Peyronie’s disease, which manifests itself by a bent penis, is one of those hidden medical conditions that nobody has ever heard of until they or their partner develops it. But it is a major condition that affects up to 1 in 10 men in the UK and can have a devastating effect on relationships and a man’s sex life
So what is Peyronie’s Disease and why the big secret?
Firstly the good news. You don’t die from Peyronie’s disease. It is not a condition that you can pass on to anyone else and it doesn’t affect the rest of your physical health. In fact, despite its name, it is not a disease at all, it is a medical condition. But that’s where the good news stops and the bad news starts, because Peyronie’s disease can have a life changing effect on the men that suffer from it.
The most significant factor of Peyronie’s disease is that a man’s penis becomes increasingly deformed. This can happen literally overnight or can happen over a period of time. The change in shape is indiscriminate. Whereas the most common deformity is an upward shape, from a modest Banana type bend through to 90 degrees or more, it can also curve or bend at any angle, including to both sides or downwards. In fact, some men suffer from a double bend, and these can be in different directions. Other symptoms of the deformity include indentation, where the erect penis appears to have chunks removed from it or an hourglass, where the penis is normal at the top and bottom, but then narrows like an hourglass in the middle.
The symptoms don’t stop there, many men go on to notice a weakening of their erections and some develop full on Erectile Dysfunction. Shrinkage is a common problem, and in some instances, the erect penis can shrink in length by over 30% and also lose significant thickness. This isn’t the same for every man. It can lead to some men having partial erectile function before the deformity and a lack of hardness after the bend or area of deformity. Most men suffer pain in the early stages. This can vary from severe to a slight throbbing. It is different for every man. And finally, many men start to lose sexual sensitivity.
What this all means for the afflicted man is that sex becomes exceedingly more difficult and, in many cases, sadly impossible. It can also have a major detrimental effect on how a man feels about themself. in one study 90% of men with Peyronie’s disease were shown to suffer from depression. Depression can in part be explained by the sheer embarrassment of having a deformed penis. From an early age, especially when boys hit puberty, a great deal of emphasis is put on manhood and many boys/ teenagers spend their early years worrying about this.
So, how does someone develop Peyronie’s Disease, and can it be prevented? There are a number of known causes for Peyronie’s Disease. The most common one is injury to the penis. An injury to the Penis can cause a scarring or fibrosis to develop deep under the skin of the penis. The penis is unique in that it is designed to expand for erections and then contract after sex. The spongy tissue within the penis, fills up with blood. The scarring on the penis, or what is more commonly known as ‘Peyronie’s plaque’ causes a hardening in this area, it restricts the blood flow and in turn results in the penis bending at the point of injury. There are many forms of Injury that can trigger Peyronie’s disease. The most common, especially for men in their 50’s is a sexual injury, which occurs during love making. Some men can remember the instant when it happened when an accident led to acute pain. But others, especially those that engage in rigorous love making, often cannot recall a specific instance. Sporting injuries are also common. Particular sports such as Rugby are an invitation to injury and from an outside perspective it often appears that any mere mortal would get injured within a few minutes on the pitch. Being hit by a high-speed cricket ball or a low kick in karate could all trigger Peyronie’s disease.
Likewise other medical conditions lead to a higher propensity to suffer from Peyronie’s disease. Two conditions, Dupuytren’s Disease and Lederhosen disease are directly correlated. With Dupuytren’s disease a man and in this case also women, will notice fingers and thumbs, bending into the palms of their hands and in severe cases their fingers bend right into their palm and can’t be bent back. They also suffer from nodules (scarring appearing on the palm of their hands). With Lederhosen a similar thing happens on their feet. Other medical conditions such as diabetes and high blood pressure affect the blood flow and this leads to a greater chance that someone will suffer from Peyronie’s Disease. Finally, some forms of surgery, which can impact the blood flow to the Penis like prostate cancer surgery can also lead to Peyronie’s Disease.
So, if you have been recently diagnosed or woken up with a bent penis and scoured the internet for information, what can you do about it and where can you go for advice.
Firstly, the best information on the web at the moment is the Peyronie’s disease website. There is also a very active UK Forum that is run and moderated by Peyronie’s disease sufferers: www.peyroniesforum.co.uk. A wide variety of questions have been raised by members and answered by fellow sufferers.
The NHS has very simple pages on Peyronie’s disease for an easy explanation of what it is, but it is very thin on the latest options for treatment as it only mentions options that are available on the NHS.
So, what treatment options does a man suffering Peyronie’s disease have?
If you are based in the UK, your first step is normally to contact your local General Practitioner. But don’t expect them to have a great deal of knowledge on these conditions. General Practitioners have to deal with 1000’s of different medical conditions and most are not experienced in treating Peyronie’s disease. Some may be able to give you an opinion or suspect Peyronie’s disease, but most will refer you on to a specialist consultant called a Urologist. The wait times for an NHS Urologist over the past couple of years has been horrific and it is not uncommon for men to wait over two years before they see a specialist. What the NHS offer is much more limited in the private sector from clinics such as Mansmatters who are based in Central London. The NHS Urologists will normally prescribe a penile pump and some PDE5 inhibitors. These are used to increase the blood flow in the penis. Depending on the severity of the deformity, they may recommend surgery, especially where it is impossible for a man to have sex with a partner.
There are three main types of surgery
Nesbit technique. This is where one side of the penis is shortened to match the side which has the scarring. This means when a man has an erection, the penis will be much straighter, but also shorter. This operation is not suitable for men with a short penis, but is probably the most common surgery in the UK today.
Penile Implants
This surgery normally takes place when a man with Peyronie’s disease also has Erectile Dysfunction. A penile prosthesis is surgically implanted within the penis. This prothesis has two tubes, which when pumped up create an erection and also straighten out the penis. A man who undertakes penile implants can never have a natural erection again. Click here for a link to a page which shows a very good illustration of this.
Surgical grafting
With surgical grafting the scarring on the penis is removed and a graft put in its place. This is a much rarer operation nowadays in the UK and is only undertaken with men who have excellent erection function beforehand. It has been reported that a high proportion of men going through this procedure then develop Erectile Dysfunction.
There are a growing number of treatments aside from the NHS, which are extracorporeal shockwave therapy, Electro Magnetic transduction therapy (EMTT), NanoVi, Penile injections and stem cells. None of these treatments involve surgery and increasingly men opt for these first.
Shockwave therapy uses sound waves, which target the scarring in the penis. This helps break down and remodel the scarring, it also increases the blood flow and helps with the nerves and sensitivity. This is normally used in conjunction with EMTT which improves the quality of the cells within the blood vessels. There are also different penile injection techniques.
