I continued jelqing for months even though my penile curvature was getting worse and now I might have Peyronie's disease

Dr. Herazy,   Firstly, I would like to thank you and this community for even being here to help those who suffer with penile curvature.  Finding information online regarding Peyronie's disease has been very tricky and even an anxious affair due to the condition's unnecessarily embarrassing nature. Anyway, a little background: I am a 23-year-old male who has had a healthy sex life for the last seven years. While dating my previous girlfriend, we had some bouts with sexual difficulty, mostly on her end due to numerous urinary tract infections and her mental condition; she has been on anti-anxiety and antidepressants for some years now. This made her very self-conscious during sex and, admittedly, other factors like privacy created tension. I have never experienced this before and thought something was wrong with me, and for some stupid reason, I wondered if my penis was somehow inadequate. So, I looked into enhancement options and discovered the murky world of jelqing and stretching.

I followed the exercise regiment very closely, with my workouts beginning in February of 2012 and ending at the end of October of 2012. I made sure to warm up every time with a hot wrap and never pushed myself too far, or so I thought. I discovered that my penis grew in length and girth, going from about 5.5 inches erect to 6.5 inches; flaccid, my penis has always been about one inch, no joke. Now, it is usually two but often three inches in length when totally flaccid. My ex at the time noticed it and was shocked I managed to change the size and shape of my penis. I was taking L-Arginine, L-Lysine, and Zinc on my workout days, including Pygeum Africanum, Lecithin, Flaxseed Oil, Fish Oil, Super B Complex, and a solid Multivitamin. But during the last week of October, after we had broken up, I think I went too hard and stretched too far, feeling an uneasy sensation in my penis. It's important to note that I had noticed the progression of a curve for months preceding this but with no pain. It is also important to note that I have always had a slight curve to the left, as several photos taken years ago prove.

Anyway, after this weird feeling from stretching, I finished my workout and decided to take some days off. But the pain got worse and I noticed a small bruise/discoloration and what appeared to be a reddish stretch mark running about two inches on my penis. So, I scheduled an appointment to see a urologist. I saw him and he said I essentially “sprained” something or caused a microtear near the glans of my penis. He told me to abstain from sexual activity for six to eight weeks. He didn't feel any plaque and said that he couldn't diagnosis Peyronie's because there wasn't significant curvature or plaque. While I didn't exactly abstain as much as I should have, I did mostly stop masturbating for weeks on end.

The pain is now completely gone but the discoloration and stretch mark (maybe inflamed vein) are still there, though they seem to have faded a bit. I am now living in Chicago and have scheduled an appointment with Dr. Levine for March 1st. I need some kind of closure on this; I need to know if I have to start treatment or maybe I just have a congenital curvature. The curve hasn't increased since my injury and, as stated above, I noticed the enhanced penile curvature while flaccid months before my injury. While erect, there's not much of a difference between the way my penis looks now and a few years ago when I was sixteen. The only difference is the discoloration/bruise, stretch mark/inflamed vein, and a bigger, more curved flaccid penis.

I am currently taking a Multivitamin, L-Arginine, CoQ-10, Acetyl L-Carnitine, and Vitamin E. I also was using Bio-Oil and Cocoa Butter, but have cut back significantly; I liked how smooth it made my unit feel. I have continued sexual activity with no pain and no loss of erectile function. Based on what you all know and what I have told you, can you point me in the right direction? Can you give me advice? My current girlfriend and ex have been very supportive through all of this, including my brother, best friend, and mother. I just want some kind of pointers and opinions; it can be quite suffocating with everyone telling you “you're going to be fine” or “you're overreacting.” This is a serious condition and I am not sure where to turn. Dr. Levine has me scheduled for an ultrasound the morning of our appointment so he can check it out before meeting with me. I seriously hope there is no scar tissue or, if there is, it is something I can deal with. I have grown fond of my curved flaccid penis and don't mind it; life is too short to dwell and panic about these things as long as I can have a functional sex life. Please. And thanks in advance for reading my story and any opinions. It means a lot!

Greetings,

Thank you for your detailed report and  insightful commentary concerning your experience with jelqing and penis stretching.

In many posts I have written about the dangers of forced penis stretching: for example please see I think I have Peyronie’s disease from jelqing. What should I do?  Too many men take a cavalier attitude about remodeling their penis to Adonis proportions.  The websites that sell the books and tapes attempt to support the idea that all problems of low self-esteem and difficulty with female relationships will simply disappear with a sausage-like member tucked in below the belt.  Life is perfect for men who have an unusually large penis.  They do not discuss the many problems and tragedies that occur with these strategies of forced stretching.  The jelqing websites try to create the idea that the penis can be squeezed and molded like a slab of clay can be tugged and strangled into an exaggerated size to please a lady or gratify a weak ego.  When penis tissue is taken forcefully and repeatedly beyond a certain point of limitation it will suddenly fail.

At this point you can only be certain that you have a bruise or micro-tear of the external tissue of the shaft.  You might be one of the luckiest guys in the world to only have a superficial injury, and not a deeper problem in the shaft at the level of the tunica albuginea; if it turns out that you have injured the tunica you are perhaps a step closer to having a case of Peyronie's disease.  Even so, with injury to the tunica and an early case of Peyronies to deal with, about half of these cases repair or reverse on their own without outside intervention – spontaneous recovery is the medical term for self healing. This is mentioned so that you can appreciate the gravity of what you have done and the position you are in at the moment.  

When you wrote that you “…  never pushed myself too far, or so I thought,”  you made a critical point about jelqing that gets to the heart of the craziness about this brutal practice. Did you ever watch a movie in which the bomb squad is called for help to defuse or take apart a complicated explosive device?  The tension and drama of those scenes where the bomb wires are being cut is based on the person never knowing if he is cutting the correct wire or in the correct sequence until it is too late.  The trick of taking apart the bomb is that you can be doing it correctly when everything is going well, until the moment you make a mistake and the bomb and you blow up.  Jelqing is not much different.  You can think you are doing it correctly and safely, until you make a mistake and injure your penis to cause a problem like Peyronie's disease.  Who knows how far to go until after you have gone too far?  Who knows how hard to squeeze and stretch, until after you have squeezed and stretched too much?  Everything can go well until after everything does badly, when the whole jelqing idea blows up in your face.

Based upon what you have written, I suspect that you have injured yourself enough to have caused Peyronie's disease.  I am lead to this conclusion by your statement, “… I had noticed the progression of a curve for months preceding this but with no pain. “  By this you say that for months your penis was becoming curved and yet you continued to jelq for months.   Since I have not examined you I can only speculate, although you will learn in time if I am correct or not.  I further suspect that you do not have at this time a curved penis when erect only because your condition is still too early and you are in the stage where the plaque has not yet formed the telltale Peyronie's scar that is far more capable of causing penile curvature.  Further based upon what you have written, “While I didn't exactly abstain as much as I should have, I did mostly stop masturbating for weeks on end, ” even when the doctor told you to abstain from sexual activity you did not.  Not only did you not stop having intercourse, you only reduced masturbating. You need to read a bit about the subject of hedonism.   

If you do not develop Peyronie's disease as a result of your immaturity and lack of self-respect, and I hope you do not, it will be a miracle.  Please try to use this experience as a way to learn something not only to learn about the dangers of jelqing and Peyronie's disease, but more so to learn about yourself and what aspects of your personality are in need of growth and maturity.

If it does turn out that you have an incipient case of Peyronie's disease, please consider that there is much you can do to assist your body to heal and repair the problem.  If half of the men who develop Peyronie's disease eventually heal it on their own without assistance and their penile curvature goes away on its own, there is the possibility you can assist your recovery over Peyronie's disease  by using information found on the PDI website.

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Good luck to you, sir.

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Is it possibile for Viagra, or any other medication, to cause Peyronie disease?

Is anyone doing research on the possibility of Viagra causing Peyronie disease or any other type of medication causing this disease?  Mine seems to have started after I took Viagra . Thank you,  Floyd Mathis

 

Greetings Floyd,

Sorry to hear of your problem with Peyronie's disease.

Yes, there is growing evidence that Viagra, Cialis and Levitra (all the PDE5 inhibitor drugs) can cause Peyronie's disease in some men.  I have reported this and written about this observation for many years now.  You can read more about this topic in these posts from the PDI website:  Viagra Peyronie's disease connection and Viagra, Cialis and Levitra Use with Peyronie’s Disease and Peyronie’s Disease Plaque, Viagra, Cialis, Levitra, and Blood Supply .  There are more articles that are available but I think you will get the idea from these. 

The basic way the injury happens that leads to the start of Peyronie's disease is from "over inflation" that damages the internal tissue of the penis called the tunica albuginea.

I was talking to a man the other day from Australia whose PD started from just a single use of one of these PDE5 drugs. He told me that he developed an erection that was so hard and large that he was scared what might happen to him.  He said he thought he might explode.  Obviously that was the last and only time he took any drug like that.  About two months later he had three internal Peyronie's plaques and a curved penis of 45 degrees.  Because he did not have any sexual activity for months before that event or after it he is positive it was the drug that injured him. 

He went to his medical doctor who told him that this sometimes happens to men.  You will notice that there is a caution on inside drug product information that warns that men with PD should not use these PDE5 drugs.  

What strikes me as especially careless and inappropriate is that there are medical doctors who actually prescribe Viagra, Cialis and Levitra to men who already have Peyronie's disease to help them have an erection when they show signs of erectile dysfunction.

Yes, there are other drugs that are said to be associated with or to cause Peyronie's disease.  The common list includes beta blockers used for heart problems and all of the statin drugs used to lower cholesterol.    

I suggest that you review some of the Alternative Medicine treatment ideas on the PDI website to learn how you can use Peyronie's natural treatment to help yourself correct this problem.  Please let me know if there is anything I can do to help you.  TRH 

Will this surgery work to correct my Peyronie’s disease?

I have peyronies a year and a half now with a 45 degree bend when erect.i have consulted my doctor.i have seen a surgeon and I am not satisfied with his straightening method.he just wants to put a slit in it and sew it back.i don't believe this would would work.i need a second opinion.i am on medical card and live in county roscommon in the west region of Ireland. i need a surgeon who is prepared to carry out the full and proper treatment I would be very thankful for your assistance doctor and advice.i am only 39 and this is ruining my relationships and I am depressed. please help me.


Greetings,

Are you sure you heard and understood everything that was told to you about this penis surgery?

I cannot directly comment about what your surgeon explained about the Peyronie's surgery he or she proposed because I was not there to hear the explanation you were given, and you were. However, as I understand penis surgery to correct a penile curvature caused by PD, the typical procedure is much more complex than simply putting a slit in the shaft and closing it up.  

If you are positive you were given this exact explanation, I suggest you contact another urology surgeon who will take your case more seriously for a second opinion.  Using the information that follows I propose that this next time around you be prepared to ask many questions and demand answers.  You should fully understand what is being proposed to you so you can make an intelligent and informed decision.  I also suggest that you spend some time on the Peyronie's Disease Institute website to learn about the possibility of using non-drug and non-surgical treatment to increase your ability to eliminate the Peyronie's plaque naturally.

I am sensitive to what you are asking and I understand your concern about penis surgery.  However, I have no way to know what is the full and proper surgical treatment for your particular problem, and frankly neither do you.  Something as vitally important and final as surgery requires a great deal of trust in the skill and competence of the surgeon in an area that a layperson does not have enough knowledge or skill to judge what needs to be done. Having said that, I think you might be correct to want to talk to another surgeon if only because it is not correct or proper that you were allowed to leave that office without a better understanding of the proposed surgery.  In my opinion, a half-hearted explanation is no explanation, and does not bode well for the kind of surgery that a doctor like that would provide.

There is always the possibility you misunderstood what was explained to you, but it is still the responsibility of the doctor to make sure you do fully understand so you can give informed consent to a surgical procedure.  There is also the possibility the doctor did not want to give you all the (somewhat gruesome) details of the surgery, since it might scare off someone with a squeamish stomach. Another possibility is that the doctor simply did not want to take the time from a busy office schedule to explain what would happen in the proposed surgery.  It has been my observation that many times a surgeon will greatly limit or modify the truth about some aspect of a proposed surgery (risks, chances for recurrence, changes for failure, degree or frequency of complications or side effects) so that the patient is more inclined to accept the idea of the surgery, and agree to have the surgery done.  It is somewhat of a "selling job" that is done.  It is not appropriate, it is not correct, and it is not legal, but it is done.  Perhaps something like this happened in your case.  Whatever was the reason that you thought the doctor was going to "put a slit in it and sew it back," it is the fault of the doctor for that notion and possible misunderstanding to remain.

More than likely, and I could be completely wrong since I was not there, the doctor proposed to do a Nesbit procedure for your curved penis.

