Surgical options may help treat Peyronie’s disease

Q. I'm 68 years old and I've been diagnosed with Peyronie's disease. How common is this?

Peyronie's (pay-roh-neez) disease is the development of abnormal scar tissue inside the penis. The scarring bends the penis and may make an erection painful. Peyronie's can make sex difficult or impossible.

A flat plate of benign scar tissue, known as a plaque, forms on the top or bottom side of the penis inside a membrane called the “tunica albuginea.” Peyronie’s disease runs in families. It is not contagious.

There have been many surveys done to determine the prevalence of Peyronie's. Estimates range from less than 1 percent to 23 percent of men with Peyronie's. Researchers suspect that we will never know the truth about the disease because men are reluctant to discuss it. Many in health research believe the problem may be more common than any statistics demonstrate. 

An age range of 18 to 80 has been reported, but most men who report suffering from Peyronie's are between 45 and 60. Almost all those affected are Caucasians. The disease is most common in northern Europeans. 

Peyronie’s disease is difficult to treat. It has been called “the doctor’s nightmare.” Most everything about it varies from man to man. 

A French surgeon, François de la Peyronie, first described the disease in 1743.  Prior to Peyronie's description of the disease, it was classified as a form of impotence.

Many researchers believe that, in some cases, the scarring develops following trauma that causes bleeding inside the penis. Aging causes diminished elasticity, and this might increase the risk of injury. However, most cases develop slowly and with no known trauma.

There is no convincing evidence proving that any treatment other than surgery is universally effective. Because some patients improve without treatment, medical experts suggest waiting a year or longer before having surgery. There are three basic surgical procedures for Peyronie’s disease. 

One surgery removes or cuts the plaque and attaches a patch of skin, vein, or material made from animal organs. This method may correct a deformity, but some patients may experience numbness and an inability to achieve an erection.

Another technique involves removing or pinching a piece of the tunica albuginea opposite the plaque; this corrects the bend. This method is less likely to cause numbness or erectile dysfunction.

A third option is to implant a device that makes the penis more rigid. In some cases, an implant will straighten the penis. If the implant does not straighten the penis, implantation is combined with one of the other surgical procedures.

Most types of surgery are effective. However, because of possible complications, most doctors prefer to perform surgery only on the small number of men with curvature severe enough to prevent sexual intercourse.