Painful erection caused by Peyronie's disease or someting else?

Hello Doctor Herazy, I have been getting a painful erection each night (sometimes a few times a night) for the last few months.  What worries me is that the pain is slowly getting worse.  The pain when I am erect wakes me up at night and I do not know what to do about it.

I have no idea what started this to act up.  I have not injured myself and my penis is not bruised.  My erections are as strong as usual, and I have no pain when I urinate or ejaculate.   Speaking of ejaculation, I have a very vigorous and active sex life, but sex is getting to be a problem since the pain makes it difficult to keep an erection. Sometimes the painful erection is so severe that I just go limp in the middle of intercourse.

I called my medical doctor and he suggested some tests that sound expensive.  Instead of doing that I went to the internet and Googled “painful erection” and found your website.  I have learned that pain while erect is a sign of Peyronie's disease, and would like your thoughts about this as a possible explanation for my problem.

Can you please help me understand what is making my erections so terribly painful suddenly? If it keeps up much longer I will have to go see a doctor I suppose.

T. K.

Greetings T. K.,

There are a few conditions that can explain your current problem of pain while being erect:

  • Trauma – you deny any injury
  • Priapism – persistent or prolonged erections; can last for hours at a time; not related to night
  • Phimosis  – constriction of penis by foreskin or prepuce
  • Peyronie's disease  – a possibility
  • Lichen sclerosis – leathery skin condition
  • Disease of the penis – chlamydia, genital warts
  • Cancer  – very rare

You do not mention any other complaints that are going on with you for me to have an indication of what might be going on in your situation.  I suspect you can probably eliminate several of these possible causes since you are aware of other aspects of your history.

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The most common complaints associated with Peyronie's disease are:

  • Nodule or bump under the surface of the shaft caused by a mass of fibrous tissue (like a scar).
  • Penile distortion while erect caused by the same mass of fibrous tissue.
  • Reduced penis length and diameter cause by fibrous tissue contracting penis.
  • Painful erection caused by inflammation of penile tissue, as well as  the presence of the fibrous tissue in the deep layers of the penis.
  • Reduced erection quality, again caused by the presence of the fibrous tissue that prevents full closure of the penile veins that create the hydraulic pressure of an erection.

Some of these complaints related to Peyronie's disease, like painful erections, are not always seen in a case of Peyronie's disease.  The only mandatory finding to confirm a diagnosis is the presence of a mass of fibrous tissue.   Many times the loss of penis size does not occur early when Peyronies is present, and many men do not notice the telltale lump of Peyronie's disease.  What I am saying is that it is possible to have Peyronie's disease and not be aware of it except for a painful erection.

My suggestion is that you should go to a urologist for an examination to get to the bottom of your complaint.

You might also be interested in reading Nine causes of pain in the penis.

If it should turn out that you do have Peyronie's disease I suggest that you undergo an early round of self-directed natural treatment of Peyronie's disease to determine if you can reduce the internal scars without the need of drugs or surgery.    TRH

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My Peyronie's disease started after I tried to straighten my curved penis with a penis stretcher, should I use another one?

Winter 2010 I used a penis extender for around 1.5 months (4-6 hours each day or less), where I probably made an injury on the left side (too hard penis with too hard stretch), just below the glans.

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I realize now that I probably have had congenital curved penis all my life.

When my penis is rock hard, it curves 30-40 degrees to the left. I think it was less before Winter 2010 when I started using the penis extender.

I wonder if it could have been possible that I didn't injure the penis, but bigger curve at the glans is due to longer extension on the right side compared to the left side (because of scar tissue on the left side) ?

Seriously, I didn't think so much about the curve before, so the curve might only have been congenital before this likely injury. I went to an urologist in May and he indicated that I maybe have had a little injury on the tunica albuginea (which makes the overall curve bigger).

In December I started to use an extender again, with the use of  XXXXXX, said to work specifically for PD. I stopped after 34 total effective days (9 h each day) as I have read some studies where they have used Verapamil injections before usage of an extender. In one study the curvature went from 30 to 0 and lengthened with 1.5 cm 🙂   I stopped using the extender 10 days ago.

Is this something you recommend? To remove the plaque first and then start using the extender after the plaque has been removed? Because it is speculated that some of the reasons the lengthening is shorter with PD, is because of the plaque. I have just started to use DMSO and SSKI (both topical), and will start to use Serrapeptase and Nattokinase as well. I see on this site that you also recommend Neprinol and some copper + +.

I have another question, so I may have to call you for more clearance; when the plaque diminished, will it leave an empty area in the flesh, maybe making the curvature worse and the penis shortened?

Peyronies disease is not just having plaque, but also having one side shorter than the other. It is then vital to use an extender so the shortest side can catch up the longest side, right?

I`m 31, which package do you recommend to me?

Greetings,

First of all, I removed the name of the penis stretcher product from your email because I think all of them are dangerous, as you have already shown us by reporting you injured yourself with one.  I wish to not promote these contraptions in any way.  The name of your particular device is not important because none of them are different from the others in any important or meaningful way.   All cars are fundamentally the same because all have a motor, seats, windows, wheels and a steering wheel; in that sense they are all identical in their basic design.  The same can be said of penis stretchers.  They all have a clamping device that holds the penis at or near the head, a base that is held against the pubic region, a pair of extendable threaded rods that lengthen the device while it is worn on the penis, a book of instructions that tells you what to do if you develop blisters and skin erosion while using the extender, and surgical wool and antibiotic ointment to keep you from hurting yourself further.

You are a rare man.  I have communicated with very few men who are able to wear a penis extender device for more than a short while; some could not wear one for even 10 minutes.  I have worked with many men who told me they could only put it on only one time and threw it away because of pain and apparent injury.   Many of those men who persisted in spite of the pain and superficial tissue erosion caused by these stretchers soon developed Peyronie's disease.  Some men put a penis stretcher on only one time for 30-60 minutes and then never again because they next day they have signs of early penis injury, and later demonstrate full blown Peyronie's disease.