For the most men the Nesbit procedure is the most common, easiest and most direct way that a surgeon can address the penile curvature of  Peyronie’s disease. However, it causes shortening of the erect penis by 2.5 to 6 cm (one to two and a half inches), and this is the greatest drawback of it.  The operation is performed under a general anesthetic and takes 40 to 60 minutes.  Men usually go home the day after surgery, or even the same day.

Basically, in the Nesbit operation the main idea is to make an elliptical incision to remove some of the shaft tissue and tunica albuginea from the long side of the bent penis (on the side opposite the inner curve of the bend), in an effort to straighten the curvature.  This tissue removal is responsible for the overall effect of penis shortening when the long side is reduced. The rule of thumb is that for every 25-30 degree of curvature that is present, a loss of approximately 1 to 1.5cm penis (about half to one inch) length at erection will occur.

An incision is made all the way around the shaft, a few millimeters behind the edge of the head (glans) of the penis.  The cut skin of the penis is rolled back down (like rolling or peeling your socks down off your leg), exposing the two corpora cavernosae so the one corpora cavernosa that is opposite the bend and the Peyronie's plaque can be shortened.  This is done by either removing tissue of the corpora with removal using an elliptical incision or simply by drawing it tighter with internal stitches.  After this is done the foreskin usually has to be shortened also so that it matches the new shorter length of the penis.  As in any operation, infection of the incision lines can be a problem and the foreskin, if left behind, sometimes becomes swollen after surgery; for this reason many surgeons will also perform a complete circumcision to prevent this complication. Otherwise direct surgical complications are not common, but occasional to infrequent side effects after surgery of erectile dysfunction, permanent numbness and penile pain can occur.

Hopefully, this explanation of the Nesbit procedure is helpful.  Keep in mind that this is the simplest Peyronie's surgery.  You can see Peyronie's surgery is a lot more complex than what you thought.  TRH

Does this sound like Peyronie's disease to you?

Hi Dr. Herazy,

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I’m glad to have found your site. I recently was diagnosed with Peyronie’s disease after having gone through numerous urologists who were stumped as to what the issue was. My initial symptoms were pain and swelling of the glans specifically the coronal ridge. This ridge now appears more pronounced than before and although I no longer feel soreness I have the sensation of the glans feeling separate from the shaft. Soon after I noticed a dent on the underside of the shaft right below my glans which is only noticeable when erect. This area also feels somewhat numb to touch. My glans also do not get as hard as before I had this dent. My urologist mentioned a “distal neurovascular bundle” which is obstructing and preventing blood staying in the head.

Have you come across such a dent accompanied by soft glans and what is the likelihood of this being permanent damage?

Suffice to say this has caused tremendous stress however I am optimistic that the body given the right conditions and support can heal almost anything.

I appreciate any comments or advice you may have regarding this matter,

Chris

Greetings Chris,

From the limited information I would say you have at best a Peyronie's-like condition. Peyronie's disease is not associated with a neurovascular bundle, but a formation of collagen and other cellular components within the tunica albuginea tissue layer of the shaft. Numbness, glans swelling, glans softness and ridge formation are not part of the Peyronie's picture. While an indentation does sometimes occur with Peyronies I think this is perhaps more of a coincidence of a similar phenomenon and does not offer sufficient support for the diagnosis you say you were given. Perhaps you misunderstood?

Keep in mind I did not examine you, and the others did see your problem, so my opinion is of limited value. But still this diagnosis does not add up to me. Further, you say that several urologists were at a loss to determine the nature of your problem. Perhaps this is just what you were told so that they were off the hook to give you a diagnosis.

From my experience it is common that when several specialists get involved in a problem like yours, it is common for them all to be more concerned about not offending each other or being guilty of contradicting anyone that the patient is often forgotten. I say see another specialist and do not tell him anything about the other doctors so that this next opinion is more honest. TRH

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Is it beneficial to achieve erection and masturbate in the early stages of Peyronies disease?

Dr. Herazy,

I spoke with you on the phone this evening, Friday May 11th.  I sincerely thank you for taking the time to talk with me.  Much appreciated.  I will be ordering your book as my first step.

If I operate under the assumption that my situation is in fact Peyronie's disease, it would be safe to assume since my symptoms of curvature and pain started about a month ago that I am in the initial stages of the syndrome.   I have two questions for you:

1. Is it beneficial to achieve erection and masturbate in this stage? My thought is that this may have some benefit in protecting from scarring, similar to prescribed rehab after a knee surgery. In that example the patient manipulates the joint frequently to break up formed and forming scar tissue. Would this be useful?

2. Do you recommend or discourage the use of Viagra and the other similar drugs in this period?  Could they help or hurt healing?

Thanks again for your time.  I will keep you posted!

R. Brown

 

Greetings R.

As you recall, I mentioned that there are often many irregularities and inconsistencies in the way Peyronies disease will present itself; it is rare to find someone with a classic text book presentation.  Since your particular symptoms and history does not strongly suggest that you have PD, and only a few a small part that does, I suggest you consult with a second urologist to confirm one way or the other your actual diagnosis. 

That masturbation might be beneficial for Peyronies' disease because exercise of joint after surgery is a standard therapy, is a flawed comparison.  What you are proposing would not be much different than watching movies after eye surgery, smelling flowers after nose surgery or listening to music after ear surgery.   In Peyronie's disease the lesion or problematic tissue is relatively passive or non-functional relative to sexual activity.  Even though  it is obviously the  primary structure that is involved in sexual activity and it certainly gets involved, in my opinion there is limited and minimal direct therapeutic benefit to masturbation for Peyronie's disease.   Having said that I think there is considerable secondary or indirect benefit.   Masturbation is helpful not only from an emotional basis, but also due to the increased blood circulation that occurs during any type of sexual activity.   I doubt that frequent or occasional masturbation would make a great difference to your eventual recovery, one way or the other, but if it feels good and it benefits you even a small amount then that is probably reason enough to do it. 

While exercise to rehabilitate a damaged joint and weak muscles are obviously appropriate and necessary therapy for a bony articulation that is meant to move and muscles that are meant to contract, none of this applies to the corpora cavernosa, corpora spongiosum or tunica albuginea of the penile shaft. 

If I have not stated the point clearly enough, allow me another round at it.  While there might be small and indirect benefit to masturbation if you have any stage of Peyronie's disease, I am sure the direct therapeutic benefit is only minimal.  I get the sense from your question that you had the idea you could "masturbate your way out of PD."   To the extent this is what you had hoped, the answer is no.    

All sexual activity, especially masturbation,  for a man with Peyronie's disease should be gentle, easy and non-traumatic in every way possible.  A critical part of being as gentle and easy on yourself  is to use an above average amount of personal lubrication to avoid abuse to the involved tissue.  Easy does it.  If it hurts, even a little, stop doing and never repeat whatever does not feel pleasant to you.  One of the worse things you can do for yourself would be to reduce or alter your usual and customary sexual activity simply because you have Peyronie's disease.  Many men do this, and it sets up an attitude of defeat and hopelessness that is not beneficial for eventual recover.   Go at it, sir, but be careful.

I can tell you a long list of sad stories related to me by teenage boys who developed Peyronies after injuring themselves while using rough and exotic masturbation practices; more 14 and 15 year old virgin boys than you would imagine, who will never have intercourse in their lives if they follow the standard medical advice of "do nothing until I say it is time for Peyronie's surgery."

I have written extensively about the frequent situations in which the use of the PDE5 inhibitor drugs (Viagra, Cialis, Levitra) can precipitate injury to the delicate tunica albuginea of the shaft and lead to Peyronie's disease.  You can search the archives for these articles, but a few are "Peyronie's disease plaque, Viagra, Cialis, Levitra and blood supply" and "Viagra, Cialis, and Levitra use with Peyronie's disease," and" Viagra Peyronie's disease connection."

Please let me know if I can help you in any other way.  TRH

I have Peyronie’s disease and cannot develop an erection, what can I do?

Hi Dr, I have been to a GP and was told i have Peyronies. My penis curves to the left but I cannot have a erection and feeling in my penis is just about null. What do i do to get an erection so at least intercourse is possible ?

Regards…D

 

Greetings D,

There are many reasons a man might not be able to develop an erection.  Penis erection is a complicated process and many things can affect it.  To keep this discussion from being a three hour email, I will limit my response only to the single issue of Peyronie's disease as it relates to ED (erectile dysfunction) or the inability to develop an erection.

During the cold winter months I like to warm up the bathroom before taking a shower.  To warm the room I will turn on a small portable electric heater in the bathroom 30  minutes before showering to bring the temperature up to a toasty temperature.  Sometimes I forget to completely close the door to the bathroom, and this prevents the heat from being trapped in the room.  If I leave the door open just a little, only a little heat collects in the room; if I leave the door wide open, no heat collects in the room.  Most of the time when I make this mistake my wife will close the door for me (after reminding me I made that mistake again), and I will give her a big hug.  But when she does not notice the heater running with the door open I will have take a shower in a room that is cooler than I like.

That little heater does a great job of heating the room if the door is closed.  Closing the door is part of the process of trapping the heat that is created.   In a way, the door is more important to the room warming up than is the heater because the heater could run all day long with the door open and it never would warm the room.

A similar mechanism happens in the penis to develop an erection.  Blood is continually being pumped to all parts of the body, sometimes more and sometimes less depending on activity and needs of the body, but all parts of the body have a continual supply of fresh blood.  The penis has a much different kind of blood vessel arrangement than other parts of the body because it can almost immediately trap the blood that is being pumped into it.  When this happens it is like the bathroom with the door closed, or like a balloon that has been tied off.   

When Peyronie's disease happens, a mass of fibrous tissue called a plaque or scar develops within the layer of the penis known as the tunica albuginea.  This scar is not supposed to be there; it is not a normal thing, and the fact that it is there within the tunica albuginea very often makes it difficult or impossible for the veins of the penis to trap blood.  You might say that the veins have valves within them, and the fibrous plaque prevents those valves from closing.   When the valves do not close, the blood is not trapped and no internal pressure is built up that is associated with an erection.   This inability to close the valves of the veins might affect just a small part, or a large part, or all of the penis, causing a small, large or the entire penis to be soft or not erect.

The solution for this problem is not to pump your body full of drugs to make an artificial and temporary erection, because this does nothing for what is really wrong with you (plaque in the tunica albuginea) and it might cause other health problems as a side effect.  The solution is to eliminate, if possible and as much as possible, the plaque that prevents the valves from closing that causes the penis to be soft or flaccid (not erect). 

To learn how to help your body eliminate the Peyronie's plaque or scar please review the information at "Start Peyronies treatment."   TRH

Would a Peyronie’s scar on the surface have the same affect as if it were underneath?

I have curvature to the left side and don't feel any bump or Peyronies plaque. I know this means the Peyronies scar can be too small or too large and flat and I've also read that it won't be on the surface of the skin. However, I do see a few little things that appear to be surface scars where my curve starts. Why wouldn't a scar on the surface of the skin have the same effect as if it were underneath?  Don't all scars share the same characteristic of not being flexible?

 

Greetings,

No, a Peyronie's scar on the surface would not have the same affect as if it were underneath.

Yes, all scar formation within the body shares the fact that a greater amount of collagen and fibrin fibers is present that is not as elastic and pliable as normal skin.

Even so, the location of the scar or plaque material does make a difference.  It is the hydraulic tension or over-filling with blood within the two corpora cavernosae of the shaft that creates the hardness and expansion of an erection.  Each corpora cavernosum is covered by the tunica albuginea (which is normally also elastic)  but will not expand as it should when the Peyronie's plaque is present within the tunica. The external skin layer does not participate in that response of creating the erection, even though it does to a degree also expand; even when erect the external layer of skin of the shaft is not especially tight or overly stretched. Only if these were extremely large in comparison to the overall size of the shaft would an external scar cause a distortion  of an erection.

I cannot comment on what you refer to as the few little things that appear to be scars on the surface of the shaft.   A scar on the surface of the shaft skin not have the same effect as if it were underneath because no blood is trapped in the skin; there is no anatomical mechanism for it to happen.  It is the trapping of blood that creates the hydraulic effect, and this takes place only in the corpora cavernosae and nowhere else.

It might be helpful to you to review some basic penile anatomy on the PDI website at "Peyronie's anatomy of the penis and related areas"  and  "Tunica albuginea and Peyronie's disease."

If you are unable to find the Peyronie's plaque that is causing your distortion, I suggest that you arrange for a telephone discussion and I will work with you to help you locate it.  It is essential to good treatment results that you know about the size, location, density and surface features of the scar that is causing your bent penis.   TRH

Corpora cavernosa and the tunica albugnea in relation to Peyronie’s disease

This is an anatomy question based on the two illustrations from your website.The first illustration of the inside view of the penis is one of the best I've seen. I particularly like the picture in the left corpus cavernosum showing a lattice like structure.

