Peyronie’s disease, also known as induration penis plastic or chronic inflammation of the tunica, is a tissue disorder involving the growth of fibrous plaques in the soft tissue of the penis affecting 5% of men. In my practice at least 25% of surgical candidates have Peyronie’s like plaques prior to surgery. Specifically, scar tissue forms in the tunica, the thick sheath of tissue surrounding the corpora cavernosa (or erectile bodies) causing pain, erectile dysfunction, abnormal curvature, loss of girth, indentation, and shortening of the penis. A variety of treatments have been used, but none have been especially effective.
Signs and Symptoms of Peyronie’s Disease
Peyronie’s may cause pain, hardened, big, cord like lesions or scar tissue known as “plaques”, and abnormal penile curvature when erect due to chronic inflammation of the tunica albuginea. It is a common misconception that Peyronie’s Disease always involves curvature of the penis, however, the scar tissue sometimes causes divots or indentations rather than curvature. The condition may also make sexual intercourse painful and difficult. Progression of the disease will result in complete atrophy eventually.
In our practice men over 50 with any degree of erectile dysfunction are directed towards the inevitable: A Penile Prosthesis. When placing the Penile Prosthesis we utilize our novel approach to correcting curvature and defects with the “Scratch” Technique. Click here to view this Technique.
Frequently Asked Questions about Peyronie’s Disease:
Please tell us a little bit about your background and your experience of treating patients with Peyronie’s disease?
I [Dr. Perito] have been the number one penile implanter in the world for the last ten years.
Roughly how many Peyronie’s patients do you treat each year?
We at Perito Urology do over 500 implants per year and nearly 25% of these patients have Peyronie’s. Another group seen in our office includes patients with Peyronie’s who are not going to surgery.
What is the average age of your Peyronie’s patients?
The average Peyronie’s patient age is 58 years old.
Approximately how many of your patients fall into each of the following groups: mild, moderate, and severe Peyronie’s condition?
10% with mild Peyronie’s, 10% with moderate, and 80% with severe Peyronie’s Disease.
How common do you think Peyronie’s is? Do you think it is on the rise, e.g. due to lifestyle changes or environmental issues, or are men becoming more open about seeking assistance?
It’s more common than previously thought. I think we must consider more “vigorous” sexual activity as a potential cause.
In your opinion, are some men more likely than others to develop Peyronie’s disease?
Yes, men who are more frequently and aggressively sexually active.
How important is early diagnosis in your opinion? Can men expect better results the sooner they start treatment, and why?
Early diagnosis is extremely important. Days can make the difference.
Can you describe the non-surgical treatments you recommend to your patients? What influences which treatments you recommend?
Colchicine, Trentyl, and vacuum devices with aggressive rehab, although new data suggest the meds do not help.
What do you consider a satisfying result from non-surgical Peyronie’s treatment?
Because I am the implantor, the patient must be perfectly straight when completed. I also push them quickly to surgery in order to avoid more loss of length.
What is your view on using supplements as part of a Peyronie’s treatment plan?
I do not consider that an effective treatment.
Have you used Xiaflex and / or Verapamil injections? If so, what is your experience of them? How does Xiaflex compare to Verapamil in your opinion?
I have used both. I believe the disruption of the plaque with the needle might actually be the only efficacious part of this procedure.
Have you recommended using traction devices or penis pumps to treat penis curvatures? If so, what is your experience with them? When do you recommend using each device?
The devices are cumbersome, and patients who do use them tend to find them to be difficult and odd.
What do you recommend for me that also suffer from low erectile quality / erectile dysfunction?
Approximately what percentage of your Peyronie’s patients do not respond to non-surgical treatment and therefore require penis surgery? Have you been able to identify any common characteristics among those patients?
80% do not respond to non-surgical treatment. If they are under 50, however, they stand a chance for conservative management.
What types of surgery do you perform and what is your experience of each?
Inflatable penile prosthesis with modeling and the scratch technique.
There is some risk involved with any surgery. In your experience, how common are serious side effects after penis surgery (e.g. erectile dysfunction, penile shortening, reduced penile sensation, loss of elasticity)?
For the aforementioned procedures, the only real risk is infection, with a rate of less than 1%.
For patients that have undergone surgery to treat their Peyronie’s disease, do you recommend some post operation treatment for them? If yes, what do you recommend?
The patients have to be responsible for their post-operative rehabilitation. Please see the videos on my website for the laundry list.
What do you recommend that men with Peyronie’s disease should or shouldn’t do to prevent the disease from getting worse?
Extensive rehab with VED and early implantation.
How do you address the emotional side of Peyronie’s? What can men do to deal with the distress caused by the disease?
Early implantation limits the loss in penile length.
In your opinion, how can partners or friends best support men with Peyronie’s disease?
Support him in early and aggressive management.
What can be done to raise the awareness of Peyronie’s, both among the public and health professionals.
Let the public know that patients with Peyronie’s disease will lose between .5 and 5cm every month.
What do the future hold for Peyronie’s patients? Are there any interesting new treatments on the horizon (short and/or long term)? Do you think Peyronie’s will ever become curable?
I’d suggest watching the scratch technique video on Peritourology.com.
For more information on Peyronie’s disease, you may also visit: http://www.mypeyronies.com.