It seems the prolonged pressure from the head clamp  causes local tissue anoxia (oxygen starvation) deep within the penis tissue; this is probably what happened to you.  When there is a lack of blood circulation in the penis caused by smashing it down with the clamp of the penis extender, blood circulation is cut off and a lack of oxygen occurs where the head is compressed.  This is very much like what happens when a tourniquet is worn too tight or for too long – the lack of oxygen caused by poor blood flow will kill tissue.  Any good boy scout or soldier learns that even if your arm or leg is severely cut you must periodically release the tourniquet – even if hemorrhaging starts again – so that fresh blood can deliver oxygen into the injured limb.  If this is not done the entire limb can become damaged and gangrene can develop.   But you report in one area of your email that you wore yours for 4-6 hours daily for six weeks, and you state later you wore another penis stretcher for nine hours daily for 34 days.  That is incredible.  If you were a boy scout you would have flunked the first aid class for leaving the “tourniquet” on for far too long.  No wonder you developed PD.

You state your congenital penis curvature is now worse than it was before you started using your first penis stretcher; your bent penis now curves 30-40 degrees to the left, more than before using the stretcher.  You think that the solution to the problem caused by the first penis stretcher is to use a second penis stretcher.  I do not agree with your thinking, and I will explain why later.

Please think about this statement I am about to make because it is very important in helping you to understand why you have injured your penis, and why I feel you are going about treatment in a totally wrong way:  If you have Peyronie disease, your problem is not that your penis is bent, dented or otherwise distorted; your problem is that you have dense scar tissue within the tunica albuginea layer of  the penis that as a secondary factor is causing your penis to be curved, dented or otherwise distorted.

Think of it this way.   If you cut yourself shaving, what is the actual problem?  Is your problem the blood running down your chin?  Or is the  problem the hole in your skin that as a secondary factor is allowing blood to leak out of the blood vessels and run down your chin? Certainly the blood gets your attention, but it is not the problem.  If you did not have the hole in your skin the blood would not be running down your chin.  If I was to offer you a way to wipe your face clean, it would not address the real problem which is the hole in your skin.   If I was to offer you something that would help you heal the hole in your skin rapidly you would not have to worry about the blood running down your chin.  Certainly when your penis is bent it gets your attention, but it is not the problem.

I emphasize this point because I believe you are seeing Peyronie's disease as being a curved penis, when it is not.  Peyronie's disease is a soft tissue condition of the penis in which a fibrous plaque of scar tissue develops excessively for some reason (congenital predisposition, nutritional deficiency, trauma, chemical or hormonal imbalance, drug side-effect, or a combination of some or all these) in the tunica albuginea, which in turn prevents the even and symmetrical expansion of the erection and a few other nasty symptoms.

You ask, “Is this something you recommend? To remove the plaque first and then start using the extender after the plaque has been removed?”   The answer is simple:  No.  If you did something to remove the plaque first, you would not need to use an extender because you would not have Peyronie's disease.  With no plaque in the tunica albuginea you would not have a curved penis and there would be no point in using the penis extender unless you are one of those men who believes stretching on the penis will make it bigger – and that is an entirely different topic.

You also ask, “…when the plaque diminished, will it leave an empty area in the flesh, maybe making the curvature worse and the penis shortened?”   The short answer is again, no.   As a longer explanation:  When a pregnant woman delivers a baby, does her abdomen stay stretched out?  When a weight lifter stops exercising, does he develop empty areas and voids where the larger muscle tissue used to be?  When you over-eat and your stomach and abdomen expand and bulge out, does it stay that way permanently?  No, to all of that.  All our body tissues are elastic (even bone to a very minimal degree), allowing the removal of unneeded or foreign tissue cells that are eliminated and healed over in the best way the body can accomplish under the circumstance.   The body always attempts to return to the most efficient and normal state it can whenever and however possible.  In the case of Peyronie's disease the body will attempt to reabsorb the strands of fibrous tissue and heals the tunica albuginea to the best of its ability.  In about half of the men who develop Peyronie's disease this attempt at self-repair and self-healing is successful.  In the approximate other half, the condition is not healed and becomes more or less permanent.

This tendency of the body to always attempt to return to normal (homeostatis), or self-heal, is the basis of the PDI concept for eliminating the Peyronies disease scar. By presenting to the tissue a wide variety of helpful and supporting vitamins, minerals, enzymes, and naturopathic modalities like moist heat applications, DMSO, gentle manual penis stretching (which is vastly different from your mechanical penis stretching concept), ultrasound and acupuncture therapy, we attempt to support, promote, stimulate and accelerate that ability of the body to eliminate the Peyronie's scar that works in 50% of men and fails in the other 50%.  What PDI attempts to do is really not so far fetched or bizarre.  We only attempt to assist and  promote a natural process that is successful in 50% of men when they eliminate their PD scar without any help from anyone.  We are not trying to make pigs fly.  The PDI concept of helping PD correction is one of working with the man who has PD so he can do a better job of what he failed to do in the first place.

Another question you pose is,  “PD is not just having plaque, but also having one side shorter than the other. Ii is then vital to use an extender so the shortest side can catch up the longest side, right?”   You ask that question as though having plaque and having a shortened side of the penis are two separate and distinct problems.  I get the impression you believe that the shortened concave side of penis curvature happens independent of the plaque, when that is not the case.   It is the presence of the dense fibrous scar that shortens the side of the penis in which it is located, and not the other way around.

To solve the problem of Peyronie's disease the body must eliminate the mass of dense fibrous scar in the tunica albuginea.  You cannot eliminate that tissue by stretching or pulling on it.  How do I know that?   Simple laws of physics governing our universe explains why stretching a penis with a PD scar will not influence that mass of inelastic tissue. 

We all have heard the expression many times, “A chain will break at its weakest link.”  We all intuitively understand what that means.   When a stretching or traction force is applied to a series in which there are stronger or stiffer areas as well as weaker or more flexible areas, the weaker or flexible parts or areas will give way, break down, fail or somehow give  up before the stronger parts or stronger areas.   In war: when the enemy attacks, the weaker part of a battle line will give in before the stronger part of a battle line.  Toilet paper and postage stamps: when the paper is pulled the area of paper that has been weakened by the small perforation holes will tear before the non-perforated paper has a chance to tear.  Tires on a car:  the softer the tire, the more it will absorb the vibration energy of a rough ride, and the harder the tire the more it will pass the energy of a rough road to your body.  There are countless examples of the idea that a weaker, thinner or more flexible area will absorb energy before a stronger, thicker or more rigid part is able to do so.  This is why a chain will break at its weakest link.  What does this have to do with Peyronie’s disease?