The second illustration has three parts (a,b, and c. Part c shows a penis curving upwards. When looking at the left corpus cavernosum in Part c, there is what appears to be a series of almost parallel squiggly lines. I've seen these lines in numerous anatomy illustrations, but have never (ever)seen anyone actually label what these lines are.

As the tunica albuginea is supposed to be smooth, I find these lines confusing. Do these lines represent the lattice like structure underneath the tunic. Or do they represent veins? Just what are these squiggly lines trying to represent?

Thanks
Rob

 

Greetings Rob,

Great question; thanks for asking.  I always enjoyed the study of anatomy when I was a student; a fascinating and exacting subject that is the basis of understanding disease and our effort to return to health.

For those who do not know the picture Rob is  referring to, go to "Peyronies Penis Anatomy," to see the layer of tissue known as the tunica albuginea and the corpora cavernosa.

The wavy or wiggly lines that Rob is referring to are simply what the artist drew to represent the walls that make up the caverns or chambers or cavities of the spongy tissue of the corpora cavernosa.  You are just seeing the cut ends of those chambers represents shown in Box B that are shown as wavy lines in Box C because those same structures are shown from a different perspective.  These wavy lines are similar to a blueprint of a house where the architect draws a series of straight lines to represent the various walls that make up rooms, hallways, closets and outside periphery of the structure.  TRH

Is it really possible that Peyronie’s disease completely disappears?

Hello,

Is it really possible that Peyronie's disease actually completely disappears?

One often-quoted study says that 13% of cases improve spontaneously after one year. This, however, includes very small curvature or plaque reduction. However, I have not heard of one single reliable and medically documented story of complete remission. It seems that even if some treatments appear to be effective in reducing or even dissolving the plaque, the tunica can never regain its original elasticity.

Can you give us your thoughts about this please.

Best regards,

Leo

 

Greetings Leo, 

Thank you for the excellent question.

How often, and to what degree, Peyronie's disease spontaneously recovers is such an interesting and important PD topic that I wrote,  "Spontaneous Remission and Natural Cure of Peyronie's Disease."    You might consider reading this also for additional ideas.

Anyone who has looked for help with Peyronie's disease knows why it has been called the bastard-child of medical practice.  No one should be surprised it has never been the subject of investigation to determine the frequency or degree of spontaneous recovery or natural healing.  I could not find any information about what criteria is used to determine a complete response to treatment or a spontaneous remission of Peyronie's disease.  For example, when all outward signs of cancer disappear after treatment, this is called a "complete remission" or a "complete response."   These terms do not necessarily suggest the cancer has been cured.  It only means the cancer cannot be detected in a way that it was previously used to identify it.  If after treatment the cancer is still present but in a reduced capacity to incapacitate the patient or of a reduced size, it is called a "partial remission."  In regard to Peyronie's disease these concepts might also apply, but this has not been worked out clinically for PD.  For this reason, the words we use (remission, recovery, response, cure, improvement, complete, partial) are subject to controversy because they have not been defined in relation to Peyronie's disease.  

Thus, there is room for interpretation when you ask if Peyronie's disease ever "completely disappears."   A consensus would have to determine if a practical (functional) or anatomical (structural) definition of recovery was to be used for Peyronie's disease.  Previously I have written, "the average man would not care at all that he had Peyronie's disease if it did not cause a penile distortion that denies him from having sexual intercourse.  If the Peyronie's lump did not interrupt sex activity, the problem would be essentially ignored." 

While i understand the thought and motive behind asking about a study of spontaneous remission of Peyronie's disease, I believe it is unlikely for the pharmaceutical or medical industries to actually spend money to research if this problem goes away on its own.  Their focus is far more likely to be directed toward drug creation or surgical advancements.  In preparation for writing this reply I Googled "spontaneous remission cancer" and "spontaneous recovery flu" and could not find any medical studies for those searches.  That this information is not available should not be interpreted that these things do not happen, but only that no one yet has taken the time, effort and money or has a vested interest to study these topics.   

For a majority of men, from a practical or functional standpoint, restoring sexual function would define "complete recovery" if this occurred as a result of direct treatment, or "spontaneous remission" if this occurred without treatment, regardless if the Peyronie's plaque persisted or the tunica albuginea was less elastic.  To underscore this prevailing and practical attitude that men take about their Peyronie's condition, I have communicated with many men who have told be that they like having Peyronie's disease because their particular direction and degree of penile curvature increased the sexual pleasure of their partner and thus they saw themselves as better lovers. Their interest in correcting their Peyronie's disease was equally practical and sexually motivated:  they were concerned that if the curvature worsened, they would not be able to engage in intercourse.  Conversely, from a clinical or anatomical standpoint, restoring previous physical normalcy (external appearance of the shaft, elimination of the internal fibrous plaque, complete elasticity of the tunica albuginea), would define "complete recovery" if this occurred as a result of direct treatment, or "spontaneous remission" if this occurred without treatment.  Without these terms being defined it is difficult to communicate accurately.

Yes, I am aware of that study reporting 13% of cases improve spontaneously; others reports suggest up to 50% of Peyronie's disease cases simply go away without treatment.  This variation in numbers is probably due to a different set of criteria for determining what degree of improvement constitutes a real improvement  or recovery; this is discussed in the 3rd paragraph. Given the nature of the problem It is easy to understand why there is still controversy and revision (usually upward) of the reported rate of occurrence of PD in the general population, to say nothing of the rate of spontaneous remission for the problem. 

When I developed Peyronie's disease I struggled frantically looking for a way out of the Peyronie's nightmare.  After reading reports of 20-50% spontaneous recovery from PD my thoughts turned in a more positive and productive direction.  The pivotal insight that occurred to me was:  "If 50% of men heal their own PD, then the body has a cure – even if the MDs do not.   All I have to do is increase my immune response to this PD scar in whatever way makes sense to me, and I believe I might be able to heal my problem like those lucky men who spontaneously correct their own problem.  Now I am in control."  Before that I held the common negative and hopeless victim mentality displayed on many of the Peyronie's forums. This little bit of information so encouraged me and uplifted my thinking, that I eventually developed the treatment protocol that enabled my body to heal my PD problem.  This same protocol (now improved in several significant ways) has since been used many hundreds of times by men who learned about it on this PDI website.

From my experience in working with men since 2002 I have used the informal, uncommitted, and long-distance format of the internet, emails and telephone calls.  Since I am not conducting formal research, I have no way to control, monitor or verify how anyone is conducting his PD therapy plan.  Men do what they want to do.  I can only offer suggestions and hope my message gets through.  Not only does everyone seem to create a slightly different therapy plan, but each man goes about using his plan in a different way.  The non-uniform and irregular application of the ideas you see on the PDI website makes it difficult to evaluate effectiveness or degree of improvement achieved.   Not only that, men are notoriously bad communicators about this aspect of their private life.  Once Peyronie's disease is eliminated from a man's life he quickly disengages from the problem and happily returns to his previous life, rarely contacting anyone about his success.  They gladly try to forget about the condition that so humiliated them and nearly ruined their lives.  Men are reluctant to discuss or report on the stigma of diminished size, erectile dysfunction and disfigurement associated with Peyronie's disease.  For these reasons the number of men who experience spontaneous improvement of their PD will always be much more speculative than even the number of men who have PD, which is wracked by speculation for the same reasons.      

You are correct, there are no formal medical studies of complete Peyronie's remission.   But what of those published medical statistics reporting 13-50% of cases that get well without treatment or outside intervention.  Is that not more than the medical acknowledgment or the single story of complete remission you asked for?  Further, what of the hundreds of urologists and family doctors each day around the world who advise their newly diagnosed Peyronie's patients to "come back in six months to see it it goes away"?  Aren't each of these MDs implicitly saying that from their experience they see a sufficient percent of PD cases clear up on their own, thus justifying the standard wait-and-see strategy they all use?  "Wait-and-see-back-in-6-months" is part of the standard medical protocol and must exist for some reason; do you think that spontaneous remissions happen often enough to build a treatment protocol around it?  I do.

I offer a simple speculation about the condition of the tunica albuginea after favorable Alternative Medicine treatment, because I do not know.  The body eliminates to the best of its ability what it does not need.   I have a scar on my knee from a childhood injury.  Over the years it has slowly faded and now is barely visible.  I assume that if there is no useful purpose for the PD scar within the tunica albuginea, the body will pick up the collagen fibers over time.  This might not be a fast process like the body removing the cells of inflammation, but it should at least in theory happen if only because the body is designed to eliminate foreign matter.  Along that line of thought, I am a retired chiropractor with a highly refined sense of touch developed over 42 years of practice.  When I report that I cannot find any evidence of my previous gang of PD scars, you can believe that they are either gone or so dramatically diminished in size.  Of course, this is ultimately speculation because surgery would be required to verify the actual state of my tunica.       

Lastly, it is difficult to know how to label my particular improvement of Peyronie's disease or the experiences of those men with whom I have worked.  They no longer come to the PDI site for treatment information because they are apparently satisfied with their previous Peyronie's problem after following their version of PDI therapy protocol.  I do not know if I can say my body eliminated or cured my Peyronie's disease, or not. I do not know if I can say I had a "complete remission" or a "partial remission" because those terms have not been defined clinically. 

All I know for a fact is that back in 2002 when I was at my worst, I could easily describe 4-5 different plaque primarily on the left and dorsal aspect of the shaft.  My primary distortion was a combination 35 degree curve to the left, a ten degree curve upward, with a counterclockwise rotation.  I say primary distortion because twice while I had this combination curve and twist, it was replaced for a few weeks by a severe bottle-neck deformity that made me sick to look at.   After following an aggressive and faithful PD therapy plan that I devised over many months, all of that went away.  I was able to monitor the slow and gradual reduction of the size, shape, density and surface features of each of those 4-5 plaque.  As I observed them slowly fragment and disappear, my distortions disappeared and my lost length and girth returned.  Today I cannot find any PD plaque and my shaft is straight.   I have worked with many men who have reported various stories along that same basic outlineOf course, some men respond better to Alternative Medicine therapy than others; not all respond well, and some do not get any improvement at all.  When I learn of men who are not making improvement I can usually trace it back to a small and non-aggressive application of the PDI therapy concepts that is revealed by meager and irregular purchase of therapies. Conversely, those men who report better results ask more questions, follow a more faithful and aggressive plan of action, and overall seem to be more focused and serious about their eventual recovery.       

Back to your original question, "Is it really possible that Peyronie's disease actually completely disappears?"   By that question I take it that you mean, "Is it possible that the tunica albuginea returns to a completely normal state after what you call a self-repair, self-healing or spontaneous remission?"  To that question l answer that I do not know.  I must assume that in order for my curvature pattern to improve, for my scars to be undetectable, for my lost length and girth to have been returned, that some favorable and demonstrable tissue change must have occurred within substance of my tunica.  This in turn should have caused the tunica to become more elastic than when it supported the nasty Peyronie's plaque.  Speculation, for sure, but logical.

For me, and I believe for the men who come to the PDI website looking for some straight information about what they can do to help themselves get well, I wish to say we do not care if the tunica albuginea completely returns to normal or not.   I am satisfied when a man tells me he cannot find his PD scar any longer; that he can have intercourse for the first time in many years; or that his penis is now straight.  At this time I am more interested in learning how to more effectively help the men who have Peyronie's disease so they can more quickly and efficiently eliminate their problem, than I am in splitting hairs while defining the words cure, healing, recovery and remission.

Again, thanks for the great question that gave me the stimulus to put a few thoughts on the internet that were not there previously.

Good luck to you and I trust that you are successful in dealing with whatever prompted your interest in this subject.  If you have interest in learning about Alternative Medicine Peyronie's disease treatment, please let me know.    TRH

Is it possible for the Peyronie’s scar to be that small?

Hello,

Please allow me to explain what's going on with me and advise on if I should proceed with treatment.

I've been having painful erections for 6 months now. It was an immediate progression and the pain has not subsided at all. It begins as i'm getting erect and the pain is quite substantial for the first few minutes after which it subsides quite a bit. There is additional pain when I squeeze/flex it…like you would if you tried to stop peeing midstream. This leads me to believe that it's something with the blood stream. The range of motion is extremely limited and is very painful whenever it's moved too much. I'm now at the point where i'm not getting as hard as I used too and part of it is a mental block because I know it's going to hurt. I haven't been able to achieve a full hard erection on my own for a couple months now.

