Developing Penile Curvature? – Its more common than we think
Developing Penile Curvature? – Its more common than you think.
Peyronie’s Disease or acquired penile curvature is a medical condition that can cause penile indentation, penile curvature, discomfort, and even an unstable penis with an erection. Initially it was thought to occur in 1 in 100 men, but now we know that it is more like 1 in 10 men. We don’t know what exactly causes Peyronie’s Disease. It can impact men of all ages. Some men are able to identify a specific injury they may have had during intercourse but in a majority of men it develops without an identifiable cause. It is common with erectile dysfunction or difficulty in getting and maintaining an erection.
Peyronie’s Disease is not dangerous and, in many men, once you are accurately diagnosed, you may choose observation. In about 40% of men the changes stay the same, 40% of men the changes worsen, and 20% of men the changes may improve. That being said if your Peyronie’s Disease is bothersome, negatively impact your life, or impacting your ability or your partner’s ability to have pleasurable sex, treatment makes sense! Since our understanding of what causes Peyronie’s Disease is not complete, there are no available methods to prevent or reverse the condition.
In many cases, just a simple history and physical examination alone is sufficient for diagnosis. Sometimes, we perform a penile ultrasound to further characterize the plaque causing the penile changes since it could impact the treatment choice and ultimate outcomes.
Fortunately, there are some treatment options that are proven to help with this medical condition. Every guy asks about pills, but unfortunately there is no evidence to suggest that any oral medications can help with Peyronie’s Disease.
Your options that have been proven to work include:
1. Traction therapy can be helpful for bothersome curvature and has been shown to improve curvature when used alone or with other therapies. It does require you to be dedicated to the therapy. Vacuum erection device can be especially helpful for men that primarily have a penile indentation and minimal curvature.
2. Injection therapy – injection therapy is a series of injections that are directly administered to the plaque or the point of penile deformity. Various medications have been used and studied, but only one, Xiaflex, is FDA approved for Peyronie’s Disease. This potent medication is designed to dissolve the plaque leading to the penile changes. This treatment can on average improve curvature 20-30 degrees. In men with other penile changes (indentation or new downward curvature), you may benefit from verapamil or interferon injections. Not everyone is an ideal candidate for injection therapy, but many men are, and this represents a proven, minimally invasive way to address your primary concerns.
3. Surgery – Although no one wants to undergo surgery especially down there, in many men surgical options may make more sense. There are two broad categories for Peyronie’s surgery 1) working on the side of the plaque and removing it 2) working on the side opposite of the plaque and using tensioning sutures to correct the curvature. Each has its advantages and disadvantages, and it is important to talk to your doctor about what procedure has the most benefit for your specific case. Lastly, in men with moderate-severe erectile dysfunction, a penile implant can correct both problems – the penile curvature/indentation as well as the erectile dysfunction.
I also talk to patients about alternative therapies they may have learned about elsewhere including shock-wave therapy, platelet rich plasma, or stem cells. These therapies are all considered experimental for Peyronie’s Disease and have not been proven in rigorous studies to actually work. There should be no reason someone should be shelling out thousands of dollars for a therapy that has not been proven. If you are interested in one of these therapies specifically consider being part of a clinical trial studying the therapy.
I believe the most important thing is to see a provider who is able to describe and offer the full spectrum of available treatments for this unique medical condition. Before you let anyone do anything to your penis, make sure you are armed with all the right information to decide on a treatment option that is best for your goals.
- Dr. Patel
