Peyronie’s disease

Peyronie’s disease occurs most commonly to men after the age of 40. There is no cause known, however, it is more common in men who have Dupuytren’s disease. This implies there is a genetic disposition. The disease is characterized by the formation of plaques of fibrous tissue in the sheath of the corpora cavernosa. The initial phase (presentation) of the disease is the development of a lump within the shaft of the penis, which may be painful, and the subsequent development of a bend in the erect penis. There may also be loss of strength, loss of length, narrowing or ‘wasting’ of the penis and difficulty with intercourse.

Peyronie’s disease is diagnosed based on physical examination and patient’s description of penis when erect. Peyronie’s disease is not contagious or cancerous and the plaque itself is benign.

Unfortunately, at present there is no effective treatment that alters the natural history of the disease. However, in the vast majority, the condition settles down over 12-18 months and leaves a mild deformity, usually a bend up and to one side.

A small number of men get a significant bend or other problems, and these men may benefit from surgical correction of the deformity. There are three operations used to straighten and correct the deformity caused by the Peyronie’s plaque.

‘Nesbit’ type operation

This is the simplest and most common operation. Several ellipses of tunica are excised in the convex side of the bend to straighten the penis. However, this does shorten the penis.

Incision and grafting of the plaque

This is a more complex operation with a higher complication rate but does not shorten the penis. This procedure is usually reserved for the severe and upward bend.

Penile prosthesis

If the penis is bent and not able to get a decent erection, then a prosthesis may be the only option.

Points to remember

  • Peyronie’s disease is characterized by a plaque, or hard lump, that forms within the penis.
  • In severe cases, the hardened plaque reduces flexibility, causing pain and forcing the penis to bend or arc during erection.
  • The plaque/fibrous tissue is benign, or noncancerous and is not contagious.
  • Peyronie’s disease is not contagious and is not known to be caused by any transmittable disease. Treatments for Peyronie’s disease include oral medicines, injections, and surgery.
  • Medical experts suggest waiting 12-18 months or longer before attempting to correct Peyronie’s disease surgically.

Following your surgery

  • You will be discharged from hospital on the same day and for some patients, the day after surgery.
  • You may experience some bruising and pain. Take regular pain relief for 24-48 hours.
  • It is advisable you rest for a few days and do not do any strenuous activities/sports for at least 2-4 weeks.
  • You will return to the rooms for a wound check 1 week following your procedure and then a review appointment with the surgeon 3 weeks later.
  • It is advisable you refrain from sexual intercourse for 6 weeks.
  • Please call the rooms if you experience any swelling, pain not relieved by medication or fever.