The PD scar is thicker and stronger than normal skin and corpora cavernosa tissue of a penis. When a traction force is applied to the penis, the normal elastic corpora cavernosa and skin tissue will absorb the energy of the traction force as it stretches out before the inelastic scar tissue has a chance to stretch – the scar will not get a chance to get stretched because the healthy penis tissue will absorb the energy as it stretches first.  Don’t believe me?  Do this experiment.  Find  three rubber bands– two that are thin and stretchy and one that is thicker and heavier than the two thin rubber bands.  Loop these three rubber bands together in a series, placing the two thin stretchy rubber bands at the ends and the thick heavy one in the middle.  Now hold this series of rubber bands at the two ends and pull on it so you are stretching the whole thing out to make them all longer.  Notice that all movement and stretch  is coming from the two thin stretchy rubber bands that are at the ends, and no movement or stretch is taking place in the thick rubber band in the middle.  Only when you stretch so far that the two thin rubber bands are near their breaking point and are ready to snap, will the thick rubber band in the middle begin to move a little.  If you continue to pull, one of the thin bands will break before the thick band has stretched only a small amount.  This will happen every time.  Thus, when you pull on a flaccid penis that has Peyronie’s disease you cannot stretch the thick fibrous scar tissue because the normal elastic skin and deeper corpora cavernosa tissue will absorb the traction force to do all the stretching just like the thick and thin rubber bands looped together.  

In Peyronie's disease any apparent inequality of length is caused by unequal expansion of the corpora cavernosa due to the presence of the dense fibrous scar material within the tunica albuginea. The dense and inelastic scar prevents full expansion of the erect penis, and perhaps only a minor amount of actual contraction of the tunica albuginea.  When I work with men who have been successful in reducing or eliminating the their PD scar material their curved penis returns partially or completely back to normal depending on how much scar elimination occurs.  I am told for some the scar elimination is complete and for others only partial; when I treated my own Peyronie's disease in 2002 it was complete elimination of the PD scar.  No mechanical penis stretching is done and no mechanical penis stretching is needed.  In 2006 a research project was undertaken during which we devised and perfected a gentle manual penis stretching method that works completely unlike and contrary to the concepts presented in the mechanical penis stretchers.  Additionally, I find that lost penis length and girth that occurs is a result of fibrous infiltration of the tunica albuginea and this often improves to the degree the body is successful in its attempt to remove this foreign fibrous tissue, owing to the natural tendency of the body to heal itself when given the opportunity.

Your last question about what Peyronie's treatment plan I recommend for you is the most difficult and also easiest one to answer.   Since I am not your treating doctor I can only advise you as I advise all other men who come looking for help in starting self-treatment.  I suggest you use the largest and most aggressive plan of treatment that you can sustain for at least 3-4months while you follow the PDI concepts of Peyronie's treatment that supports and encourages your body to eliminate this terrible scar material.  If you decide to do so, you might use the gentle manual penis stretching technique as part of that effort.

I appreciate your hard work, earnest effort and sincere desire to rid yourself of your Peyronie's disease.   You are like many men I deal with daily.  I commend you for not accepting your problem and encourage you do all you can to heal your problem.  If I can help you in any way, please let me know.  TRH

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I was injured by rough masturbation, and now I have a bent penis. Will I be able to have sex with my girlfriend?

I am 21 year old and i used to masturbate for the last four years until I developed a bent penis.  My penis head is not covered by skin and its by birth, not from circumcision. About 2 years back i found that masturbating on the bed is more exiting than by hand for me and due to that one day i slightly bent my penis and had a slight pain in the middle of the penis.  But that didn't bother me too much so i masturbated like that regularly.  My question is this now. For the last 6 months that have passed i realized that i was doing it in the wrong way and that i have hurt my penis,  and i discovered I have a bent penis with a bend in the middle of the penis on the left side, but i don't have any pain in erections now.  i used to masturbate with my hands 2 times a week.  There is no difficulty in ejaculation and pain in erection,and yaa doc. One more thing when half erected it bents downward easily and not upward as its tight some time i had seen hour glass shape when its not erect and i m still a virgin, and very upset with my peyronie condition.  Can it become straight again?  Can i be able to have sex ever with my girlfriend?  i am too much depressed. sir plz help me…its very important for me……

Greetings young man,

Rough or unusual masturbation practices can injure the penis, especially when repeated many times, and can lead to Peyronie's disease. Please read I am 19 years old and I need your help with a curved penis after rough masturbation

A bent penis and an hourglass shape indicate you could have Peyronie's disease.  However, your young age, lack of pain, and the fact that you do not mention a lump or knot of tissue under the surface of the penis indicates that you might not have Peyronie's disease at all.  At this time, you are only thinking it is PD, and maybe it is not.  First things first.  You should go see a doctor who specializes in this kind of problem, a urologist, who can tell you definitely one way or the other if you have Peyronie's disease.   

If you have Peyronies disease then you can discuss with the doctor the best way to proceed to help yourself.  At your young age, and having relatively mild symptoms,  I suggest that you be extremely reluctant to allow yourself to be talked into surgery.  It might eventually be necessary, but I would offer to you that it only be done as a last resort after you exhaust all possible conservative Peyronie's treatment measures that would help your body to cure any Peyronie's plaque you might have at this time.      

Many men continue to have sex in spite of having Peyronie's disease, even with a bent penis.  It depends on how badly it is curved and where it affects the penis. All is not lost.  But you need to learn more about this problem and change how you masturbate.  Please read Peyronie's disease and masturbation.

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I suggest that you read and learn about natural ways to help your body eliminate the Peyronie's problem, and reverse your bent penis, if it turns out that is what is going on with you.  Please let me know what you learn and what you decide to do.  TRH   

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Should I continue with pentoxifylline as a Peyronies treatment?

