Cause of Peyronie’s disease

How Peyronie’s disease starts

As anyone who has the problem knows, the cause of Peyronie's disease is not well understood.  However, any research topics that shed light on this basic question are of great interest to men who have Peyronie’s disease.

Perhaps a good question to start with is, what causes the erect penis to bend in a case of Peyronie’s disease?  The answer lies in the function of the corpora cavernosa functions in the mechanism to produce an erection. There are actually two corpora cavernosa, laying side by side like two cigar shaped, paired balloon-like chambers that must be filled with blood to create an erection. Their connective tissue wall, the tunica albuginea, offers resistance and rigidity when it is stretched to its maximum.  The tunica is elastic to a point, but unlike the thin and flexible wall of a balloon, the tunica albuginea is interlaced with strong connective tissue fibers. These strong fibers do not allow for much expansion, and eventually determine the shape of the erect penis because of their structural rigidity.

Thus, in a very real and fundamental way, Peyronies disease is a disorder of the tunica albuginea. By producing dense and rigid areas of the tunica, called Peyronie's plaque or scars, Peyronie’s disease interferes with the full expansion of the tunica. Plaques are either regions of reversible inflammation in early phases of Peyronies, or permanent scars later if the inflammation is severe and continues too long.  Much like a piece of tape placed on the wall of a balloon, the plaque or scar causes uneven filling and expansion of the tunica, and this causes bending  of the column of the corpora cavernosa.

A basic question is, what causes these plaques to begin?  Microscopic and chemical studies show that plaques represent an early stage of the wound healing process when the tunica is injured. Whatever starts Peyronie’s disease, the problem seems to the inappropriately increase of the normally healthful and proper process of wound repair.  Actually, wound healing may not be the appropriate term in all situations.

Most likely cause of Peyronie's disease

One cause of Peyronies disease is obvious and direct trauma to the erect penis. This trauma can range from sudden and unexpected angulation during sex, to am actual rupture of the corpora cavernosa.  However, the fact is, many men with Peyronies do not recall any such traumatic occurrences.

Over time, all sexually active men will experience some degree of wear and tear on vulnerable areas of the soft tissue erection mechanism. Both the structural arrangement of the corpora and the inherent elasticity of its connective tissues counteract the strong mechanical stresses created by strong sexual activity.  But when men reach their mid-fifties, fundamental connective tissue elasticity throughout the body, and the penis, is on the decline.   And so, it just so happens that the average for appearance of Peyronies disease is fifty-four.

Peyronies plaques most often appear along the top surface of the penis. It is this region where the two corpora meet side by side, along the upper edge of the “inflatable I-beam” created during an erection that is most vulnerable to stress induced delamination.  Another word for a layer is a lamina; when layers are disrupted or separated, it is called delamination.

Autopsy studies in the mid-1990s on men have shown the earliest microscopic changes thought to be early Peyronies disease changes are actually a common finding.   It seems that while many men develop these changes, they will evolve into Peyronies plaques only for a small percentage of cases.

So what causes the process of normal wear and tear to develop abnormally into the destructive process of wound healing that is called Peyronie’s disease?  There are no clear answers to this question.   However, Peyronies disease is more common in diabetics, as well as men who have gout.  These are two conditions that can have an adverse affect on normal connective tissue healing. It is also more common in the presence of Dupuytren’s contractures. These scars of the fascial covering of the finger tendons in the palm of the hand are thought to be inherited, and may reflect an abnormal tendency toward scar formation in other areas.

Thus, we see that much is still to be learned about Peyronie’s disease, but as these microscopic tissue clues are unraveled, the mystery of this problem will be advanced, as well as Peyronie’s disease treatment.


4 thoughts on “Cause of Peyronie’s disease

  1. Pilgrim says:

    What is the best diet for PD ? Exactly what should we eat or not eat ? Also, I am taking 4 Neprinol 3 x a day with no problem. You posted somewhere that men who take more than 12 a day get good results. Should I consider taking 10 – 3 x a day and knock this thing out quicker ?

  2. therazy says:

    Greetings Pilgrim,

    You ask a simple question about the PDI Peyronie’s disease diet that is a lot more complicated than it might first appear. To fully answer this common – and important – question, i devoted an entire chapter in my book, “Peyronie’s Disease Handbook,” so everyone would fully understand the way to go about this important part of Peyronie’s disease therapy.

    You ask a basic question about Neprinol treatment. The men I supply Neprinol are given specific instructions for taking this enzyme, perhaps different than what you have received from the party from whom you purchased your products. What did your supplier advise you? When we send out any product used to treat PD, each comes with full instructions to answer these kinds of questions, so our PDI customers are fully informed.

    Since I do not know how you are conducting your Peyronie’s disease treatment plan, or what you could possibly be taking for your problem, nor have I received sufficient input about your condition, it is not possible to offer an opinion.

    With only so many hours available in the day, I am afraid I am forced to limit my correspondence to answer all the emails and blog posts of those people who are customers of PDI; I hope you understand. TRH

  3. froggy says:

    Hi Dr. Herazy,

    My wife recently came across an article about SSKI or potassium iodide as a potential treatment for Peyronie’s disease. Here’s the link to the article:

    Do you think there is any validity to this?

    Also curious about a comment made by sflo a while back….is it ok to eat just egg whites on the Peyronie’s disease diet or no?

    Lastly, been using the stretching techniques from the Peyronie’s disease stretching video quite often and have seen some noticeable improvement. One thing I have noticed as well is that the scar seems to be more visible throughg the surface of the skin on the shaft — definitely more so after stretching, but also during times of not stretching. Was this something that occurred in the men that participated when the stretching technique was being developed?

    Thank you so much Dr. Herazy!

  4. Pingback: Peyronie's plaque | Peyronie's Disease Treatment Forum

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.