Peyronie’s Disease or Bent Penis

What Is Peyronie's Disease Or Bent Penis?

Peyronie's Disease or bent penis is a medical condition in which there is development of fibrous scar tissue within the penis resulting in erections which are painful and penis takes a curved shape. The shape and size of the penis varies from individual to individual. Having a penis that is a bit curved in shape or bent is quite common in people, although in Peyronie's Disease this curve is a bit abnormal and is accompanied by pain. Bent penis negatively impacts the ability of a man to have sexual intercourse and makes it difficult for a man to maintain erections. This difficulty in having sex and pain with erections becomes a major cause of anxiety and stress for the affected individual. In some cases, Peyronie's Disease resolves on its own without any specific treatment but in majority of cases it stays the same or even worsens. Treatment for Peyronie's Disease or bent penis is needed in case there is significant bending of the penis to the extent that the man is unable to have a satisfying sexual intercourse.

What Is Peyronie's Disease Or Bent Penis?

What Are The Causes Of Peyronie's Disease Or Bent Penis?

The root cause of Peyronie's Disease or bent penis is not completely known but there are several factors which contribute towards development of Peyronie's Disease. These factors are:

Injury: Some studies suggest that Peyronie's Disease may be caused due to repeated injury or damage to the penis. This injury can be caused during sexual intercourse, during sporting activities like hockey or baseball in which the man can be hit on the penis by the ball. The penis can also be damaged due to some type of accident in which the scrotal area is injured. During the healing process of the injury, there is development of scar tissue which may cause development of nodules causing curvature to the penis.

If an individual has Peyronie's disease, during erection, the area which has the scar tissue does not stretch enough and the penis tends to bend and becomes painful.

In some cases, Peyronie's Disease or bent penis comes on without any known cause or injury. Research is ongoing to identify any genetic link to the development of Peyronie's Disease.

What Are The Risk Factors For Peyronie's Disease Or Bent Penis?

Any minor injury to the penis does not result in Peyronie's Disease, although there are various factors which contribute to the development of scar tissue and ultimately causing Peyronie's Disease. Some of these risk factors are:

Heredity: As stated above, there is a genetic connection to the development of Peyronie's Disease. In case if a first degree relative of an individual has Peyronie's Disease then more likely than not the individual will also have Peyronie's Disease at one point or the other.

Connective Tissue Diseases: Males with connective tissue disorders tend to have an increased risk for development of Peyronie's Disease or bent penis. Citing an example, in quite a few cases of Peyronie's Disease it has been observed that the affected individual also has a condition called Dupuytren's contracture.

Age: Age also plays a vital role in development of Peyronie's Disease or bent penis. Due to normal wear and tear of the tissues with age they may become more predisposed to injuries and likely development of scar tissue during the healing phase.

Other Factors: Certain other factors like chronic smoking, certain forms of prostate surgeries may also predispose an individual to Peyronie's disease.

What Are The Symptoms Of Peyronie's Disease Or Bent Penis?

Some of the common symptoms related to Peyronie's Disease or bent penis are:

Scar Tissue Formation: The scar tissues which are associated with Peyronie's disease can be felt below the skin of penis in the form of lumps.

Bending of Penis: The penis is significantly bent. The curve may be pointing upwards, or downwards, or it may be bent to one side.

Erectile Dysfunction: The affected individual will also have pain and difficulty in maintaining erections due to Peyronie's Disease or bent penis.

Shortening of Penis: The length of the lenis may also get affected with it becoming short due to Peyronie's Disease.

Pain: The affected individual will experience pain in the penis with or without erection.

Additionally, the curve of the penis due to Peyronie's Disease may gradually worsen with time, although at some point it does stabilize in most of the cases. In some instances the pain and the curvature may improve spontaneously where as in some instances it may persist for about a year before beginning to improve.

How Is Peyronie's Disease Diagnosed Or Bent Penis?

In order to diagnose Peyronie's Disease, most of the time a physical examination is enough to detect the presence of scar tissue. It is very rare that other medical condition causes the same type of symptoms as Peyronie's Disease or bent penis.

Some of the tests which the treating physician may do in order to confirm the diagnosis of Peyronie's Disease are:

Physical Exam: While performing a physical examination, the physician will palpate the penis in its dormant state in order to identify and estimate the degree of scar tissue formation. The length of the penis may also be measured as a baseline, as if the condition worsens it may help the physician identify whether the penis has shortened in length or not. The physician may also ask for photographs of an erect penis to observe the degree of curvature, where exactly is the scar tissue located and other details so that they can formulate a treatment plan for the individual.

Ultrasound: The physician may also order an ultrasound so as to determine the inflow and outflow of the blood from the penis. It is also helpful in detecting any abnormalities present in the penis.

What Are Treatments For Peyronie's Disease Or Bent Penis?

For the below mentioned situations the treating physician may take a watchful waiting approach:

  • If the penis is not bent at an incredible acute angle
  • Individual is able to have sexual intercourse without discomfort or pain
  • Absence of any form of erectile dysfunction.

In case if the symptoms are worsening over time then the physician may recommend medications to correct the problem and in some cases may even recommend surgery.

Medications To Treat Peyronie's Disease: The main aim of medication use in Peyronie's Disease or bent penis is to reduce scar tissue formation and reducing the bend that the penis has. A medication recently approved by the FDA for Peyronie's Disease is Xiaflex. This medication is used for men who have a curve of the penis that is greater than 30 degrees. During clinical trials this medication was found to be quite effective in controlling the symptoms and reducing the curvature of the penis. It is always advisable to discuss the risk benefit ratio with the physician before starting the medication. Some of the other medications that can be used for treatment of Peyronie's Disease or bent penis are Trental, verapamil, or interferon.

Surgery For Peyronie's Disease: Majority of the specialists are against surgical correction of Peyronie's Disease or bent penis. It is only done in cases where the curve is severe enough to cause significant discomfort and it does not allow the individual to have a satisfying sex. Some of the surgical methods used for correcting Peyronie's Disease are:

Plication: In this method the unaffected side of the penis is plicated. This method is called the Nesbit Plication. In this method the unaffected side of the penis is sutured to make the penis straight. This method is successful in straightening the penis but it tends to make the size of the penis much smaller than the original size. In some cases this method has also caused erectile dysfunction.

Incision/excision and Grafting: This method is used in severe cases of Peyronie's Disease where there is a significant bend of the penis. This method has greater risk of erectile dysfunction than the Plication procedure. In this method, the surgeon incises the scar tissue and may even remove some of the scar tissue thus freeing up the sheath and stretching it making the penis straight.

Penile Implant: Artificial implants may be inserted in the spongy tissue of the penis which can be straightened when preparing for a sexual intercourse. Another implant which is sometimes used is a type of a tube which can be inflated with a pump which is fitted on the scrotum. The penis can be erected with the help of this tube like implant.

Another treatment for Peyronie's Disease or bent penis known as iontophoresis can also be done. In this method, very small amount of electric current is used and verapamil and dexamethasone are given through the skin. It is noninvasive procedure. The efficacy of this treatment is still under question.

Ways To Cope With Peyronie's Disease Or Bent Penis

Some of the ways to cope up with Peyronie's Disease or Bent Penis are:

  • Being frank with the partner and explaining the meaning of the disease condition and its affect on the ability to have sex.
  • Talking freely with the partner about the ways with which sexual intimacy can be maintained.
  • Consulting with a mental healthcare specialist to talk about the disease condition and take expert advice about how to maintain a healthy sex like despite having Peyronie's Disease.

Written, Edited or Reviewed By:

, MD, FFARCSI

Last Modified On: October 5, 2016

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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