Hi Dr. Herazy,

I have been told by two urologists that I have Peyronie and told to come back in 4 or 6 months. I originally felt a tighter than usual erection and latter felt a lump inside my penis. I can feel this with my thumb and another finger, like a small ball inside the shaft close to the base. I am not sure how long I have has this for. I am not sure for how long a have had the curve upwards. It’s not big and I have asked my wife and she is not sure either. Looking closer I can feel where the bent is. I have had no major trauma etc.

I don’t have pain on erections but have been feeling some itchiness type pain when flaccid. And if I have been sitting for long time, I have felt really uncomfortable tightness beginning from under my scrotum to the top of the base of my penis. I get the sense that it’s where I felt the lump.

I have read that TRENTAL/PENTOX/OXPENTIFYLLINE has helped some people in combination with CoQ10 and have got a script from my GP.  I took a test run today of TRENTAL 400 to check for side effects — none so far.

Should I continue with this?

 

Greetings,

I cannot comment whether you should take pentoxifylline (pentox) or not.  That is a decision you must make for yourself in consideration with the advice offered by your treating doctor.   Ultimately you have to feel confident with your treatment and know that it is right for you, and not just simply do what you are told to do.

To give you some perspective, you might want to consider reading Pentoxifylline, niacin and Peyronie’s disease and Pentoxifylline and Peyronie’s disease treatment.

It is good that you have not experienced any side effects to pentoxifylline, but the real question is if it will help your Peyronie’s disease or not. 

I suggest that you consider using Alternative Medicine in the way that is described on the PDI website.  Let me know if you have any questions in this regard.  TRH

My husband will not see a doctor about his curved penis (we think it is Peyronie’s disease), what should I do?

Avoiding medical care for Peyronie’s disease is common  

Refusal to see a doctor about a bent penis is an unwise but common reaction among men who find themselves dealing with the long-term negative prospects of Peyronie’s disease. The male tendency to be slow about seeking medical attention in general is compounded by the shock and utter disbelief of learning that there is actually a urological medical condition called Peyronie’s disease that undermines the ability to function as a sexual human being.

In Peyronie’s disease the development of fibrous plaque tissue below the surface of the shaft results in a curved penis or some other deformity that reduces or eliminates the ability to engage in sexual intercourse.  Making matters worse it frequently reduces the length and girth of the shaft, as well as weakens the quality of erection.

Take advantage of the fact the body cures Peyronies disease half the time

When a woman looks for helpful information about Peyronie’s disease she can turn to the Peyronie’s Disease Institute woman-to-woman program for a telephone discussion during which our nurse will answer any questions about PD treatment, sexual dysfunction problems or anything that is of interest to a woman when her husband will not help himself.

The proposal that a man can move his status from someone who was not able to eliminate his own Peyronie’s disease to become a member of the 50% group who rid themselves of this affliction is a simple and easy one to understand.  It is based on the observation that about half of the men naturally and spontaneously heal or correct their Peyronie’s disease within the first 12-18 months after onset.

When a man finds that he has not self-corrected or eliminated his Peyronies plaque he still has the option to promote his own recovery.  This can be attempted by an aggressive plan to actively support or increase his natural healing ability using several different natural therapies identified by medical research to assist the removal of the offending fibrous plaque material. To find out more about this process go to “Start Peyronie’s treatment.”

Alternative Medicine offers natural treatment options to Peyronie’s surgery and drugs

Since 2002 the Peyronie’s Disease Institute has developed the concepts, as well as nutritional and external techniques, that proposes any man can follow a program of self-administered Alternative Medicine care in an effort to increase his ability to heal and repair the Peyronie’s plaque.  By focusing multiple therapies to enhance healing potential many men find they can increase their immune response against the soft tissue changes that cause all the outward signs and symptoms that are so deeply disturbing and disruptive to normal male function.

This is good news for any man who realizes that there is indeed a cure for Peyronies disease; half of the time the body will naturally rid – or cure – itself of the internal scar or plaque material that causes all the problems of altered sexual structure and reduced sexual ability without any outside help or intervention. In other words many men just get rid of their own PD without any help.  Using well placed and logical assistance that is guided by research done in this area for the last 40 years, the Peyronie’s Disease Institute finds that it is often worthwhile for a man to simply support his immune system to reduce the foreign fibrous material of Peyronie’s disease in order to support his tendency to eliminate his PD fibrous plaque as happens half of the time.

A woman can help her man in many ways   

Probably as the two of you were going through information on the Internet your husband got stuck on the idea that there is nothing that can be done for PD except Peyronie’s surgery, which the Internet information also reports will be followed by recurrence of the same problem in a few years and the possibility of side effects that are sometimes worse than before the surgery (loss of all sensation, constant pain, impotence).  With the negative atmosphere and bleak prospects for medical care associated with Peyronie’s disease many men feel a natural hesitancy to get started moving in that direction.

A great paradox commonly develops for a couple when they struggle to understand what is happening to them when they are first learn about Peyronie’s disease.  The contradiction is that after getting the diagnosis and learning about the disease that neither of them knew existed, the man is typically motivated by embarrassment and fear of the future to be quiet and introspective while the woman instinctively wants to discuss the problem and explore her feelings with others.   As time goes on and Peyronies exerts its negative influence on their lives, each will be driven deeper into their opposite direction, and each will not understand why their partner is behaving that way.  This makes for increasing tension between the couple while they should be coming closer together to deal with their mutual problem.

The special relationship between a woman and a man is always tested greatly when Peyronies enters the scene.  While not absolutely true, it has been my observation that most couples will find that the many trials and tribulations of Peyronie’s disease and women will cause whatever is good and strong in their relationship to increase and become better, and whatever is troubled and weak in their relationship to deteriorate further.  Peyronie’s disease does not actually create new conflict within a relationship, but only increases and intensifies whatever strength or weakness was present before it arrived on the scene; it acts as a great reference point that amplifies whatever was going on between the couple before its arrival.  It does not have to be that way, but it happens because people are not prepared for what lies ahead.  They are caught so unprepared for the drama that becomes their lives together that the truth of their relationship is not only exposed but it is exaggerated by the emotions that emerge.

