Peyronie's Disease

Peyronie's disease

What is Peyronie's disease?

Peyronie's disease is a disorder affecting the penis that can cause:

* a lump within the shaft of the penis

* pain in the shaft of the penis

* abnormal angulation of the erect penis ('bent' penis).

Not all of these features are necessarily present, but, typically, a man would first notice a tender lump in the penis, which might later be followed by bending of the penis when erect, sometimes at very odd angles. The flaccid penis is not usually deformed. It is important to remember that a degree of upward (towards the head) angulation of the erect penis is quite normal and not a feature of Peyronie's disease.

Good advice

Noticing a lump in the penis can be a frightening experience. Men are often concerned that they have developed a cancer. Cancer within the penile shaft is very rare indeed, while Peyronie's disease is by far the most common cause of such lumps. If you find a lump, it is important to seek prompt medical advice, but you should not be too fearful that a serious cause will be found

What causes Peyronie's disease?

The penis consists of basically three cylinders, covered by several sheaths of tissue and, finally, by skin. A pair of corpora cavernosa form the erectile tissue that becomes engorged with blood during erection, acting like the inner tube of a tyre. They are surrounded by the tunica albuginea, a tough, inelastic, fibrous sheath, which might be compared with the tyre itself. When the penis becomes erect, the inner tubes (corpora cavernosa) inflate, filling the space within the tyre (tunica albugenia), making it more rigid.

In Peyronie's disease, tough, fibrous plaques spontaneously appear within the tunica albugenia, and are felt as tender lumps. When the penis becomes erect, it inflates unevenly and tends to bend around the plaque, causing the characteristic deformed appearance of Peyronie's disease.

Experts are not certain why some men get Peyronie's disease and others do not. Several factors might be involved, including:

* genetics: occasionally the disease has a tendency to run in certain families (inherited or genetic predisposition), but this is not common.

* injury: Peyronie's disease is more common after injury to the penis, such as penile fracture or forceful bending of the erect penis. It also occurs more frequently in men that give injections into the penis for the treatment of erectile dysfunction (impotence).

* circulatory disorders: more men with Peyronie's disease seem to be affected by high blood pressure and hardening of the arteries (atherosclerosis), so these conditions might possibly be involved in its development.

* diabetes: this is more common in men with Peyronie's disease, so might also be involved in its development.

What are the symptoms?

Peyronie's disease occurs at any time from adolescence onwards, but most commonly in men aged 40 to 60 years. It affects around 1 in a 100 (0.4 to 1.0 per cent) of the middle-aged male population.

The disease causes very variable degrees of deformity and inconvenience. Some men are barely troubled by it, while others find sexual intercourse physically impossible. Many men will not require treatment, but all should seek prompt medical advice.

The symptoms are:

* a lump within the shaft of the penis: this can slowly develop over several months and frequently takes 12-18 months to reach its full extent.

* pain in the shaft of the penis: two-thirds of men with Peyronie's disease will experience pain in the penis. In most cases, it will gradually settle down and disappear without treatment in a few months.

* abnormal angulation of the erect penis ('bent' penis): during the 12 to 18 months that the plaque or lump is developing, the deformity of the erect penis can change - 30 to 40 per cent get worse, 10 to 20 per cent get better and 50 per cent remain the same.

Some men will develop varying degrees of erectile dysfunction (impotence) as a consequence of Peyronie's disease. This can vary from a complete inability to attain and/or maintain an erection adequate for satisfactory sexual experience to a slight reduction in penile rigidity. Some men report a tendency for the penis to buckle around