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Peyronie’s Disease

The truth is that the injury to the penis that causes “Peyronie’s Disease” can literally go unnoticed. Vigorous sex in various positions can result in the penis slipping out and being acutely bent (in some cases being fractured), especially with the partner on top. The penis has three functions: urination, transporting sperm and sexual pleasure. The penis is three tubes in a larger tube. The larger 2 pipes or tubes are the corpora cavernosa which are responsible for giving a man an erection. The corporal bodies are surrounded by sturdy, tendinous tissue called the tunica albuginea. The third tube is the urethra which is responsible for carrying urine and semen (the carrier of sperm). An acute bending of an erect penis particularly during intercourse or masturbation can result in a tear or abrasion of the tunica albuginea of the corporal bodies of the penis. There can be bruising and severe pain associated with the injury. When the tunica is injured there is often pain and the formation of a dense scar called a Peyronie’s Plaque. This scar will gradually shrink or contract in size shortening that area of the corporal body with a resultant curve which can be extreme in some cases. The curve can become so acute that sexual activity is too painful.

Men with this condition may experience loss of penile length during an erection, penile pain in the area of the plaque, loss of normal erections and deformities in the shape of the penis. Depending on the severity of the curve, the end result can be devastating. This condition is typically managed by an urologist who will usually ask for or take pictures of the curved erection to measure the degree of curvature. Most urologists will not treat the plaque during the active inflammation phase and will wait for the injury to become non-tender. Treatment options include Vitamin E (not very effective), injectable medications, surgical excision with grafting, penile prosthesis with excision of the plaque and grafting and penile prosthesis with “modeling” of the penis. Each treatment has its risks and benefits, however, treatment of the disease is often better than staying sexually inactive.

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