During countless talks with PD couples since 2002 it has been observed many times that either a couple is a naturally good problem-solving team, or it is not.   When it is not, and the man and woman do not work together well, it is very difficult for them to develop and practice whatever new personal skills of good communication, tolerance, compassion, forgiveness or whatever assistance might be needed to help their situation.  It takes extra effort and great patience to acquire the skills and ability needed to come together as a team, while at the same time dealing with the harsh realities of Peyronie’s disease.  Just as it might be difficult to learn to swim while being swept away in a flood, it is just as difficult to develop those skills that lead to becoming a solid team if at the same time they are being tossed about while dealing with PD.  Having presented that observation, it should bring comfort to know it is still possible to minimize and perhaps even overcome the negative and destructive forces that develop as a result of Peyronies disease if exceptional effort and honesty are applied.

You can begin to help your husband with his Peyronie’s disease by encouraging him with information that it might be possible to help himself correct his own PD problem as those 50% of men whose internal plaque are naturally eliminated.  Offer this information to him, showing him that there are more options available to him than Peyronie’s surgery.

My husband has Peyronie’s disease, how can I help him?

How women can help men deal with Peyronies disease

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There is a wide range of unique problems that can develop based on the dynamics of special situations within a relationship, especially concerning sex. Even so, there unfortunately also tends to be a list of common problems and pitfalls that most couples must deal with in order to keep their relationship strong and working together well for his eventual recovery.  From this reason the Peyronie’s Disease Institute has a special program in which our staff nurse will consult with and advise any woman who needs help in a program called “Woman to Woman.”  Women can speak to our nurse to ask questions of any sort that deal Peyronie’s disease, from the anatomy, physiology and pathology of PD, to personal relations questions, as well as help in dealing with sexual difficulties.

There are many ways, obvious and not so obvious, a woman can help a man deal with his Peyronie’s disease on a personal basis, in addition to helping with those issues that threaten their life together as a social and sexual couple.  Here are a few ideas that will get you started in the right direction.

It is not just the man with the obvious physical problem that is affected, but Peyronie’s disease and women who deal these men on a daily basis are also distressed and are an integral part of any solution he might need. To really help him requires that his partner does her best to try to understand the strange and stressful thing he is going through with Peyronie’s disease, and forgive him if his behavior and personality have deteriorated under the weight of his burden. More than anything else, much of what is required to help him right now is in the form of emotional support and great acts of kindness by letting go of the hurt feelings that will probably arise.

If a woman really wants to help her man deal with his problem, and wants to protect the bonds of their family unit, she can:

  1. Make a special effort to understand and forgive his moodiness and embarrassment since he has been diagnosed with Peyronie’s disease.  Women commonly notice that a man who previously was confident and eager for sexual contact will suddenly refuse sexual activity, and even hide his body rather than exposing himself to his mate. These temperament changes are usually based on a powerful sense of low self-esteem and deep lack of self-confidence that arises from his lost sense of masculinity.  Many women comment that their husband’s personality has changed so much that he is like a different man.For many men this change is a reflection of how he thinks of himself since the most masculine part of his body has been so flawed that he thinks of it as being taken away from him. He might easily act out in fits of child-like anger.  It is valuable that his mate attempts to be as tolerant of these outbursts, just as she would a child; at these times he is functioning at very primitive and instinctive level of emotional development as a child would.Above all else, he will require more patience and understanding than ever before. This is not to say a man with PD should be given license to be abusive and use ugly behavior, but only that any tolerance that can be afforded to him should be used since it will help to prove to him that he is not being rejected by his mate.  As discussed below, fear of rejection and fear of loss are two of the primary driving forces that most deeply trouble the man with Peyronies.His thinking about the subject of PD is often overridden by his strong emotions, so do not count on him to be logical or mature about this subject.  Think of him as a scared child having a temper tantrum and you will not be too far off; treat him with that same compassion and forgiveness as you would a child when necessary.  You can help him deal with his Peyronie’s disease, but it will most especially help you to understand and deal with him effectively.
  2. Be prepared for him to be down on himself, and to not accept or believe you when you say that his Peyronie’s disease, curved penis and reduced sexual ability are something that you can learn to live with. Be prepared to be rejected when you say that you still love him in spite of his distorted penis.Many men cannot make themselves believe it is true no matter how many times they are told that their physical distortion does not matter, regardless of the sincerity and emotion that is used.  They see themselves as so pathetic and unworthy that they cannot believe any woman could accept them in their reduced state.  Men will push women away in anger when she only reaffirms her love and acceptance.  The more she insists she is not affected by his loss, the more aggravated and lost in denial he can become.  It makes for some very emotionally charged moments.Do not take his anger personally; it is delivered to you because you are standing in front of him, but is really a reflection of his despair and anger with himself.
  3. Over and over, in small and large ways, offer direct and indirect assurance he is still acceptable and attractive to you. His confidence and self-worth can easily be taken to at an all-time low because of the humiliating effects of Peyronie’s disease.  His reduced penis size, erectile dysfunction and penile curvature can cause a man to think less of himself, and he will assume you do the same.  While the physical change of his genitals can be shocking, do your best to respond to him in a way that is as positive and normal as before his Peyronie’s disease started.  The majority of men disbelieve that their spouse is willing to stand by  during his difficult time.  Calm repetition of your acceptance and love is your best ally.

In my work helping men who have Peyronie’s disease I frequently encounter those whose lives have been ruined not just by the emotional effects of a curved penis, but by the women who abandoned them.  Often these problems are avoidable if someone would explain to these women why their men behave in such a bad way, and how little it takes to not only help these men but also help the women to protect what is an otherwise good relationship and keep their families together.

In the case of the women who deal with Peyronie’s disease, trying to understand he is just a scared little boy who is behaving badly because he is scared of losing you.  Treating him with a little compassion can go a long way toward protecting your little boy and your relationship with him.

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Does any Urologist perform a needle aponeurotomy for Peyronies disease?

Needle aponeurotomy for the hand is all I see online. I am a Kaiser Permanente subscriber and even at that, I don't see anywhere online where needle aponeurotomy is performed on a penis…Got any suggestions? Do you know of any Urologist in my medical plan who does needle aponeurotomy for Peyronie?

Sincerely,

Martin Carroll, Jr.

