Peyronie's disease

Dear Reader,

You're certainly right that you deserve to enjoy your sex life well beyond your 57th year! As you mentioned, a bent or curved penis isn't an uncommon occurrence. Whether to the left or right, up or down — every penis is unique. The physician in Chicago your urologist was referring to could be Dr. Laurence Levine, who specializes in male sexual function and fertility. He’s a professor of Urology at the Rush University Medical Center in Chicago, Illinois. Dr. Levine has contributed a substantial amount of research to Peyronie’s disease and is considered a leader in the field of urology. That being said, many other health care professionals may be able to help you. Other than natural variation among men, a bend in your “member” can be due to a variety of causes, including an autoimmune disorder, an inherited fibrous tissue abnormality, an injury, or Peyronie’s disease. So, as you experienced, if your curve takes a “turn for the worse” and becomes painful or impedes your normal sexual functioning, discussing your symptoms with your health care provider is a great move.

Peyronie’s disease is still somewhat of a mystery to many urologists and health care professionals. In contrast to a typical penile bend, those with the condition may have developed scar tissue in the sponge-like spaces of their penis, which expand with increased blood flow during erection. While many health care providers suspect the root cause of Peyronie’s to be related to injury, not all who develop the condition report any kind of harm to their penis. Furthermore, the symptoms of Peyronie’s disease may be noticed gradually or suddenly and typically occur in two phases: the acute and chronic phase. The acute phase includes having symptoms such as pain, increasing curvature, shortening of the penis, erectile dysfunction, and the formation of plaques (a flat area of scar tissue) that can be felt through the skin. In contrast, the chronic phase is when the curvature of the penis remains constant and the formation of plaques has stopped. In addition, it's possible for erectile dysfunction (ED) to develop during this phase.

An exam to test someone for Peyronie’s disease will typically start with a physical evaluation of the non-erect penis for the location and amount of scar tissue. Your health care provider may also measure the length of your penis to use as reference if your symptoms worsen and the curvature progresses. Additionally, some medical providers will request a picture of your penis when erect, or perform a physical evaluation of your erect penis. This is to help them better identify the degree of curvature, as well as where the formation of plaques are. Moreover, a healthcare provider may also request follow up tests, such as an ultrasound, in order to get a better visual of where the plaques are and check blood flow in the penis.

Historically, treatment for Peyronie’s has been fairly limited to surgical options, such as shortening the unaffected side of the penis, lengthening the affected side, or penile implants. There is still a great need for research on effective treatments, but the most recent reports suggest there are some possible options that are less invasive. These can include:

• Oral prescriptions: This treatment method isn't recommended for those in the chronic phase. However, as long term studies haven't been able to show consistent effectiveness.
• Intralesional therapy: This is when medication is directly injected into the areas with plaque.
• Penile traction (traction therapy): This is the use of a mechanical device in order to lengthen and reduce curvature gradually.
• Shockwave therapy: This uses pulsing shocks to decrease scar tissue. However, there isn't much evidence that this is an effective treatment for Peyronie's.
• Radiotherapy: This exposes the affected area to low dose radiation to reduce inflammation. However, there is limited evidence regarding its effectiveness.
• Iontophoresis: This is the use of electrical current to speed up the effectiveness of topical prescriptions. However, research has shown conflicting results when it comes to effectively treating Peyronie's.

While vitamin E has been widely recommended for initial treatment of Peyronie’s disease due to its affordability and availability, results are mixed when it comes to how effective it is for long-term treatment of Peyronie’s. So, if you’re not happy with your current treatment plan, you may want to seek a second opinion. Furthermore, maintaining a healthy sex life doesn't need to be an afterthought as you decide on the treatment that is best for you. While talking with your health care provider may help you decide on prescription or surgical intervention, you may also want to consider talking with a mental health professional or sex therapist to address any stress or sexual concerns Peyronie’s disease causes in the bedroom. The Peyronie’s Association also houses additional information and Q&As on how to navigate intimacy and sex.

While you may have a few more curves in the road ahead, hopefully you can continue to seek out information and options that support your health and sexual wellbeing.

Best of luck!