Peyronie’s Disease

Description

Peyronie’s disease is a condition characterized by penile deformity caused by the formation of fibrous scar tissue (plaque) within the tunica albuginea of the penis.

The disease is named after the French surgeon François Gigot de la Peyronie, who first described the condition in the 18th century. It is estimated to affect 0.5–3% of men, although the true prevalence is likely higher because many affected individuals do not seek medical attention. Peyronie’s disease most commonly occurs in men between 40 and 70 years of age.

Cause

The exact cause of Peyronie’s disease is not fully understood. It is believed that the condition most commonly develops following repetitive microtrauma to the penis during sexual intercourse, sports activities, or accidents. These injuries damage the tunica albuginea, the fibrous connective tissue surrounding the erectile bodies. During healing, excessive fibrosis and scar tissue formation may occur, leading to penile curvature or deformity. In some cases, Peyronie’s disease develops without any identifiable trauma.

Risk Factors

Risk factors for Peyronie’s disease include:

• Advanced age.
• Family history. The risk is increased in men with an affected father or brother.
• Connective tissue disorders. Approximately 30% of men with Peyronie’s disease also have Dupuytren’s contracture, a fibrotic condition affecting the palmar fascia.

Symptoms

Symptoms of Peyronie’s disease usually develop gradually and may include:

• A palpable fibrous plaque beneath the penile skin.
• Penile pain, particularly during erection.
• Penile curvature or other deformity during erection.
• Difficulty with sexual intercourse.
• Erectile dysfunction, particularly in more advanced cases due to extensive fibrosis.

Diagnosis

The diagnosis is usually based on the patient’s history and physical examination of the penis, including inspection and palpation. In more advanced cases, penile ultrasonography may be performed, often after intracavernosal administration of a vasoactive agent to induce an erection. Plain radiography may also detect calcified plaques.

Treatment

In some men, Peyronie’s disease stabilizes or improves spontaneously within approximately one year. Several medical therapies have been used, although evidence supporting their effectiveness is limited. Extracorporeal shock wave therapy may be used to reduce pain and treat fibrotic plaques. In selected cases with significant penile deformity or functional impairment, surgical correction may be required.

Source | Author Doctor Nikas Samuolis, reviewed by Prof. Virginijus Šapoka | Vilnius University | Faculty of Medicine | Head of the Department of Internal Medicine, Family Medicine, and Oncology