Greetings Martin,

Well, you are certainly an adventurous person. Here you are a layperson and you are thinking outside the box about your Peyronie's treatment, but you are in a risky area. The problem is that this idea of using a needle to tear up the fibrous Peyronie's plaque without having to cut the penis shaft open has already been explored.

As you know, needle aponeurotomy is a type of surgery done on the palm of the hand to surgically reduce the cords that develop in Dupuytren's contracture. It is a less invasive hand surgery performed by inserting a needle under the skin of the palm, and then blindly slashing and tearing at the cords and contracted fascial tissue since the skin is never opened by the surgeon so he/she never actually sees the tissue that is being cut and torn. The purpose of this procedure is an attempt to weaken and reduce the cords that develop under the skin in Dupuytren contracture to the point that the surgeon can eventually break or snap the weakened Dupuytren cords. The recurrence rate of the Dupuytren nodules and cords returning after needle aponeurotomy is fairly high, about a year or two faster than conventional hand surgery. Even though they return after this kind of hand surgery, the real caution and reason many people do not get this surgery is that when the Dupuytrens comes back in that year or two it will come back worse than the first time around. This is common for many of these Dupuytren hand surgeries and a good reason to think long and hard about getting started with the first one.

There are many hand surgeons who are proponents of this technique, and others who are not. No surgical technique is perfect, and they all carry risks. You might want to read more about these drawbacks and apply that thinking to what might happen if that same kind of technique was done for Peyronie's disease.

This same technique in which the tip of a large gauge needle is used as a cutting tool to reduce the Peyronie's plaque while the actual slashing and tearing of the tissue is not directly observed by the doctor who is doing the penis surgery is called the Leriche technique for Peyronie's disease. But it is not called an aponeurotomy because there is no aponeurosis in the shaft of the penis; that is why you were not able to find any information using the terms you were searching. If this surgery for the penis was to be named in a way similar to what is being done in the hand, it might a name like Needle Tunicotomy. This term would be applicable because it is the tunica albuginea of the penis that would be surgically cut by the needle tip and left in place, just as it is the aponeurosis of the palm that is cut with the needle in Dupuytren's contracture. You will not find this term anywhere but here because I coined it. to read more about this procedure, click on “Leriche technique for Peyronie's surgery.”

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There are many more conservative ways of trying to correct your Peyronie's disease than having the internal scar blindly being cut to shreds. I suggest you consider avoiding that kind of risk and look at some of the less risky non-invasive Alternative Medicine options that are on the PDI website. TRH

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Is there anything I can do to help my husband recover from Peyronie’s disease?

Any woman can help and support his effort to reduce Peyronies disease in several ways

There obvious and not so obvious, direct and indirect, ways a woman can help the man in her life to deal with his problems of Peyronie’s disease not only on a personal treatment basis, but also by supporting and assisting with those personal matters that threaten their relationship as a social and sexual couple.

It goes without saying that the obvious physical problems of a curved penis, reduced length and girth, and erectile dysfunction that are part of Peyronie’s disease directly affect the man who has this condition.  But the woman in a relationship with such a man is in a critical position because of their personal relationship to help him deal with the many negative aspects of Peyronie’s disease, and so can provide an integral part of any solution he might need.  Her role begins by understanding and accepting that he is going through a strange and stressful event for which no man is ever prepared.  Throughout a woman’s life, even before her teen years, she is talked to and prepared for changes in her reproductive system; she discusses these events that affect her genital area with her mother and perhaps her sisters and girlfriends who also experience these changes; she even goes to a special kind of doctor, a gynecologist, who specializes just in the female reproductive system; each month she is reminded that her pelvic region does unusual things; if she becomes pregnant she soon overcomes her modesty and privacy about this area of her body.  A man does not ever experience anything remotely like that.  His genitals are his prized masculine region, but they are private.  For the most part his reproductive area is uneventful and is not discussed much – except if he develops Peyronie’s disease.

For these reasons he has been completely unprepared by his past experiences to deal with  suddenly learning that there is a problem he has never heard of before, called Peyronie’s disease, that jeopardizes his ability to engage in sexual intercourse and denies him the act that defines manhood to him.   For a man Peyronie’s disease is perhaps not so much experienced as a health problem in which fibrous plaque material develops internally within the penis, but more so it is felt to be a loss of what makes him a man.  The woman who must deal with her man’s Peyronies problem must see this condition as a great emotional issue for him and be prepared to forgive him if his temperament and mood suffers while he comes to grips with his curved penis that no longer works as it once did.

He will benefit greatly from his mate’s emotional support and patience, and her ability to forgive him while he wrestles with the fears that are connected to Peyronie’s disease. Probably his biggest fear is the losing you because of his reduced sexual ability; no longer being able to provide you the pleasure of sexual intercourse, that you will leave him for someone else. He fears that he will never experience regain the pleasure of traditional sexual satisfaction. He fears that if you do leave him he will never be able to develop a relationship with another woman, and he will be alone in life. He fears being pitied and ridiculed as the man with the deformed and shrunken penis. He fears feeling like less of a man.  It is not really the physical aspects of Peyronie’s disease that drives a man into despair, it is being unprepared for the emotional isolation he feels.  More than ever he needs you but he feels ashamed and embarrassed to be with you, adding to the torment he feels.

From the combination of physical, emotional and sexual problems related to Peyronie’s disease comes a list of common problems and pitfalls that happen to most couples. Since the man with Peyronie’s disease will often shut down emotionally and a state of denial, totally ignoring his problem, the burden to actively learn about and reach out for help will fall to the woman in that relationship. From this reason the Peyronie’s Disease Institute has developed  a special program in which our staff nurse can consult with and advise a woman who needs help dealing with any aspect of Peyronie’s disease.  During a friendly phone call our nurse will answer questions of any sort about Peyronie’s disease (male and female anatomy, sexual difficulties, personal relationship problems, treatment options, or anything else that is on her mind).

