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.
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.
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.