Peyronies Disease

Menstuff® has compiled the following information on Peyronies Disease.

The Basic Facts
Beginnings
Photos
Resources

The Basic Facts


Men with Peyronies disease generally seek medical attention for pain or bending of the penis during erection, which results from inflammation and scarring in a particular part of the male anatomy known as the tunica albuginea.

Francois de la Peyronie, surgeon to Louis XIV of France, first described treatment for this disorder in 1743.

This condition is most commonly acquired at about age 55. A man can be born with curvature of the penis, though this is not Peyronies disease.

Severity varies - only a minority of the men afflicted with this problem are unable to engage sexually. Through an effect on the erection mechanism it can reduce rigidity (hardness), but it rarely causes impotence.

It is somewhat uncommon, affecting somewhere between one and three men in a hundred.

In addition to producing curvature, Peyronies disease may change the shape of the erection in other ways: indentation, diameter reduction, or loss of length.

Peyronies disease can have a strong psychological impact.

Some cases are mild, healing without treatment within a year of onset. Most cases produce at least some degree of persistant curvature.

A noticeable lump, or plaque within the penis is commonly detected. Contrary to prevalent anxieties, it is noncancerous, and unrelated to cholesterol – containing arterial plaque

Peyronies disease can run in families, though most cases do not appear to be hereditary.

This condition is not associated with serious internal disorders. 10 –20% of men develop scarring of either the hands (Dupuytren’s contractures) or of the feet.

The goal of therapy is to maintain sexual function. In some cases, education about the disease and reassurance is all that is required. Rarely, when long-term deformity prevents intercourse, surgery is recommended.

Beginnings

The cause of Peyronie's disease is not well understood. Nonetheless, research findings that shed light on this question are of interest to patients as well as to medical scientists.

Consider a more specific question: What causes the erect penis to bend? The answer lies in the functioning of the erection mechanism, the corpora cavernosa. These cigar shaped, paired balloon-like chambers must inflate with blood to create an erection. Their connective tissue wall, or tunica albuginea, produces rigidity only when maximally stretched. It is elastic to a point, but unlike the flimsy wall of a balloon, tunica albuginea is interlaced with strong connective tissue fibers. These fibers control expansion, determine the shape of the erect penis, and translate internal filling into structural rigidity.

Peyronies disease is a disorder of the tunica albuginea. By producing firm areas, or plaques, it focally interferes with the expansion of this normally pliant material. Plaques can be either regions of reversible inflammation in early phases of the disease, or permanent scars later on. Regardless of their composition, they alter the shape of the distended corpora cavernosa and distort the resulting erection. Like a piece of cellophane tape on the wall of a balloon, they cause uneven inflation and bending out of column.

The real question is, what produces these plaques? Early on as painfully swollen patches of inflammed tunica albuginea, or later in the disease as the site of inelastic and permanently disfiguring scars, they are at the heart of the problem.

Microscopic and chemical studies have shown that plaques represent stages in the wound healing process, whether early or late. Whatever brings on Peyronies disease appears to do so by inappropriately turning on this normally healthful process.

More accurately, wound healing may not be inappropriate in all cases. We know that one cause of Peyronies disease is overt trauma to the erect penis. This can range from painful unexpected angulation during sex, to actual rupture of the corpora cavernosa, an even that produces immediate loss of the erection and subsequent severe swelling. The fact is, most men with Peyronies relate no such occurences.

Probably, all sexually active men experience some degree of wear and tear on particular vulnerable areas of the erection mechanism. Both the structural arrangement of the corpora and the inherent elasticity of its connective tissues counteract the strong mechanical stresses imposed by active intercouse. But by the time men reach their mid fifties, inherent connective tissue elasticity is on the wane. The median age for the appearance of Peyronies disease is fifty-five.

Peyronies plaques most commonly appear along the top of the penis. It is this region between the paired corpora, along the upper edge of the "inflatable I-beam"created by their inflation, that is vulnerable to stress-induced delamination . This is the region where fibrin, a protien involved in activating wound healing, can be found in men with Peyronies disease.

Autopsy studies on men have shown that the earliest microscopic changes thought to be evidence of Peyronies disease are actually a common finding. Though many men develop these changes, they evolve into Peyronies plaques in a very small percentage of cases. So what causes normal wear and tear to abnormally activate wound healing? At this point there is no clear answer. Peyronies disease is more common in diabetics and in men with gout, two condtions that can affect 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 can be inherited, and may reflect an abnormal tendency toward scar formation in other areas.

Resources

A nation wide referral source to physicians trained in and dedicated to the treatment of erectile dysfunction. www.ImpotenceSpecialists.com

An interactive forum for patients, sponsored by a company currently engaged in developing new therapy for Peyronies disease. www.biospecifics.com/forum/index2.html

An excellent site with discussion sections and referral guide. www.peyroniesassoc.org v

The American Foundation for Urologic Diseases, an organization dedicated to funding research. www.afud.org

The American Urological Association, a professional organization dedicated to the advancement of urologic patient care. www.auanet.org

The Journal of Urology where the majority of important contemporary research is printed in. www.jurology.com

The Mayo Clinic patient information system. www.mayoclinic.com

National Institutes of Health Clearinghouse for information on urological diseases. www.NIDDK.nih.gov/health/urolog/urolog.htm

Source: www.peyronies.org

Peyronie's Diseses Institute This group discusses at great length and depth the Alternative Medicine treatment of this problem. http://www.peyronies-disease-help.com or info@peyronies-disease-help.com

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