Here are a few ideas to consider to help him deal with his penile problems and to protect the bonds of your family:

  1. Continue your usual sex life if at all possible, limiting traditional intercourse only to the extent that his curved penis prevents it.  In case you believe that you cannot any longer engage in intercourse, please know that there are many techniques and ideas that can help you allow entry and increase your ability for traditional sexual intercourse. Few couples are as limited in their ability to engage in intercourse as they assume; usually all they need are some basic ideas and simple instruction. This is such an important topic; please refer to my second book that covers many aspects of this topic at great detail and length, “Peyronie’s Disease and Sex.”
  2. An important aspect of Alternative Medicine treatment of PD is the PDI diet to assist recovery from Peyronies.   This subject is covered in detail in chapter 5 of “Peyronie’s Disease Handbook.”  You can assist his recovery greatly if you can coach him through these dietary ideas, and make it easier to follow if you incorporate these principles into your lifestyle for the time being.
  3. Moral support at this time is crucial.  You will help him, and help yourself as well, if you can offer him encouragement and praise during these rough times.  You will prove your loyalty and earn his admiration and respect when you demonstrate you are not a fair weather friend.  Men commonly refer to their time dealing with Peyronie’s disease as the lowest point of their lives, feeling alone and depressed, offering them all the excuse needed to behave badly.  Just because a man is acting like a jerk does not mean he does not know he is acting like a jerk; he knows his behavior is bad; he just does not care to control his primitive emotions of the moment. This is the time a man needs a friend to offer support and a trusting heart.  Even though he might push you away out of embarrassment and self-consciousness for his reduced physical state, he will soon recognize your acts of steadfast friendship and tolerance as proof you are not going to reject him.  Once he is confident you are not going to run away because of his sexual problems, your man will come around to his old self (and probably better) because you will have proven your love for him to an even greater level than he knew before.  This is how your relationship will grow under the adversity of Peyronie’s disease, by showing your strength and loyalty to him no matter what happens.
  4. Be tolerant and understanding about his reduced sexual interest and flawed sexual ability.  Both of you are afraid of what will happen in the future regarding your sex life together.  The way to make our fears become a reality is to place a lot of pressure on his sexual performance.  Easy does it.  As discussed at length in “Peyronie’s Disease and Sex,” we find that most couples can actually engage in sexual intercourse for a far longer time than they imagine, but stop only because the do not know how to solve get around some of the difficulties of gaining entry with a bent penis; this book explains how to be successful with sex using a curved penis than you could imagine.  In the early stages of Peyronies it is most valuable to continue traditional intercourse for as long as possible.  It is not necessary to stop sexual activity as long as no pain occurs for either partner.  Engaging in sexual activity is good for the physical and emotional health of both partners, as well as beneficial for your personal relationship.  Sex can be the all-important emotional glue that keeps you together, so use sex liberally since PD is really all about sex when you think about it.  If you reduce sexual activity at this time it will only confirm his worse fear that you are no longer interested in him as a sexual person. If traditional sexual intercourse turns out to not be possible due to his curved penis it is necessary to explore, expand and use a greater variety non-intercourse sexual activities and techniques, with the hands, lips and whatever else is mutually agreeable to you as a couple.  Your previous thinking and attitude about sexual activity might have to change to satisfy your unfulfilled physical needs for intimacy.  With an open and honest dialogue you can work these things out.  Again, your helpful and willing approach to sexual problem solving and cooperation only proves your place in his heart as the best possible partner he can have.

Many of the conflicts and stresses a couple goes through when Peyronie’s disease enters their lives are avoidable.  A little understanding, a few suggestions about altered sex techniques, the man having the woman’s side explained to him, the woman having the man’s side explained to her, reading the positive and informative books that are available from the Peyronie’s Disease Institute, and starting an aggressive Alternative Medicine treatment plan to increase his ability to heal and repair the Peyronies plaque can do wonders to reduce stress and misunderstanding between people dealing with Peyronie’s disease.

If the woman would keep in mind that her man with Peyronie’s disease is very much like a scared little boy who is behaving badly because he is scared of losing you, and treat him accordingly, things would improve greatly. With understanding, love and a little compassion you can help that little boy know you are not going to leave him and you will protect your relationship with him.

Connection between dental problems and Peyronie’s disease?

Dr. Herazy- I have had bad health for the last four years and have developed peyronie the last year and a half.
I have had a cough-skin problems-fatigue etc. I have been getting better and think that most of my issues were related to terrible dental infections. I have had 10 teeth pulled in the last year and they all were black/green below the gum line.

I am also getting three more pulled monday.

Could have caused my peyronies?

 

Greetings,

Sorry to hear of your recent health problems.   Glad you are taking care of yourself and getting better.

The only remote connection between your dental infections and Peyronies disease might possibly be related to some drug reaction from the combination of different medications I assume you were prescribed over the last few years.  I suppose there is always the possibly that your depleted immune system  might have allowed this genetic problem to get out of hand.   Otherwise I am not aware of an direct relationship that might have allowed this problem to develop.

Good luck to you.   TRH

Should I get my hopes up about Xiaflex for Peyronies and Dupuytrens?

I've been reading that Xiaflex (used for Dupuytren's contracture) was tested for Peyronie's disease with pretty successful results and could be on the market as early as this year.  Should i get my hopes up?  Is this worth being excited about?

Greetings,

I am hearing more and more about nasty side effects and bad reactions from Xiaflex injections for Dupuytren contracture.  I think this is – or should be – the reason that Xiaflex has not been given fast approval for Peyronie's treatment.  I hate to think of what might happen if Xiaflex begins dissolving normal soft tissue structures in the penis as it sometimes does in the hand. 

From the tone of your email I get the sense that you are genuinely hopeful about Xiaflex might do for you, because you feel so helpless against Peyronie's disease.  Most men feel this way. You can get your hopes up, and you can get excited about it, if you wish.  Many people are sitting around waiting for a medical miracle cure while their lives slip away with a curved penis or useless hands.  They have the attitude that if there is no drug to save them, there is nothing to help them because the body cannot do anything against Peyronies disease or Dupuytren contracture.  Personally, I do not accept that line of thought.  I have seen too many people injured by drugs, like Xiaflex, and helped by Alternative Medicine. 

