placement of a 3 – piece penile implant
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Collagenase is an enzyme that literally dissolves the penile plaque, so long as it is not calcified. This medicine was recently approved by the FDA for the treatment of Peyronie’s disease. Collagenase injection is appropriate for men with severe curvature of the penis.
The collagenase regiment consists of several injections directly into the plaque. After you receive this injection you need to perform modelling or stretching of the penis on a daily basis. Dr. Lazare will teach you how to perform the modelling technique upon your penis.
Studies show that collagenase significantly decreases the bend of the penis during the erection. The main risk of this treatment is rupture of the corpora cavernosa. This occurs in a small percentage of patients – about 2 %. This complication requires emergency surgery in order to repair the problem.
Most surgical procedures are performed on an out-patient basis. After surgery, you will receive prescriptions for antibiotics and pain medication. You probably can to return to work within a few days following their procedure. You should avoid sex for a minimum of three weeks following surgery.
Video About Peyronie's Disease
If you have or suspect that you may have Peyronie’s disease, contact our Brooklyn office today to schedule an appointment with Dr. Lazare.