In Peyronie’s disease, the penis curves when it becomes erect. Another term for the disease is induratio penis plastica. Strongly related to Peyronie’s disease are Dupuytren’s disease (curvature of the fingers) and Ledderhose’s disease (overgrowth of connective tissue under the feet). What causes Peyronie’s disease, what are the symptoms and what is the treatment option?
Article content
- Explanation of the name of the disease
- Peyronie’s disease
- Who affects Peyronie’s disease?
- Cause of Peyronie’s disease
- Symptoms of Peyronie’s disease
- Diagnosis of Peyronie’s disease
- Treatment of Peyronie’s disease
- Complications of surgery
- Dupuytren’s disease or Dupuytren’s contracture
- Ledderhose disease
- Major research into Peyronie’s disease, Dupuytren’s disease and Ledderhose disease
Explanation of the name of the disease
Peyronie’s disease owes its name to François de la Peyronie (1678-1747). He was the first surgeon to Louis XV.
Peyronie’s disease
Peyronie’s disease involves a hardening of the shaft of the penis with curvature during erection. A penis consists of three erectile tissues, two at the top and one at the bottom of the penis. The erectile tissues are each covered with connective tissue. Peyronie’s disease involves an excess of connective tissue. The erectile tissue in question cannot stretch with the other erectile tissues during an erection and this leads to curvature of the penis. This usually results in pain during erection and sometimes the penis is less hard. If the penis is not stiff, a person will feel a hard part in the wall.
Who affects Peyronie’s disease?
About one in a hundred men is affected by Peyronie’s disease. Usually these are men over forty years old.
Cause of Peyronie’s disease
Usually there is no clear reason why someone gets Peyronie’s disease. Very occasionally, an injury to the penis may be the cause of the disease. Sometimes Peyronie’s disease runs in families, which suggests a hereditary factor. It is also known that the risk of Peyronie’s disease increases with age. Approximately thirty percent of men with Peyronie’s disease also have diabetes and two-thirds have one or more risk factors for calcification of the arteries . Examples of these risk factors are high blood pressure, smoking, excessive body weight, lack of exercise, and increased cholesterol levels. Strongly related to Peyronie’s disease are Dupuytren’s disease and Ledderhose’s disease (growth of connective tissue under the feet).
Symptoms of Peyronie’s disease
- A bent penis (to one side) during an erection;
- A painful feeling in the penis during erection;
- A lump is felt in the penis when the penis is flaccid;
- Erectile dysfunction occurs in approximately fifty percent of men with Peyronie’s disease. This can be caused by the curvature, by the thickening of the connective tissue, but it can also have a psychological background (the pain can cause anxiety or the man may be afraid that he cannot perform).
Diagnosis of Peyronie’s disease
If someone has complaints that are consistent with Peyronie’s disease, it is advisable to take a photo of the moment when the penis is in a crooked position. This may sound strange, but this way the GP can assess what the next steps may be. A referral to a urologist may follow. By injecting a drug into the penis that causes vasodilation, the urologist can gain insight into how serious the curvature is. An ultrasound or MRI scan can also provide information.
Treatment of Peyronie’s disease
- Many men recover from Peyronie’s disease without treatment.
- If sexual intercourse can take place without pain, then treatment is not necessary. The pain during erection often disappears on its own, but it can take a year to a year and a half. The pain will then be gone, but the curvature remains, this is called the chronic phase.
- If the complaints worsen with a wait-and-see policy, then it is time to intervene; treatment is necessary. This is also necessary if the pain gets worse or if sex is no longer successful. Sometimes it is advised to inject a corticosteroid into the thickened part and there are other treatments with medications.
- A large proportion of men with Peyronie’s disease must undergo surgery to resolve the symptoms. This is called the Nesbitt operation, sutures are placed in the erectile tissue, which is not affected. In this way the penis is pulled into an erect position. Consequences of the operation: the penis is slightly shorter when erect (as long as the shortest side of the curvature).
- The last option: placement of an implant. This ensures that the penis returns to an erect position.
Complications of surgery
The operations generally go well, but the outcome cannot be fully predicted. The penis does not always become completely erect. Bleeding may occur and sometimes the sensation in the glans decreases slightly. The latter usually goes away after a few months.
Dupuytren’s disease or Dupuytren’s contracture
Other names for the disease: Morbus Dupuytren, coachman’s disease. It is a condition that leads to the fingers becoming crooked. An increase in connective tissue under the skin causes lumps and strands to form. The strands can appear in all fingers but also in the palm of the hand. If the strands contract, the fingers become crooked and can no longer be straightened properly.
Ledderhose disease
Ledderhose disease is a condition in which painful hardenings (nodules) develop in the connective tissue under the foot.
Major research into Peyronie’s disease, Dupuytren’s disease and Ledderhose disease
The UMC Groningen, Department of Plastic Surgery, conducts extensive research into the genetic cause of Peyronie’s disease, Dupuytren’s disease and Ledderhose’s disease. It is clear that hereditary factors play a role, but exactly which ones are not clear. Anyone with Peyronie’s disease, Dupuytren’s disease or Ledderhose can participate. This involves completing the questionnaire and donating 20 ml of blood from the arm once. If someone needs surgery for Dupuytren’s, Peyronie’s or Ledderhose’s disease, the surgeon removes the abnormal tissue. You can then ask whether this can be used for research. Researchers extract DNA and RNA, carriers of genetic material, from blood and tissue. This material is compared with genetic material from people who do not have the diseases. This way, researchers can find genes that are related to the diseases. Ask the specialist at your own hospital for information about the test. Participating in the study will not provide you with any direct benefit, but the research may lead to better treatment in the future.
read more
- Dupuytren’s disease: cause, symptoms and treatment
- Ledderhose disease: proliferation of connective tissue under the foot
my view on