I believe a far more rational and safe approach to treating these two problems, and many others, is to first attempt more conservative treatment using a wide variety of simultaneous Alternative Medicine treatment methods.   Only after exhausting all possible conservative options would I remotely consider taking the calculated risk of a drug like Xiaflex.   The tone of your question suggests to me that you are not aware of, or even considering, the possible harm that can be done with a drug like Xiaflex.  

Many new drugs come on the market each year because of glowing reports and spectacular enthusiasm for the wonderful research results.  The new drug is highly advertised and heavily used for a while.  Then slowly and quietly new information comes out that bad things are happening to those who take this new wonder drug.  Even more quietly the drug is removed from the market a year or two later.  How many times have you heard that same story played out over and over?  High hopes based on questionable research, people hurt, drug withdrawal, many lawsuits. 

Why do we see so many TV commercials from lawyers who are trying to sue the pants off these drug makers?  The legal profession has created this large industry for themselves because there are so many bad drugs on the market and so many people who are injured, that lawyers can profit from this misfortune.  What should that tell you?  The lawyers are not making this stuff up.  They are just taking advantage of the huge opportunity they are given by bad drugs and injured people. 

Fact:  The U.S. is the heaviest user of drugs and surgery.  Fact: The U.S. is ranked about the 16th healthiest nation in the world, and we die at an earlier age, behind 15 other countries that take fewer drugs and use less surgery than we do.  If the use of drugs and surgery leads to health and long life, we should live the longest and be the healthiest country and we are not.  What does that tell you?

Sure, there are good drugs and not all drugs are bad.  But you must be extremely careful how you go about using them.  Xiaflex might help you, I cannot say one way or the other.  In my opinion, if you are going to use Xiaflex it should be the last thing you do, not the first thing.  You should certainly talk to your doctor about your decision and educate yourself to the best level you can.How you approach the treatment of your problem is your decision.  TRH 

Common Peyronie Treatment Problem

Peyronie treatment when husband does not help

A few weeks ago I received an email from a woman who wrote about the trouble she was having with her husband who did not want to cooperate with his Peyronie's treatment:

“My husband of 22 years developed a severely curved penis when his Peyronie problem started after taking blood pressure medicine.  The doctor who prescribed the drug that started this whole mess didn’t seem too upset.  He said we would just have to learn to live with it.

“My husband is a proud man, and he is taking this condition very badly.  He has withdrawn from me and refuses to discuss his condition.   He gets angry and shouts if I bring it up.  We have not had sex in over a year.  He keeps telling me it would be alright with him if I left him.

“What can I do to help him deal with this?”

I wrote back to her:

“Sorry to learn that your husband has withdrawn from his problem and from you.  It is important for you as a wife to remember that your husband’s reaction is very common.  Some men become emotionally devastated by the loss of their sexual ability and sexual identity that they just withdraw from the person they think they are hurting.  There are usually elements of shame and embarrassment that arise from the physical appearance of a severe penile curvature.  It can be very stressful and confusing for a woman in this situation who desperately wants to help.  It can hurt a lot.

“This subject is broad and deep.  In fact, because it is so common and important in Peyronie treatment I devoted a considerable portion of the 2nd book I wrote to this area of the relationship of any couple dealing with Peyronie's disease.  I suggest you go to the PDI website and order the book, “Peyronie’s Disease and Sex” to learn what you can do to help your husband, because there is actually a lot you can do.  To view information about this book, click “Peyronie’s Disease and Sex”    What you will find is that his inability to face his PD problem, his lack of communication with you, and his withdrawal from sexual contact are all related to fear and shame.  I believe this book will help you to understand what is going on inside him, and what you can do now to bridge the gap between you.

“Please let me know if you have any specific questions I can assist you with.”

Well, I never did hear back from that woman.  The story is very common in which a grown man behaves like a scared little boy when his physical appearance and masculinity are threatened.  It is unfortunate that some marriages get stronger under this stress, while others fall apart under this dark cloud.   There is help and a solid plan of action that many men find comforting and effective to treat their Peyronie problem.

The key seems to be for a woman to convince her spouse to get started with Peyronie’s treatment.  Once a man finds direction and takes control of his situation his attitude and behavior often change for the better.  Don’t allow your man to feel like a Peyronie victim.

Peyronie’s desease

Peyronie's disease misspelled commonly – Peyronie's desease

Peyronies disease is commonly misspelled as Peyronie's desease. There is so much basic information that people lack concerning this problem that even the name is confusing to some. Other than Peyronies desease, the most common way I find people referring to this problem is to shorten the name and avoid the apostrophe and just call it peyronies, without even capitalizing the first letter, and peyronie, by dropping the final letter altogether.

Just as a basic review, it is important to know that Peyronie's disease is most well known for the Peyronie's plaque or deposit of fibrous tissue (also called a scar) that develops within the deeper layers of tissue of the penis.  This fibrous material often, but not always, will cause a Peyronie's curved penis and pain in the penis.

This Peyronie’s plaque or scar material itself is benign, meaning it is always non-cancerous. It is a common fear among men when first learning they have Peyronies desease to wonder if it could develop later to become something more serious.  This is not the case.  You can rest assured that Peyronie’s disease will not develop or progress into a worse or life-threatening condition – Peyronie’s disease is bad enough.  It does not need any help to make a person’s life miserable all on its own.

Peyronie's disease typically occurs in men around their mid-50s, however,  even teenagers can develop it.  The cause of Peyronie's disease and its natural progression or development are not well understood because the course of the disease is so variable.  In my experience while researching Peyronie’s desease and in discussion with hundred’s of men every years concerning all aspects of this problem, it is rare to find two cases that share a remotely similar history or course; each case is unique in small and large ways.  This great variability is what makes this condition so difficult to diagnose, treat, and live with.  While many researchers believe the Peyronie’s plaque often develops in response to some type of trauma, either minor or significant, that results in localized bleeding within the internal tissue of the penis.

Sexual problems associated with Peyronie’s desease can also be variable, since there are such physical and emotional differences among couples, to say nothing of the variability of sociological factors that also can disrupt a couple's physical and a stressful emotional relationship. The goal of Alternative Medicine Peyronie’s treatment is to keep a man and woman who deal with this problem as happy and whole as possible.   Peyronie's disease surely affects all the people whose life it enters, even if you happen to spell it Peyronie’s desease.