I've gone to my general practitioner and a urologist and left without a resolution. I've searched tirelessly for an answer and peyronie's is the only thing that even remotely fits my symptoms. I've been checked for STD's, did a urine and blood sample, and everything checked out. My hesitancy with the diagnosis is I have no deformity with my penis and I'm unsure of any plaque buildup. There is a very small hardness in the center of my penis when flaccid that is a little painful when I press it. I would relate it to the size of the tip of a ballpoint pen. But it's not rock hard because it still feels somewhat squeezeable. Is it possible for the Peyronie's scar to be that small?

Could I be in the beginning stages and still feel this much pain? Is it safe for me to treat myself as if I have it to see if works? I keep reading about where this could lead and it's quite scary. My experience with traditional doctors has been very frustrating and expensive. The urologist didn't even consider peyronie's until i mentioned it but both doctors checked for it and neither felt any buildup. He said to take some vitamin E and that should fix it. I've been taking an extensive amount for 2 months now and nothing has changed.

'm 32 years old and in great health with an active sex life. I'm extremely concerned with these issues and i feel completely lost in finding a solution…please help.

 

Greetings,

Your story creates a picture of some poor care. 

First some basics about a few statements or observations made about Peyronie's disease in general and your situation in particular.  I will just respond back to what you have mentioned:

  1. Peyronie's symptoms can be rather variable from one man to the next.  You are having more pain, and more consistent pain, than most men experience with PD, but that does not mean it is not PD.   Some men have no pain with their PD condition.  
  2. Not having the advantage of having examined you, I can only speculate about the source of your pain.  My educated guess is that it is not coming from a blood vessel but from the PD scar pressing on the tunica albuginea and another layer of penile tissue called Buck's fascia which is rick in pain fibers.  If you had constant pain, or if your pain coincided with your heart beat I would then consider it could be related to a blood vessel.  Both of these tissues I mentioned could be irritated and stimulated enough to generate pain when being squeezed.
  3. You say you left two medical offices without resolution, meaning they did not come up with the diagnosis of PD.  What did they speculate could be your problem.   Did they just leave you hanging with no ideas, no follow up?  So it is you who has come to this possible conclusion of Peyronie's disease on your own after doing some reading on the internet.  The fact that you mention your blood work was negative makes a case for not having a serious or life threatening problem going on, my speculation is that this supports PD as a possible diagnosis.  Personally, I have to suggest that you go to a third doctor to see if you can find a doctor who will take your problem more seriously than the first two.
  4. Peyronie's disease does not always cause a deformity, especially as early i the problem as you could be at six months duration.  Do not expect all cases of PD to demonstrate deformity, or to have it so soon; some do, and some do not.
  5. The small area of hardness you feel when flaccid that is the size of a ballpoint pen tip, could be your PD scar.  Did you show the MDs this area?  What was their response?  Many times a rushed medical examination will miss a small lesion like this.  You should have shown it to both of them, and demanded more time and attention to your problem. 
  6. Not all PD scars are rock hard. Some are so soft as to be almost undetectable.  This is why so many are missed on examination.
  7. Yes, you could have this much pain in the early stages of your problem.   It is amazing to me that you could have seen two doctors about your PD and not have been given this basic information. 
  8. Considering you were told you have Peyronie's and they only extended vitamin E as a treatment option, it is up to you to determine how you wish to proceed.  It is also up to you to determine the safety and appropriateness of undergoing a therapeutic trial of care for Peyronie's disease using Alternative Medicine  I cannot make that judgment; you have to take that responsibility for yourself.   I have had many men take this approach and were glad that they did.
  9. The PDI website is full of information for you to read and learn.   I suggest that you go the PDI website to learn how to start Peyronie's treatment if that is what you decide to do.  

Good luck to you and let me know if I can answer any questions as you look into this further.    TRH

Is it possible my Peyronies plaque or scar is like a piano wire?

Dr. Herazy, I wrote you last month and you really helped my confidence with what I am doing. Is it possible that my PD scar is like a piano wire from the base to the head? That is the only irregularity I can find. Thanks Dick R.

Greetings Dick,

Yes, it is certainly possible that your scar feels like a piano wire. The Peyronies plaque or scar material presents in a wide variety of ways, just as most everything about PD seems to be variable. 

Although you did not say so, I will guess the long ridge of scar material tissue you say feels like a piano wire is located on the top or dorsal surface of the shaft.  This is a very common location for long narrow PD scars.  It is the anatomical structure, called a septum, where the tunica albuginea of the two chambers meet in the mid-line, and it runs from the base of the penis to the head (glans).   This septum is especially susceptible to separation during trauma, and can consequently develop a long thin scar.  

You can assume this is your only, or your primary, Peyronie's scar if your curved penis is directed upward.  

While you might be correct that it is only as thin as a piano wire, I suggest that you examine this thin ridge again to determine if you can detect that it tapers down to a flat band.  Almost like the gable roof of a house, your piano wire structure might just be like the uppermost ridge of the roof that gets thinner as it slopes down laterally.  I mention this speculation because it is always beneficial to have a clear and accurate visualization of each scar so you can closely monitor it  for changes as you continue to treat your PD. 

You might find, if I am correct, that this flat tapered surface on either side of the piano wire will undergo changes in size, shape, density and surface features as your scar deteriorates as your treatment progresses. 

If you do not know it is there, you will not have this useful information available to you to guide your treatment.  You must try to know everything there is to know about each of your Peyronies scars.

TRH

Does this mean I have Peyronies?

In previous questions someone asked below "how do I find my PD scar?"

In your answer you stated: "…….it is important to know your scar is not located on the surface; it is located below the surface and cannot be seen……"

I have been informed that I have Peyronie's disease, however my erections are 100% straight.  They are just less flexible and half the top surface of my penis feels very hard, because of the scar tissue.  When my penis is flaccid and erect I can easily always see the scar tissue.

Does this mean I have peyronies, also does this mean the scar tissue is just below the external skin and not on the actual erectile tissue? Is this possible? I have spoken to you previously but I am not sure if I mentioned this.

 

Greetings,

If you have been medically diagnosed with Peyronie's disease, what you say does not give me reason to doubt that diagnosis.  

After reading your entire question several times I am unsure what you mean when you say "I can easily always see the scar."   If I were to try to hide a ball under the blanket on my bed, it would still be "seen" because of the way the ball would push up and distort and wrinkle the blanket.  I would not be able to see the ball directly, only able to see the effects of the ball on the blanket that is above it.  Is this what you mean when you say you can see your PD scar?

By definition the Peyronie's plaque or scar is not located on the top surface of the skin.  It is located within the layer of tissue called the tunica albuginea that is located well below the surface of the skin, by many millimeters.     The tunica albuginea is sitting right on top of and is in contact with the actual erectile tissue, making it anatomically impossible to directly see the Peyronie's scar.  

I have communicated with many men whose PD scars are so thick and dense that they distort the skin above, and thus they can see the outline of scar that lies below.  TRH

If I can’t find the Peyroinie’s plaque where is DMSO gel applied?

Dr. Herazy,

My order arrived last week, and today I started the treatment.  I’m very upbeat that I made the right decision. I have carefully reviewed all the documentation and explanations that came with my order.  It is very impressive how well you prepare your customers to work with their Peyronie’s treatment products.

The one item that I’m most confused about is the PMD DMSO gel.  Exactly where is this gel applied?  My instructions say that the topical therapies should be applied over or on top of the location of the Peyronie’s plaque or scar. I do not have any scar. I don’t have a problem shaving as described but I do not have a scar either on the part to be shaved or the penis. Or, when they mention scar, do they mean the part of the penis that is abnormally hard?  Please advise.  Randy

 

Greetings Randy,

Actually, if you have Peyronie’s disease you do have a plaque or scar.   However, the scar is not external or superficial, it is internal and below the surface. It is located under the skin surface and within the tissue of penis called the tunica albuginea.  The scar or plaque is not visible from the surface; you cannot see it.  The closest you can come to actually seeing it is if the scar is so large and thick that it raises or elevates the penile skin above it and you can see the raised lump of tissue because of the large scar below the surface.  

In order to be successful you really want to get to the point that you know the size, shape, density, and surface quality of your scar(s). If this is a new concept to you, I suggest you get the 1st book I wrote “Peyronie’s Disease Handbook.” It will help you immensely.

Scar location is sometimes a complicated topic, especially in the case of multiple scars or plaques. You can expect to find at least one scar at the point of greatest concavity of your distortion. Again, this is a topic of such concern and importance that you really should get at least that one book so that you know what you are doing in regard to monitoring your scar. The physical change in your scar is going to guide your therapy; it will direct you to the best use of your therapy plan. to assist you with this subject, please go to Difficulty Finding the Peyronie’s Plaque.

To answer your question about where to apply the DMSO gel and related external therapies, they should be applied directly over the area of Peyronie’s plaque or scar.  You do not need to apply these external therapies to the entire shaft, unless, of course, you have a wide spread pattern of scars over most of the penis.  TRH

Is it adviseable to needle the penis directly?

Dr. Herazy,

I am an acupuncturist treating a patient with Peyronie's disease.  I bought your "Peyronie's Disease Handbook,"  hoping you had included specifics on the use of acupuncture, especially whether or not you think it's advisable to needle the penis directly?  I know you advise to not cause additional injury to the penis, but needling near scar tissue on other parts of the body is not contra-indicated, but actually beneficial.

What are your thoughts on this please? My patient is willing to try anything.

Greetings Doctor, 

Yes, needling a superficial scar on other parts of the body is very often beneficial, but the penis is a different part of the body. I would not needle the penis for concern of puncturing the tunica albuginea and further extending his Peyronies problem.  My concept is never to puncture the tunica in an attempt to help this problem. 

However, local treatment has always been an important part of my acupuncture practice, such as the famous Circle the Dragon technique, and that is why I advocate heavy use of the Genesen Acutouch pens to treat the PD lesion in this particular way because it will not risk injuring the patient by avoiding compromise to the tunica.

If you feel required to needle, distal points are always advisable. I do not treat a lot based on Five Elements theory, but I believe you would likely benefit your patient by evaluating for an Excess Wood situation.  Bear in mind that the “Peyronie’s “scar” is not a scar in the traditional sense of being a superficially located skin lesion; it is below the subdermis and within the tunica so the standard methods of needling a scar – that I have done daily for over 35 years – does not apply to PD.  At least, that is how I understand it based on my concept and methodology in guiding Peyronie's treatment.

If you feel obligated to needle, distal points are always advisable such as SP3, SP6, K3, GB34, the master points of the Conception Vessel, Sedation points for the Wood element and and Stimulation points for the Fire element. as well as appropriate Eight Extraordinary Meridian points (Du Mai, Chong mai, Yin Wei mai, etc.)    TRH  

 

Should I continue penile injections for Peyronies treatment?

I have Peyronie's disease causing a bend to the left and downwards and it's closer to the tip then the base. I have seen a urologist who has injected it twice now. I haven't seen any improvement. both my doctor and myself have trouble finding any plaque. I'm 50 and in good shape….this just showed up a couple of months ago…there was no trauma…should I continue with the injections?  .

Greetings,

It is not my intention or desire to interfere between you and your urologist concerning your treatment or any other aspect of your relationship.  Nor will I answer your question directly if you should or should not continue with the penile injections you are receiving – I have no direct opinion or advice for your question.  That is a subject for discussion between you are your treating doctor.  My only interest and purpose in making this reply is to offer ideas, and pose questions to you, to broaden your discussion with the urologist about the progression of your care.

My opinion and ideas for you to consider are these:

    1. Any time you make a simple injection into the penis with anything, even sterile water,  you are physically traumatizing the thin tunica albuginea membrane where the Peyronie's plaque is located.  Many times when these injections are given at multiple sites of the tunica albuginea at one office visit, causing multiple trauma.  Yes, these are small needle holes, but they are holes none the less.  When given at multiple sites within a small area, and done on multiple occasions, that is still a lot of trauma (think of a shot gun blast which is just a lot of small holes). Your body has already demonstrated the tendency and ability to lay down excess collagen in the form of Peyronies plaque without any trauma or trauma so small that you do not remember it, so what will be its reaction when actually traumatized?  It is my opinion that any injection is a direct injury that could possibly cause more plaque or scar tissue to develop or worsen plaque already present. 

Avoidance of the trauma of needle injection is the reason that since 2002 I have counseled perhaps 20 or so MDs (of whom 2 were urologists) who had PD and wanted to avoid surgery, injections and drugs. 

    2.  The needle injection points are not the only potential trauma to the tunica.  Since you did not mention what drug was being injected by your doctor, I cannot comment specifically on that issue, but it is my opinion any drug has a potential to cause chemical trauma in the form of an allergic reaction, side effect or perhaps just a chemical irritation to the tunica in certain individuals.  If this is the case with you, this could result in additional irritation internally and further trauma to tissue that has already created Peyronies plaque for no apparent reason you recall.  It is my opinion that any drug reaction or unexpected side effect could possibly result in additional  plaque or scar tissue or further aggravate plaque already present.  

