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Peyronie's disease
Treatment
Because
the course of Peyronie's disease differs from man to man and some men
experience improvement without treatment, doctors often initially
recommend a wait-and-see approach. Your doctor may suggest monitoring
the progression of the disease for nine to 12 months by assessing plaque
formation, penile curvature and erectile function before attempting
treatment. Some treatments — surgical and nonsurgical — can increase a
man's risk of ED.
Nonsurgical methods
If
Peyronie's disease doesn't improve without treatment, your doctor may
suggest one of the following nonsurgical treatments:
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Vitamin E.
Researchers have reported improvements in Peyronie's disease when
vitamin E is taken orally, yet the effectiveness of vitamin E
therapy has yet to be proved in controlled studies. Similar research
exists on para-aminobenzoate, a substance belonging to the family of
B complex molecules. The benefit of para-aminobenzoate also remains
unproved.
-
Intralesional injections.
Your doctor can inject drugs such as collagenase, verapamil or other
calcium channel blockers directly into the plaque. These drugs are
intended to break down scar tissue deposits and return the tissue
building process to normal. Multiple injections occur over a period
of up to three months. The success of intralesional injections
varies. Intralesional injection of steroids, such as cortisone, has
caused harmful side effects to healthy penile tissues.
Surgery
If
other methods of treatment don't help and your penis is still curved or
bent when erect, surgery may be an option. Doctors usually suggest
surgery when unacceptable appearance, pain during intercourse and poor
erection quality persist for one to 2 years or longer. Surgery is
generally effective at restoring normal erections, although each method
can cause unwelcome side effects such as partial loss of erection or
shortening of an erect penis.
Common
surgical methods include:
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Plaque
excision.
The plaque is removed and replaced with a patch of skin from the
pubic area.
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Nesbit
plication.
Tissue on the opposite side of the penis is removed or pinched,
canceling the bending effect.
-
Plaque
incision with saphenous vein graft.
Several linear cuts are made in the plaque, which allows
straightening. The cut plaque is then covered with a grafted vein.
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Penile
prosthesis.
An implanted device is used to straighten and increase the rigidity
of the penis.
Prevention
There's no known
prevention for Peyronie's disease. It's possible that the problem may
begin with trauma to the penis from being hit or bent abnormally when
erect or during sexual intercourse. Avoiding injury to your penis when
erect may prevent the development of Peyronie's disease. However, trauma
to the penis doesn't explain all cases of the disorder.
Coping skills
Peyronie's disease
can become a source of mental and emotional stress for you and your
partner. Having the disease shouldn't be seen as a reflection of your
health, virility or masculinity. If you have Peyronie's disease that has
progressed to include erectile dysfunction, remember that your partner
may see your inability to have intercourse as a sign of diminished
sexual desire. Your reassurance that this isn't the case can help your
relationship.
Peyronie's disease
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