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Southern California Urology Institute
Gary Bellman, M.D., F.R.C.S.
Board Certified Urologist
Fellowship Trained, Certified in Robotic Surgery

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Understading Peyronie's Disease

By: Dr. Gary Bellman on February 26, 2016, 5:20 pm

Like a lot of men’s health issues,  Peyronie’s disease is something that until recently wasn’t largely talked about.  Most likely, this is because men don’t often like to bring attention to problems ‘below the belt’ or ‘in the bedroom’, so to speak.  However, research shows that approximately 5%  of men have Peyronie’s disease (and that number could be higher for reasons mentioned above).
 
What are the symptoms and causes of Peyronie’s disease?
Because of the somewhat rarity of diagnosis, and the fact that it isn’t often openly discussed, many men or their partners aren’t even sure what Peyronie’s disease is--  Peyronie’s disease is a condition of the penis that causes it to curve and feel painful when erect.  Symptoms of Peyronie's disease include pain during intercourse or ejaculation, erectile dysfunction, the inability to have sexual intercourse, anxiety, stress, an indentation of the shaft at the site where there is plaque or scarring, and an angulation when erect or flaccid.
 
The exact cause of Peyronie's disease is not known.  However, whatever can cause plaque or scar formation in the penile shaft is a likely candidate.  Researchers have suggested several possible agents such as vitamin E deficiency, beta-blocking medications, elevations in serotonin, and genetic causes.  Some researchers think that minor vascular traumas to the penis (during sex or athletic endeavors) that may reoccur over time may lead to scar formation.
 
There are, in general, two phases of the disease. The acute phase lasts about 18-24 months and usually has the highest pain component; the chronic phase (begins at about 18- 24 months after first symptoms) usually has less pain but in this stage, the plaque or scarring is more refractory to treatment  and may begin to develop large calcium deposits (calcified plaque or scarring).
 
 
So why is it important to start talking about Peyronie’s disease?
Because this condition has many implications on men’s health beyond just sexual, including:
 
  • social stigmatism
  • negative self-image
  • relationship difficulties
  • anxiety
 
The FDA announced a newly approved drug called Xiaflex to treat patients suffering from Peyronie’s.  Xiaflex is said to work by breaking down a buildup of scar tissue underneath the skin that causes the penis to curve.  Some men are treated with surgery, but many are wary of it because it results in a shortening of the penis.
 
Xiaflex will give patients and doctors an alternative to surgery, which is the typical treatment for Peyronie’s disease.
 
 


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