Unexpected drug reactions and unexplained side effects are a fact of life in medical practice.  This is such a large problem that there is a medical term for it, "Adverse Drug Reactions" or ADR.  In fact, a 1999 report in JAMA of a meta-analysis entitled "Incidence of Adverse Drug Reactions in Hospitalized Patients" by J. Lazarou concluded that

             "The overall incidence of serious ADRs was 6.7% (95% confidence interval [CI], 5.2%-8.2%) and of fatal ADRs was 0.32% (95% CI, 0.23%-0.41%)
             of hospitalized patients. We estimated that in 1994 overall 2216000 (1721000-2711000) hospitalized patients had serious ADRs and 106000
             (76000-137000) had fatal ADRs, making these reactions between the fourth and sixth leading cause of death.

 

 

             Conclusions.— The incidence of serious and fatal ADRs in US hospitals was found to be extremely high."

I am not at all suggesting that any penile injection could cause a fatal reaction, but I am suggesting that if in hospitals serious and fatal ADRs occur at the rate of 6.7%, the rate of less serious ADRs must be even higher.  All of this means that drug reactions occur at a seriously high rate, you are taking drugs directly into the penis, and you are already in a position in which you should be extremely careful because your penis will probably overreact if it is further injured.   

    3.  If you say that you and your doctor have trouble finding any plaque, then where are these injections being given?  If the exact location cannot be confidently identified by your doctor, then how accurate is the placement of these injections you are receiving?

    4. It is estimated that 50% of men who begin Peyronie's disease will self-limit or cure their own problem without any outside help or medical care.  The  Alternative Medicine treatment concepts of PDI is simply to do all that you can with natural methods to increase the natural healing ability of your own immune system to eliminate your Peyronie's plaque.  How to go about doing this is the subject of the large PDI website.  I suggest that you, and everyone else with Peyronie's disease, consider attempting conservative measures before undertaking more aggressive Peyronie's treatment that has potential for side effects and drug reactions.     

Good luck in discussing this subject with your urologist.   TRH    

What can I do to reduce the PD plaque?

i am 48 years old, and have had peyronie’s for approximately 5-6 years from unknown origin (but most likely from a crush injury). my condition has progressed to the point where i have a very significant plague that runs almost the entire length of my penis; the plague quite literally feels like bone, and is located more near the top of my penis (between the outer skin and urethra). my penis is not curved, but rather has shortened (fairly substantially) and has lost significant girth; while my erections are reasonably hard (though not as hard as previous to the condition), the overall size of my penis has reduced quite significantly. in addition, i seem to have lost nearly, if not all feeling in my penis, so much so that when i do have sex w/ my wife, i feel virtually nothing, where it takes me a very long time to reach orgasm, if at all. sadly, i most often fail to reach such; only very rarely am i able to achieve orgasm now. in fact, it is somewhat difficult for me to even know precisely how full/ hard my erection is unless i actually palpate such. i have recently returned to the united states (from living in china), and will now be able to resume taking a fairly substantial series of supplements recommended by you and provided from your company. what can i do to reduce the plaque, and to hopefully regain feeling in my penis? can i ever regain feeling? your assistance is greatly appreciated … eric

Greetings Eric,

Thank you for your detailed description and questions.

I am a bit confused by your description of the location of your Peyronie’s scar or plaque (part of your description sounds like your plaque is on the bottom/under side of the shaft and another part sounds like your Peyronie’s plaque is on the top/upper surface).

In my reply I will assume it is on the upper/top surface of the shaft as you are looking down at your erection, since this is by far the most common presentation of plaque that runs the length of the shaft. This plaque location is most often responsible for lost length and girth, such as you describe, and for generalized erectile dysfunction. Many men with PD experience localized reduction of erectile ability, resulting in soft spots, or nicks or dents or dings in various areas of the shaft. Yours sounds like the entire shaft is soft, often the result of plaque development within the septum of the penis (the point where the tunica albuginea that is around one corpora cavernosa touches or combines with the tunica albuginea of the other corpora cavernosa).

Your loss of feeling is not common; most men with Peyronie’s disease with have little trouble with loss of sensation. While lost penile sensation could be due to other factors unrelated to PD, I will assume it is related to the central location of your plaque compromising your nerve supply. If this is true, and I have no way of knowing for a fact that it is since I have not examined you, I assume that your penile sensation should return once your plaque is reduced. Besides reduced reduction of sexual sensation, do you also notice general loss of sensation to light touch or pain (as when you pinch the skin of penis)?

You ask what you can do to reduce the plaque. I saw in today’s list of orders that you purchased a large assortment of internal therapies (Acetyl-L-carnitine, MSM, Neprinol, Omega T, Quercetin-Bromelain, Factor 400/400 and Maxi-Gamma). However, you did not order any internal therapies (PMD DMSO, Unique-E oil, Super CP Serum, or Genesen Acutouch pointers). Both internal and external therapies are necessary for effective treatment. It is also necessary that you follow the dietary modifications outlined in “Peyronie’s Disease Handbook” to keep your blood pH toward the alkaline side. The stretching video contains detailed information how to address plaque formation found within the septum, such as you have. All of these therapies must be applied at the same time to achieve best results.

You will probably have to modify your plan to achieve favorable changes to the size, shape, density and surface features of your plaque. Do not be slow in making those changes to your plan when you see that after 10-14 days of treatment the plaque is not responding. For this reason it is absolutely critical that you clearly can identify the size, shape, density and surface features of your plaque. I know I might sound like a broken record when I continue to repeat this, but if you do not know these four aspects of your plaque description, you are only guessing at your treatment. Please, do not guess. Know what is going on down there below your belt and you will have an excellent way to direct and guide your therapy toward the greatest degree of success of which you are capable.

Please stay in close contact with me as you begin your self-directed therapies. Let me know of any problem or questions that arise, and I will be happy to offer you information and ideas for your consideration. TRH

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Broken Penis and Peyronie’s Disease

Penile fracture can lead to Peyronies

The most frequently found explanation of Peyronie’s disease usually refers to it as an exaggerated healing of penile trauma. This injury can be so small as to be unnoticed or so severe as to be considered a broken penis or a penile fracture.

A fractured penis is also known as a broken penis syndrome.  It is a severe and painful form of bending injury that occurs to the erect penis typically during intercourse when a thin tissue membrane of the penis called the tunica albuginea becomes ruptured or torn crosswise, not along the length of the penis.  When a penile fracture occurs it is often accompanied by a popping or cracking sound that can be heard by the sexual partner, and results in immediate flaccidity. Because of the severe pain in the penis, bruising, and swelling, this is considered a medical emergency that often results in surgical repair. When the fractured penis is severe, the urinary tube within the penis that drains urine from the bladder (urethra) can be damaged, leading to blood in the urine.

All couples who use the woman-on-top intercourse position have experienced times when the woman will thrust back and lift off  the penis only to come back down again, forcefully pushing and bending the penis against her pelvic bone , groin or vulva region.  And all men have had the experience of missing the point of penetration at the opening of the vagina during intercourse.  These two are the most common way to cause a penile fracture.

Approximately 1,000 cases of broken penises are reported each year in the U.S.  Men in their 20s and 30s are a higher risk because they are more inclined to engage in vigorous or acrobatic sexual activity that result in a broken penis.   Men in their 50s and 60s are less inclined not only because of reduced frequency and vigor of sexual activity, but because their erections tend to be less rigid.

It is not necessary to stop sexual activity if you have Peyronie’s disease, only that you become more careful and conservative about a few aspects of your sexual repertoire.  Especially for a man who already has a penile problem, it is most wise to avoid additional injury of another fractured penis so that the Peyronie’s sex problem is not made worse.   Peyronie’s Disease Institute suggests the following safety steps to avoid reinjury and possible worsening of an existing case of Peyronies:

  1. The man should not allow himself to be so filled with sexual excitement and abandon that the throws caution to the wind during intercourse.   He must be the calm and sensible one who monitors and evaluates the strength and control of thrusting and selection of sex positions so as to avoid those that put him at risk for additional injury.
  2. The man should be the one who does primary thrusting in intercourse  to reduce the chance of  additional penile trauma.
  3. Use of additional sexual lubrication during  sexual intercourse.  Even if his sexual partner produces adequate natural lubrication, apply additional sexual lubrication to avoid dryness during intercourse that can lead to additional injury while thrusting.

After the broken penis has healed begin a treatment plan using Alternative Medicine measures found on the PDI website.  

Erections and Peyronie’s Disease

Erections can be difficult to develop on demand while in a sexual situation.  Paradoxically, erections can be difficult to stop or inhibit at certain times, especially during sleep.  All of this is important to Peyronie’s disease treatment since erections during sleep can have an adverse affect on progress of care.

A nocturnal, or nighttime, erection occurs because it is important for the basic health of the deep tissue, known as the corpora cavernosa, of the penis.  These deep tissues of the shaft fill with blood and trap it within the corpora cavernosa to create the erect state. If this term, corpora cavernosa, sounds familiar it is because the tunica albuginea is a thin and tough layer of tissue that covers the corpora cavernosa and the tunica albuginea is where the Peyronie’s scar is located. A nocturnal erection can be thought of as type of stretching exercise that takes place during the night when there is little other activity going on, to make sure the penile tissue is stretched and used in this unique way to keep the tissue healthy.

The problem during a nocturnal erection when Peyronie’s disease is present is that restriction and binding of the already-bent erection can be sustained against the penis for a long period of time.  Also, it is important to keep in mind that this added pressure poses a risk of additional injury top the man who already has PD.  For this reason it is important to be careful with an erection when the penis has no comfortable or safe direction to extend itself.   Since it is not possible to stop an erection while asleep, it is smart to not wear tight or limiting underwear or pants while sleeping if you have Peyronie’s disease. It might be even smarter to wear nothing at all while you sleep since this avoids a great potential for binding and restriction.

For the most part, a normally occurring erection th

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at can simply “stand on its own” with no pressure against it, is not going to bind or incorrectly stretch out the penile tissue in a way that is detrimental to the penis.  Problems occur during a drug-induced (Viagra, Cialis, Levitra) or artificial erection, during which an abnormally great amount of blood is drawn into the penis by more soft tissue relaxation than normal.   For this reason it is understood that a naturally occurring erection is safer than an artificially created erection.

Drug induced erections can start Peyronie’s disease

Over the years I have communicated with many men whose PD started after a drug induced erection that stressed the penile tissues by greatly increased internal pressure.  This process would not be much different than taking a car tire that is meant to go no higher than 40-50 pounds per square inch during normal use, and over-inflating it to 100-150 pounds per square inch.  Because it is not built to take that kind of pressure, you could expect some problems to develop in using a tire that way.  Not much different with the penis.

Sexual activity is NOT to be avoided if you have Peyronies, but rough, aggressive, hard sex can be dangerous and really injure the already damaged tissue further. Developing and using a natural erection is not to be avoided either in Peyronie’s disease.  However, it is important to keep your wits about you and do not go wild during sex.  The emphasis should be on an easy, smooth and gentle sexual encounter.  Any sexual activity or posture that causes pain should be avoided.

Many important related topics about taking care of yourself, avoiding injury, doing nothing to set your progress back while you are attempting to heal your problem, are covered in my book, “Peyronie’s Disease and Sex.”  You will enjoy learning more about what you can and should do to take care of this nasty problem.

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Fix Penis Curvature

How to straighten curvature of penis

For most, the main focus of Peyronie’s disease treatment is primarily to fix penis curvature or whatever distortion might exist.  However, this is not the best goal to have when you want to get fix your bent or curved penis.

The primary goal of Peyronies treatment should be elimination of the internal scar (Peyronie’s plaque material) that causes a curved penis to develop in the first place – not to fix penis curvature.  Although the most obvious aspect of Peyronie’s disease is the curved penis, it is not the actual problem.  Using penile curvature to determine success of any Peyronie’s disease treatment is unwise and counter-productive since it is not the real problem.

Healthy internal tissue of the penis is able to fill, trap and expand as blood enters it for a normal erection to develop. In Peyronie's disease one or more areas of a layer of tissue known as the tunica albuginea develop a dense and inelastic fibrous scar tissue or Peyronie’s plaque.  During a normal erection the slightly elastic tunica albuginea will stretch and expand evenly in all directions.  But when a man has Peyronies disease expansion is limited because the tunica albuginea contains fibrous tissue, resulting in a curved penis.

Peyronie’s disease usually begins as a small internal nodule or band of fibrous tissue on the top or sides of the penis, within the tunica albuginea.  A few weeks to a year later, this fibrous nodule can develop into a larger irregular plaque of variable size, shape, density and surface quality.  The Peyronie’s plaque can be as long as the penis and sometimes surrounds the penis, creating an hourglass indentation around the shaft. Some are one large mass, while others are small isolated islands of fibrous tissue in many areas. Scars can be so soft and small, with edges so tapered and vague, that no scar can be found.  When no Peyronie’s plaque or scar can be found it is assumed to exist when a curved penis develops during erection.

