Peyronie's Disease (Bent Penis)
Peyronie’s Disease is a problem with the penis where scar tissue, or plaque, form in the blood vessels of the penis that makes it erect. When the blood vessels don’t stretch like they are supposed to the penis can curve towards the scar tissue, have a dent in the area or be less erect. In severe cases the penis can bend > 180 degrees! Sometimes the scar tissue can be painful or make it difficult to have sex.
What Causes Peyronie’s Disease?
We’re not sure but many cases start with some minor trauma, usually during intercourse. Some people are predisposed to forming scar tissue. Peyronie’s Disease is also listed as a possible side effect of some medications.
How Do We Treat Peyronie’s Disease?
Most cases of Peyronie’s Disease are mild and resolve on their own. It can take up to 3 years for the scar to mature. Sometimes the plaques calcify and make treatment very difficult. There are reports that Vitamin E and Potaba can help but the data isn’t strong. Verapamil, either in gel form or injected directly into the plaque.
In December 2013 the FDA approved the first medication for treatment of Peyronie’s Disease. Xiaflex (collagenase clostridium histolyticum) is injected directly into the scar and breaks down abnormal scar formation. A typical treatment cycle involves marking the scar, 2 injections on different days and finally a modeling session where the scar is stretched. The patient is given instructions to stretch and manipulate the scar at home. These cycles can be repeated 6 weeks apart and up to 4 times. Dr. Nelson was one of the first in Arizona to treat Peyronie’s Disease with Xiaflex.
Surgical Options for Peyronie’s Disease.
Surgical options include excising the plaque and placing a graft in it’s place. In severe cases with combined Erectile Dysfunction (ED) a penile prosthesis can be considered.