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

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.”