Peyronie’s disease causes penile curvature because the inflexible fibrous tissue of the Peyronie plaque prevents incomplete filling as an erection develops or by pulling unevenly on those same internal tissues.  The location and degree to which this poor filling and internal tug-of-war takes place is different from man to man, and so the bends and distortions are also different.  At times a small internal scar can cause a great amount of distortion and poor erection quality, just as a large scar can cause very little problem.  In other words, the scar size does not determine the degree of problem that is observed.  Sometimes as a Peyronie’s plaque or scar increases or decreases, the distortion can get either better or worse; many times the degree of penile curvature does not indicate the severity of the Peyronies plaque or the success of Peyronies disease treatment.  For this reason, the true measurement of success of Peyronies treatment should be determined by the reduction of the Peyronies plaque or scar.  Once the fibrous plaque material reduces in size, shape, density or surface quality, only then can improvement of the curved penis or reduced erection strength be expected in time.

Fix penis distortion by treating the Peyronie’s plaque

A curved penis that suddenly appears one day might be difficult to ignore, but it is only a symptom of the real problem of Peyronie’s disease that lies below the surface – the fibrous scar in the tunica albuginea.  Without that Peyronies scar there would be no curved penis; because it is the cause of the distortion it should be the only way that treatment success is determined.

Evaluating progress of a Peyronie's therapy plan can be difficult, if not impossible, if only paying attention to a curved penis.  A small scar – or a scar that is getting smaller – can cause a large penis curvature.  A large scar – or a scar that is getting larger – can cause no bend at all if it is balanced by other scars that are applying a symmetrical force.  Making matters more complicated, a man can have many more scars than he can locate because the often overlap.  Thus, it happens that a curved penis can worsen as the scar is actually being reduced or eliminated.

When only one scar is present the curvature problem is direct and easy to understand, although this is uncommon.  More commonly multiple scars cause internal pulling and twisting that create complicated distortions that can worsen as the scars become smaller.   Several scars can interact on many planes of internal penile tissue.   Any significant reduction in one or more scar will alter the internal tension on the tissues, resulting in an altered curvature.  Because there is no guarantee the curvature will improve initially, I advise to focus all attention to the size, shape, density and surface qualities of the scar while treatment of the Peyronies problem continues.  Realize the curved penis is just a reflection of Peyronie’s plaque structure below the surface.

Do not be discouraged as you try to fix the penis curvature related to Peyronie’s disease.  Instead, look for changes in the size, shape, density and surface qualities as you continue your Peyronie’s disease treatment.

Viagra, Cialis and Levitra Use with Peyronie’s Disease

 

Peyronie’s treatment using erection producing drugs

The erectile dysfunction and soft erections associated with Peyronie’s disease are sometimes treated with Viagra, an erection causing drug made by the Pfizer Pharmaceutical Company.  The information about Viagra duplicated in this blog post is written by Pfizer about Viagra, in relation to Peyronie’s disease.   The basic information presented by Pfizer is essentially true for other erection producing drugs, like Cialis and Levitra.

Here is the Viagra drug information from Pfizer, found their website.  I have removed a considerable amount of technical Viagra information that does not apply to Peyronie’s disease to make it easier to find what you need to know. Notice the section below that I have put in bold and underlined.

PRECAUTIONS

General

The evaluation of erectile dysfunction should include a determination of potential underlying causes and the identification of appropriate treatment following a complete medical assessment.

Before prescribing VIAGRA, it is important to note the following:

The safety of VIAGRA is unknown in patients with bleeding disorders and patients with active peptic ulceration.

VIAGRA should be used with caution in patients with anatomical deformation of the penis (such as angulation, cavernosal fibrosis or Peyronie’s disease), or in patients who have conditions which may predispose them to priapism (such as sickle cell anemia, multiple myeloma, or leukemia).

The safety and efficacy of combinations of VIAGRA with other treatments for erectile

dysfunction have not been studied. Therefore, the use of such combinations is not recommended.

In humans, VIAGRA has no effect on bleeding time when taken alone or with aspirin. In vitro studies with human platelets indicate that sildenafil potentiates the antiaggregatory effect of sodium nitroprusside (a nitric oxide donor). The combination of heparin and VIAGRA had an additive effect on bleeding time in the anesthetized rabbit, but this interaction has not been studied in humans.

Use of any drug to assist erections in Peyronie’s disease

It is my opinion that any man who is undergoing Peyronie’s disease treatment is taking a huge risk to use any of these erection producing drugs because it has been my observation and experience in talking to hundreds of men about their Peyronies problem, that these drugs can injure the penis and actually start Peyronie’s disease, make it worse, or possibly delay or interfere with your effort to try to heal your Peyronie’s plaque.   This happens because of the damage done by the surprisingly strong and uncontrollable erections these drugs can create.

With the use of these drugs it is possible that the forced erections they cause can place great internal stress within the penis that can injure the delicate tunica albuginea.  The erections created by these drugs can be indeed super-erections, greater than what a man normally experiences.

I have had a number of men tell me they are convinced their Peyronie’s disease started after using Viagra, Cialis, etc.   I am confident that at a later time we will start to hear reports about more side-effects of these medications.  This should not be so difficult to believe when you can read for yourself that the drug manufacturer is already warning men in particular with Peyronie’s disease to be cautious about its use.

Peyronie’s disease aggravated easily

Super-charging an erection is not the way the body was designed to be used.

What if you could take a drug that would enable you to lift a ton of weight above your head and keep it there for an hour?  Nice trick, very impressive, but your body is not built to take that kind of pressure to the muscles, ligaments, joints, bones and blood vessels.  A trick like that would cause great damage to internal organs, your spine, blood vessels, all major joints, etc.  Simply put, “It just ain’t natural.”  Same with these erection drugs like Levitra and Viagra.  The increased pressure created by these medications can be very damaging to the delicate tunica albuginea, and can result in or worsen a case of PD.

What would happen to your car tires if you happened to over-inflate them with 100 pounds of air pressure, even though they were built to take just 40 pounds of pressure?  You would be running the risk of damage to the internal structure of tire, wouldn’t you?  Of course.  The same thing can happen if the penis is over-inflated and then given a “rough ride.”  This is where the problems start, and this is what I want to bring to your attention.

Viagra, Cialis and Levitra are not a Peyronie’s treatment

It is very likely that the MDs who prescribe these medications to men with Peyronie’s disease will not agree with this thinking.  MDs tend to favor a chemical “fix” to most problems, so you would tend to expect a natural and automatic prejudice from an MD to use drugs to solve most problems.

If you have taken Cialis or any other erection producing drug because it was prescribed for you, and you mention this information to your MD, what do you suppose he or she will say?  Well, the first thing you must consider is that this information indicates that your doctor prescribed something for you that was not safe or appropriate.  The natural reaction would be for your doctor to immediately defend her decision.  That makes sense.  It is not my intention to make trouble for your doctor, she was only doing what she thought was best for you.  It is my intention for you to independently think about these things and see if they make sense to you, the owner of the penis that could become injured.  Do more research on your own, then talk to your doctor.  This way you are armed with both sides of the story.

It is my further intention to prevent you from injuring yourself further with these erection producing drugs.

A penis that is predisposed to Peyronies in the first place cannot tolerate the kind of stress that these erections drugs create.  It is just like someone with asthma cannot tolerate dust, odors or smoke that does not bother other people.  If you already have Peyronies you should do everything you can to avoid any kind of stress to this tissue, including avoidance of erection producing drugs.

I talk to a lot of men who are given a prescription for Viagra, etc. to help their sexual difficulty, and they instinctively know that this treatment does not make sense to them.  Yet, they are tempted to use the drug because of the promise of improved sexual performance; besides, they are also tempted because they feel, “Heck, my doctor would not do anything to hurt me, maybe it is OK to do.”  I would agree, your doctor would not want to hurt you intentionally.  Yet, we all know that tens of thousands of people are hurt each year by drugs that are given with good intentions and bad consequences.

In addition, I have talked to many men who have reported to me that they used these erections drugs many times, maybe for several months, with absolutely no problem.  The erections were “normal” and controllable, and everything was fine, and the sex was great.  Then, one night, one time, they took that same drug in the same way, and they got an erection that was unbelievably hard and huge, and they thought they were going to explode.  It scared the devil out of both partners.  A few days or weeks later – a curved penis and Peyronie’s disease developed.

If you attempt to think independently and logically about what might happen to your Peyronie’s disease when these drugs are used, you should have no trouble understanding how this could work against you.  If your doctor can convince you that they are perfectly safe, then you should do what your doctor says to do. Just remember, who that penis is attached to if a tragedy happens.  Your doctor will shrug his shoulders; you will have a worse case of PD.

My opinion is that the use of Viagra and similar erection drugs could easily be worsening the very problem you are attempting to heal.   The use of these drugs represents a calculated risk that you are taking, and you should be aware of it.

Please write a comment or question about this article if you want to know more about Peyronie’s disease treatment with Viagra, Levitra or Cialis.

Difficulty Finding the Peyronie’s Plaque

Peyronie’s disease plaque

Let’s clear up the confusion about the Peyronie’s plaque, the fibrous scar-like tissue that is the most common characteristic of Peyronie’s disease.  Many people when reading “scar” automatically think they should see it on the skin surface; for this reason I prefer the term Peyronie’s plaque.

Peyronie’s plaque is usually a flat or slightly elevated mass of fibrous tissue just under the skin, in a thin but tough membrane of the penis known as the tunica albuginea.  Sometimes it is cord-like or nodular, but usually it lies flat making it difficult to locate.

Peyronie’s plaque is not in any way related to plaque material that line artery walls. It is benign, meaning it is not cancerous and it is not a tumor.  Peyronie’s disease and this fibrous material is not in any way contagious, and is not in any way the result of any transmittable disease or microorganism – thus there is no way for a sexual partner to “catch’ the Peyronie’s plaque.

The mystery of Peyronie’s disease

For a male health problem that affects up to nine percent of the adult population, it is amazing that practically no man ever hears about PD until the day he is given the diagnosis.  It is this shock – a “mystery” condition that comes out of the blue, for which there is no known cause and no known cure that can wreck a man’s life.  While caught off guard, totally confused and shocked upon first learning about Peyronie’s disease, a man is often does not ask all the standard questions and does not remember the information as he receives his diagnosis.

With so many details pouring into his ears, and so many questions rolling around in this brain, it is easy to understand why a man can leave his doctors office and not remember much about the mystery condition.  Even the doctor’s explanation about a Peyronie’s plaque can become confused, making it sound like it is related to the blood vessels.

Location of Peyronie’s plaque suggested by penile curvature

You can usually count on finding your internal plaque on the concave part of a curved penis.  If a plaque is located on the topside of the penile shaft (the most common location), the penis will bend upward.  A plaque on the underside causes a downward penile curvature.  A plaque on the left lateral side of the penis causes a curvature to the left, and a Peyronie’s plaque on the right lateral side of the penis causes a curvature to the right.

Many times a distortion develops on both top and side, or top and bottom, resulting in twists, hourglass deformities or indentation, even shortening of the penis.

Peyronies plaque is elusive

Each week I receive emails asking, “Since my doctor examined me and could not find any Peyronie’s plaque material, and I cannot see a scar, do you think I really have Peyronie’s disease?”

There is never an EXTERNAL scar or plaque in Peyronie’s disease that can be seen.  The Peyronie’s plaque is always an internal mass of fibrous tissue that is sometimes called a scar, but is not a scar in the usual sense.  Peyronie’s plaques or ‘scars” are only sometimes obvious, while at other times they cannot be found if a person’s life depended on it.  Ultimately, if you have Peyronie’s disease you must assume it is there and you should try as many different tactics as you can to find your scar(s) because having a clear and accurate information will help your Peyronie’s disease treatment effort.

To find the internal Peyronie’s plaque, sometimes it is helpful to think about it being much larger than you have previously imagined; mentally expand the size of the scar you are looking for.  If you were looking for a “pea” before and couldn’t find it, start looking for a “postage stamp” or a “thumb nail” size structure.  This change of the mental image increases your odds to detect it.

When the plaque cannot be located, but there is still pain and distortion of any kind, a diagnosis of PD can still be made.  This is so because the fibrous plaque can be so:

1. Small – it cannot be found

2. Soft – it blends into the other tissue and cannot be detected

3. Deep – it cannot be reached easily

4. Large and flat – that the edges are not determined, almost like something that is so close to you that you do not see it because you are looking far away

When plaque is never found it is because of a combination of two or more of these factors – deep and small, or soft, large and flat, or deep, soft and doctor error, and so on.

It is common to have difficulty locating the plaque for the first time.  Sometimes it is best to forget about finding a “scar.” Instead just try to find something – anything – within the mass of erectile tissue that feels unlike the other tissue.  Finding something unlike the rest of the penis tissue will help define the problem tissue that can be difficult to locate. It might be you have an unreasonable expectation of what a “scar” or Peyronie’s plaque should feel like, making it easy to miss what is rather obvious to someone else with experience in this regard.

After an unusual tissue is found, mark its location on the penis with a marker pen or something that will stay on the skin for a few days.  Return to that location each day to re-evaluate it.  You want to determine if it becomes easier to make sense of it, so you can monitor it during your Peyronie’s treatment.

Curved Penis and Peyronie’s Disease

Peyronies bent penis is focus of problem

While the primary interest of Peyronie’s disease treatment is the internal scar tissue or fibrous  plaque material that causes the distortion or curved penis to develop, it is not the primary interest of the man who has PD.  For him, the most important aspect of Peyronie’s disease is the curved penis that plagues him.  For this reason Peyronies is also known as the “bent nail disease.”

For those interested in viewing graphic pictures, click curved penis of Peyronie’s disease.

Peyronie’s disease causes a curved penis when the fibrous tissue of the Peyronie scar or plaque pulls unevenly or causes incomplete filling within the erect penis.  This can vary in degree or severity from man to man.  For this reason the curved penis does not indicate the severity of the Peyronies problem or success of Peyronies disease treatment.  The true success of Peyronies treatment is based on the change that occurs in the Peyronies plaque or scar.  Once the fibrous scar changes, eventual improvement in the curved penis can be expected in time.

The internal tissue of the healthy penis is flexible and expandable.  This normal tissue is able to allow for a normal erection to develop when blood is trapped inside the organ.

In Peyronie’s disease some of the tissue is not healthy or flexible and elastic.  Specifically, the deep tissue known as the tunica albuginea is not elastic because it replaced by dense and inelastic fibrous tissue that is called a scar or plaque.   As an erection develops the elastic tissue of the tunica albuginea must stretch and expand evenly on both sides, left and fright, and top and bottom, of the penis.  If this cannot happen because an area of the penis is no longer flexible and expandable, then a curved penis results.

Peyronie’s disease usually begins with a small nodule or bump that is found on the top or sides of the penis, just immediately below the surface.  A few weeks to several months to a year later, a small fibrous nodule can expand into a larger irregular scar of variable size, shape, density and surface quality.  These scars can be as long as the penis.  Some appear like a collar to go around the shaft.   Some are one large mass, while others appear to be like small isolated islands of fibrous tissue in many areas.   Scars can be so soft or small, with edges so tapered and vague that no scar can be found.  In a case of Peyronie’s disease when no scar or plaque can be found, it is still assumed to exist when a curved penis develops during erection. .

Normally curved penis

Most men have a straight erection, but some are born with a penis that curves or bends (usually upward).   Just as fingers on the hand or a nose can display a natural bend, or arms can be of different length on the same person, the penis can be bent without the presence of Peyronies.  Typically, the normally curved penis follows a more gradual and arched design, more like a banana.  In Peyronie’s disease the curved penis is more localized and abrupt, like an angulated bend.

When the two primary chambers (corpora cavernosa) of the penis are a different diameter or length, the penis will bend when erect.   The penis will appear straight when flaccid, and on erection it will bend.

This slight penile distortion will not be associated with pain, there will be no trauma in the history, and it will not appear suddenly as does the curved penis of Peyronie’s disease.

Curved penis affects sexual intercourse

It is estimated that 75-90% of Peyronie’s disease couples will sooner or later experience a sexual intercourse problem, in regard to either pain or difficult penetration – or both.   The curved penis of is the primary reason sexual penetration is compromised, and it is also the reason for the pain that can be experienced by either – or both – partner. This is especially so in those cases in which the distortion is so severe it is described as “cork screw” or “cane handle.”

Incomplete filling of the penis with blood during erection can also happen in Peyronies.  This results in an area of the penis, either small or large, that is soft and unable to sustain the rigors of intercourse.  A soft area within an otherwise firm erection presents a weakness and vulnerability of the normally turgid erection.  A weak area of erection can suddenly collapse or buckle during intercourse, causing additional injury to the penile tissue.  This can cause pain, inflammation and additional fibrous infiltration.

It is a rare Peyronies couple that does not deal with some level of sexual difficulty related to penile distortion and reduced firmness of the erection.  The many physical, emotional and social issues of Peyronie’s disease are complex.  For this reason the reader is referred to “Peyronie’s Disease and Sex” for more information about this complicated area of life with a curved penis.

Treatment of the curved penis

It is important to remember that any penile distortion that develops in Peyronie’s disease is not the primary problem of this condition.   A curved penis that appears one night is difficult to ignore, but is only a symptom of the real problem of Peyronie’s disease – the scar. Without the Peyronies scar there would be no curved penis.

This is the reason I advise men who are undergoing Peyronies treatment to focus on the size, shape, density and surface qualities of the scar or plaque to determine if their Alternative Medicine treatment is being effective.  The curvature can improve or worsen as the scar is reduced.

A small scar can cause a large bend, just as a large scar can cause no bend at all if it is balanced and symmetrical.   For this reason a curved penis can worsen as the scar is being reduced or eliminated.   Estimating progress or success of a PD therapy plan is difficult .  A man can have many more scars than he is aware of, and they can be larger than can be detected since they are often difficult to locate and often overlap.

If only one scar is present the curvature problems are direct and easy to understand, although  this is unusual.   However, if multiple scars are present the internal pulling and twisting they cause can be very complicated.   Several scars can interact on many  planes of internal penile tissue.   Any reduction in one or more scar will alter the internal tension and pulling of the tissues, resulting in an altered curvature.  There is no guarantee the curvature will change for the better initially – sometimes it can look worse as the scars become smaller.  This is why I advise to focus all attention to the size, shape, density and surface qualities of the scar while treatment of the Peyronies problem continues.  Realize the curved penis is just a reflection of what is going on with the scar9s) below the surface.

Do not be discouraged by the curved penis of Peyronie’s disease.  Instead, stay focused on your plan for effective Peyronies treatment.  Learn more about Peyronie’s disease treatment.

Peyronie’s Disease and Baby Boomers

Peyronie’s disease: male health problem no one knows about

If you are a member of the baby boomer generation and have never heard of Peyronie’s (pay-row-neez) disease, you are not alone. However, if you are a male baby boomer or married to one, you are in the prime age group to experience a problem you know nothing about. This is so because Peyronies disease primarily affects men between 50 to 65 years of age, although an age range of 18 to 80 years has been reported, with an average age at onset of 53. Few people know about the problem until they need Peyronie’s disease treatment. This is why it is important for all baby boomers to know about, and how to avoid, it because this health problem can easily ruin your life. Peyronie’s disease remains one of the most perplexing and difficult urological diseases to treat; it has been called “the doctor’s nightmare”. Most everything about this condition (cause, progression, symptoms, age distribution, response to treatment) is variable and unique to the man who has it. The great variability of Peyronie’s disease that makes it difficult to study and to understand, also makes it almost impossible to treat like other medical conditions. It is a complex problem that is much more common than most people realize. Estimates suggest that up to eight out of 100 men over the age of 40 have Peyronie’s disease – that is a lot of people worldwide – and still only a small percent of people have ever heard of it. People are reluctant to discuss this problem because it involves the male organ. For this reason it is difficult to develop accurate information and statistics, especially since men are so shy on one hand, yet also inclined to exaggerate.

Definition of Peyronie’s disease

Peyronie’s disease can best be understood as an exaggerated wound healing in response to an injury in which an excessive amount of Peyronie’s scar tissue develops within the man’s shaft. Peyronie’s disease (also known by over 12 different names, among which is “iduratio penis plastica”) is very special disorder of the connective tissue in which fibrous “scars” or “plaques” develop usually after direct injury. This Peyronie’s plaque occurs in a special tissue of the shaft known as the tunica albuginea, a fibrous chamber or envelope that surrounds the two penile cylindrical shaped masses of spongy tissue known as the corpora cavernosa. The corpora cavernosa enlarge during sexual excitement, and the tunica albuginea covering, are designed to expand and elongate. If there is fibrous scar or plaque material in the tunica albuginea, the expansion and elongation cannot develop properly resulting in bending, weakness, shortening and incomplete filling of the organ. Sometimes this distortion is mild (just a few degrees) and does not affect the ability to perform, while at other times the distortion can be extreme (more than 90 degrees) resulting in greatly adverse consequences. A certain degree of normal penile curvature can and does occur in some men. This is a benign and natural condition many men are born with, commonly referred to as congenital curvature; this is not Peyronie’s disease.

Peyronie’s disease signs and symptoms

Four common findings of Peyronie’s disease:

  1. Pain – caused by inflammation and stretching of internal tissues in response to injury and distortion; can be present constantly or only during erection
  2. Nodule or mass formation – variable size lumps or elongated cords can develop in one or multiple areas; sometimes these are difficult or impossible to locate depending on the density, depth and size of the scar formation
  3. Curvature or distortion – caused by presence of one or more nodules or masses of scar tissue in the tunica albuginea, preventing normal expansion during erection; can be minor to gross in appearance
  4. Reduced sexual ability – due to physical distortion that prevents penetration or due to reduced firmness that also prevents penetration (erectile dysfunction).

The onset of Peyronie's disease symptoms can be sudden or slow, but often appears within a month or two after direct injury. The pain of Peyronie’s disease is extremely variable; from hardly noticeable to the kind of pain that prevents sleep. Peyronie’s pain is worse in the beginning, usually gradually improving over time – improvement in a few weeks while others continue for years. For these reasons Peyronie’s pain is not a reliable way to judge the severity or calculate the time for eventual recovery. Even though Peyronie’s disease is a male health problem, women are also affected by it. They are indirectly and adversely affected by the erectile dysfunction, organ curvature and distortion that make intercourse often impossible, as well as loss of organ size that often occurs over time. Additionally, and perhaps even to a greater degree than men, woman bear the brunt of the mood swings, anger, brooding and ill-temper that accompany their partner’s Peyronies problem.

Treatment of Peyronie’s disease

There is no standard or accepted medical Peyronie’s cure since no drug is proven to eliminate the scar within the shaft. The only accepted and available medical treatment is Peyronie's disease surgery. However, given enough time after Peyronie’s surgery the condition will only re-appear in a worsened presentation. This surgical outcome is made bleaker by knowing that even the first Peyronie’s surgery can result in total loss of sensation (anesthesia), increased pain and increased curvature and greater scar formation than before surgery, and in some cases amputation. The Peyronie’s Disease Institute has specialized for the last eight years in the use of Alternative Medicine therapies and techniques that are found to be successful in perhaps 60-80% of cases. None of the therapies are known to result in adverse reactions or side effects. For more information about the Alternative Medicine approach, visit Peyronie’s disease treatment.

Prevention of Peyronie’s disease

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With so many variable aspects of this problem to consider, it is important to know that in addition to everything else, there is no universal agreement about the cause of Peyronies. Some say that injury alone cannot start the problem as we have described above, but that other genetic and metabolic factors must also be present. The Peyronie’s Disease Institute takes the position that this is true. However, if a man never sustains direct injury to the area he is far less likely to develop Peyronies. With age not working in the favor of any baby boomer couple, it is important to evaluate all situations in which direct injury can affect this area – especially sexual activity. This requires that special caution is exercised if a baby boomer gentleman finds he no longer has the usual firmness he previously possessed (erectile dysfunction). Attempting intercourse with a partially flaccid organ can result in sudden buckling or abrupt bending during insertion or the sex act itself. Another way to prevent injury is to modify the techniques used during sexual relations. The single most common injury that starts Peyronie’s disease occurs when the female partner is on top, and she loses hold of him while she thrusts down, jamming and painfully bending him against her upper thigh. To avoid this kind of injury it is important to not use any female-superior position, but to use other techniques in which physical contact is controlled, firm and not likely to disengage during activity. Even if baby boomers have never heard of this terrible condition that robs a couple of one of the greatest pleasures of life, it happens every day. Now that you know about Peyronie’s disease you can do a lot to protect the best years of your life. Dr. Theodore Herazy has practiced Alternative Medicine for over 40 years, and has directed the Peyronie’s Disease Institute for the last eight years. He has written two books about this problem, “Peyronie’s Disease Handbook” and “Peyronie’s Disease and Sex.”

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Peyronie’s Plaque or Scar

Peyronie's plaque or scar central issue

The central issue of Peyronie’s disease is the infamous Peyronie’s plaque, also called a scar. Peyronie’s disease typically occurs in men between 40 and 65 years of age, although a range of 16 to 80 years is documented; some experts say it can occur at any age. From personal communication with a particular man, I was told that his own Peyronie’s disease was started after a dog bite to the groin – at the age of 10. Nonetheless, it is most important to recognize that all clinical signs and symptoms of Peyronie’s disease originate from the effects of the plaque upon the internal tissue layers (tunica albuginea) of the penis.

A developing Peyronie’s plaque appears in response to either micro-trauma to the small blood vessels from a single injury of great force, or multiple injuries of a small force. While there is strong evidence that genetic factors and drug factors also influence the start of PD, it is trauma that is usually considered to be the most likely cause of the Peyronies plaque or scar.

A Peyronie’s plaque on the cellular level initially consists of fibrin threads deposited in a massive network throughout an area of injury within the tunica albuginea of the penis. Peyronie’s plaques, or scars, later combine the dense threads of fibrin connective tissue with reduced and fragmented elastic connective tissue fibers, as well as excessive amounts of type III collagen material, which happens to be specially inclined to excessive scar development. In about one-third of chronic cases of Peyronie’s disease, calcification of the plaque can occur over time. For more technical information about the Peyronies disease plaque.

The curvature of the Peyronies penis is due to the fact that scar tissue does not stretch as easily or as fully as healthy normal tissue. The normal tunica albuginea is composed of elastin fibers and collagen, although the site of scar tissue from Peyronie's disease is composed mostly of collagen. This difference in composition of these two tissues is what causes a bent penis to develop during erection.

Eventually as one or more Peyronie’s plaques develop into a mass of hardened tissue in the delicate tunica albuginea, it results in variable pain and penile distortion that most often takes the form of a bend or curve; sexual function is often reduced as a result of direct or indirect affects of Peyronie’s disease, also. The penile curvature of Peyronie's disease is caused by the dense inelastic scar, or plaque, material that shortens the involved side of the tunica albuginea layer that covers the corpora cavernosa of the penis. In approximately one third of patients, the scarring involves either the top or bottom portion of the penis shaft, occasionally both. The lateral sides of the penis can also be affected by Peyronie’s plaque development, if that area experiences injury.

Peyronie's plaque not easy to find sometimes

In some men the Peyronies plaque is easily found on manual examination, in others it is found with difficulty, and in some men no Peyronies plaque is ever located. It can be frustrating to have a wicked penis distortion, and still not be able to locate the Peyronie’s plaque.

 

To locate the plaque or scar material a light and inquisitive touch is most effective. Do not be heavy-handed, or press down into the deeper layers to find the Peyronie’s plaque material, because it is found just below the surface of the skin. And, oh yes, you will never directly see the plaque or scar, since it is not on the surface of the skin, but below. Make peace with the Peyronie’s plaque and do not hate it, just determine how to assist your body to remove it.


To learn about using Alternative Medicine to increase your ability to heal and repair the Peyronie’s plaque, a good place to start is the PDI website, Peyronie's disease treatment introduction.

Peyronie's Pain

Peyronie's disease pain is different with each man

Peyronie’s disease symptoms – even Peyronie’s pain – can be extremely variable. In fact, one of the things that makes Peyronie’s pain so undependable as a factor on which to create a diagnosis of Peyronie’s disease is that the penile pain is a different presentation from one man to another. Because of the wide variety of Peyronie’s disease pain symptoms, Peyronies treatment can be equally variable when using Alternative medicine.

Peyronie’s pain symptoms

The onset of Peyronie's pain symptoms can be sudden or slow, but most often will appear in less than a month after direct injury. Often the pain related to Peyronie’s disease is worse at the beginning of the problem, and then gradually improves over time – perhaps in a few weeks or months. Other men have a delayed onset of Peyronie’s disease pain. For all these reasons it is not a reliable way to judge the severity of the condition or to use to calculate the time necessary for eventual recovery.

For many men the pain associated with the actual injury that causes the problem to begin can be greater than the daily Peyronie’s pain that is associated with living with the condition. For others, the pain associated with the actual injury is mild and brief compared to the daily Peyronie’s pain they experience. Again, all of this is related to the variable nature of all Peyronie’s disease symptoms.

Peyronie’s disease pain patterns

Peyronie’s pain most often occurs with an erection during the first six to 18 months after onset. However, pain associated with Peyronie's disease may present itself in many ways:

  • Only during an erection
  • Only when not erect (flaccid)
  • Only during an orgasm
  • Only when the penis is touched

Peyronie’s pain originates in Buck’s fascia

The scar tissue, also known as a plaque, associated with Peyronie's disease and the variable pain it can cause can often – but always – be felt below the surface of the skin of the penis as small elevated or flat beads, lumps, bands of slightly to greatly dense and hard tissue. These soft tissue masses are located in a layer of soft tissue in the tunica albuginea. However, the scar in the tunica albuginea does not cause the actual Peyronie’s pain. The pain originates from the many pain fibers found just below the tunica albuginea in another layer of soft tissue called Buck’s fascia.

Apparently, when a man experiences intense or frequent Peyronie’s pain, it is because the scar is large enough or deep enough to press down deeper from the tunica albuginea into Buck’s fascia. And when pain is not as great a complaint, it is because Buck’s fascia is not being irritated by the scar or plaque material.

For a more comprehensive discussion of Peyronie’s disease pain, local penile anatomy and Peyronie’s disease treatment you can start searching the Peyronie's Disease Institute website at Peyronie's disease introduction.

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Peyronie’s Disease Plaque Fibrin Patterns

Peyronie’s plaque is the heart of the problem

Peyronie’s disease is an abnormal collection of fibrous pathological tissue in the deep tissue layers within the substance of the tunica albuginea and the Peyronies plaque; it is also characterized by excessive deposition of collagen within that same plaque material. Even thought the cause of Peyronie’s disease remains unknown, direct injury or repeated small trauma is most often thought to be the two most likely inciting events eventually resulting in Peyronie’s disease.

Materials and Methods

To understand the onset and cause of the Peyronie’s disease plaque or scar tissue that is always present in every case of PD, it is necessary to follow a simple approach that examines for the presence of collagen, elastic fiber, and fibrin content within the PD plaque material and evaluate its distribution.

Peyronies plaque or scar tissue specimens were taken from 33 Peyronie’s disease patient volunteers, and control penile tissue samples and nodular tissue samples were taken from eight patients with Dupuytren’s contracture (a related and similar problem of the hand). These samples were analyzed to determine collagen staining characteristics, and patterns of elastic tissue distribution. In addition, plaque tissue from another 19 Peyronie’s disease patients, control tissue and nodular tissue from Dupuytren’s disease were also analyzed for fibrin in these same samples.

Results

Abnormally stained collagen was found in 32 of 33 plaque specimens (97%), disrupted elastic fibers in 31 of 33 plaque specimens (94%), and abnormal fibrin deposits were also found in plaque tissue from 18 of 19 patients (95%). None of these abnormalities were located in normal or scared tunica from control patients.

Conclusions

These findings of fibrin deposits in Peyronie’s plaque tissue is consistent with the concept that repetitive injury and disruption of the small blood vessels and capillaries of the area results in fibrin deposition in the tissue space and has served to provide insights into the pathophysiology of Peyronie’s disease.

Peyronie’s Disease Treatment Philosophy – General Comments

The Peyronie’s Disease Institute treatment philosophy for dealing with Peyronie’s disease is not accepted within the medical community. You should know the PDI opinions and Peyronie's disease treatment philosophy are not current mainstream medical thinking, although PDI has assisted a dozen or more MDs with their Peyronies problem in the last few years.

The Peyronie’s Disease Institute philosophy for Peyronie’s treatment is different from standard medical thinking in two fundamental ways.

1. PDI recommends using mainstream Alternative Medicine therapy products (vitamin E, copper copper, DMSO, enzymes, etc.), and procedures like a special gentle manual penis stretching technique we have developed, and acupuncture). These are recommended even though they have not fulfilled the testing standards usually required of medication.

2. PDI has found after seven years of review and research that taking multiple therapies, all at the same time, in sufficient quantities as described on its website that it often stimulates or supports some degree of improved ability to heal and repair the famous Peyronie’s plaque or scar. The scientific term for this phenomenon is "synergy".

The specific therapy products used by PDI are well known and generally accepted as important, and often essential, for health and well being, such as vitamin E, MSM, acetyl-L-carnitine, etc. However, what is unique is that PDI advocates these therapy products are used in combination and in significant number for maximum potential effect and benefit. This synergistic concept of therapy used by PDI to treat PD takes advantage of the affect of synergy – a concept that is very well known in medical practice. Synergy is the ability of two or more substances to work together to produce a total effect greater than what each individual therapy could produce by itself. 

This Peyronie’s disease treatment concept is based on simple observations about this problem:

· Why do some men completely recover from Peyronie’s disease without treatment? You know, this happens in about half of the case.

· Why do some men get worse and need surgery, no matter what treatment they try?

· If the Peyronie’s plaque is similar to scars like I have on other parts of my body, why does it seem to change so much – not only the size, shape, and density of the scar, but also the location?

· If it’s actually the same problem among all the men who have it, why does Peyronies vary so much from one man to the next?

· What’s the difference between the two groups of men whose Peyronie’s disease goes away on its own, and the other in which it only gets worse no matter what they do for it?

· What is the fundamental difference between these two groups of different responses?

· How can I join the group that repairs and eliminates the Peyronie’s plaque and reverses the bent penis of PD?

Certainly , no one has complete or easy answers to this questions – yet. However, I think it makes perfect sense that the man whose Peyronie’s disease simply goes away on its own has a better healing capacity, than another man whose PD never improves. It cannot be a mater of luck; nature is just not that way. It is my opinion that you can increase your healing capacity and become healthier in some yet undetermined way so you are able to heal your Peyronie’s scar and reverse your Peyronie’s bend to the best of your ability.

The fact that some men are able to recover better than others, must mean there is variable − not static − capacity to healing and repair among men. Common sense and generally accepted knowledge about health, nutrition, and the healing process offers you and I the foundation for a treatment concept and philosophy that should improve your chances to recover from Peyronie’s disease better than if you did nothing to enhance your ability to heal. It is really as simple and direct as that.  The Peyronie’s plaque found within and on the tunica albuginea can be seen as an expression or extension of the overall health and healing potential of the body in which it occurs. Similar to an ulcer, a Peyronie’s plaque or scar can be thought of as the result of abnormal body chemistry and physiology. As such, treatment of Peyronie’s disease should attempt to improve that distressed or abnormal chemistry and physiology of the penile tissue in which the plaque is found.

 

 

 

All therapy products, nutrients, techniques and ideas presented by PDI are all directly or indirectly intended to improve the chemistry and physiology of the body in general and plaque elimination in the tunica specifically. The end result of this effort should be a healthier person with healthier tissue that can heal better. That is the reason all Peyronie’s therapy items are selected on the basis of their potential to improve or normalize the chemistry and physiology of the tunica of the penis and the foreign plaque material.

 

 

This Peyronie's treatment philosophy is not offered as though we have an absolute Peyronie's cure, not at all.   While we have a high success rate, it is not an absolute cure in that sense. It is merely presented as a way to treat the man who has Peyronie's disease, because  we all know this happens in 50% of the cases – so it can be done, and it is being done.  PDI is merely offering a way to increase your potential to join the ranks of the men whose Peyronie's plaque is healed naturally.  The only difference is that you are doing specific things in a deliberate and methodical manner to heal yourself better than you did the first time around.

 

Peyronie’s Disease Institute adopts the judgment of Mayo Clinic concerning Peyronie’s disease when it stated. ”early stage disease [of Peyronie’s disease] is reputed to respond better than well-established plaques, an early trial of inexpensive, safe and well-tolerated oral therapy is often initially recommended. … With advances in the molecular biology of inflammation and wound healing, the management and understanding of this frustrating disease will no doubt improve.”

With this statement in mind, I strongly recommend that any man, in any stage of Peyronie’s disease – no matter how chronic or advanced – should at least investigate the use of synergy created by the combination of several simultaneous non-invasive treatment measures selected on the basis of the best understanding of your problem and the information that is available to you. Peyronie's disease treatment is variable from one man to the next. Because the Alternative Medicine therapies used in Peyronie's disease treatment are intended not to treat the disease but to support and strengthen the man who has the problem, so he can heal and repair it to the best of his ability.  Since we are all different, each man must approach his own search for a Peyronies cure on an individual basis.

When you look at the different therapy products on PDI website, realize that they are intended to increase your ability to heal and repair PD, just as it naturally and spontaneously happens in 50% of the men who develop this condition.   Keeping this in mind should change the way you look not only at Peyronie's disease, but also the way that you consider your relationship to the problem and how you hope to eventually overcome it.