By Dr. Kemi Ailoje with Info@lifelinkfertility.com
Peyronie’s disease is a medical disorder caused by the presence of a scar on the penis and this makes the penis to be curved in its physical appearance (abnormal bending) during erection and thus makes sexual relationship difficult. It is one of the causes of erectile dysfunction (a case where a man has difficulty achieving or maintaining erection). It affects both erection and urination. The time to which this scar develops and the hardness of the scar after an injury varies from patient to patient as the skin of the penis reacts differently.
Morphology of a Normal Human Penis
The human penis is the external organ which serves as passage for both urination and ejaculation of semen. The parts of the human penis are the root, the body, the epithelium, the fore skin and the shaft skin. The penis contains two cylindrical, sponge-like structures (corpora cavernosa) and the body of the penisalso comprises of three columns of tissue.
The size of the human penis differs as different individuals have different sizes determined by genetics. When a male becomes sexually aroused, nerve impulse increases the blood flow to both cylinders. This sudden influx of blood causes an erection by expanding, straightening and stiffening of the penis.
A reduction in normal size and abnormality in morphology could be considered as a reason to see your doctor.
Symptoms of Peyronie’s disease
➢ Visible scars: having plaques or scar tissues on the skin of the penis which may be hard or sometimes flattened lumps.
➢ Erectile dysfunction: difficulty in achieving and maintaining erection is a major symptom in Peyronie’s disease.
➢ Penis length: the presence of this disease causes a decrease in the normal length of an individual’s penis.
➢ Severe pain: having severe pain when achieving or trying to maintain erection and/or orgasm is another common symptom in men who have this disease.
➢ Low libido: once erection can’t be achieved or maintained, it automatically affects the man psychologically and in turn affects his libido.
How to diagnose Peyronie’s disease
➢ Physical examination: the doctor physically examines the penis with and without erection to check for visible scars tissues or plaques. The doctor also measures the length of the penis to check for length reduction if the case becomes worse.
➢ Ultrasound and x-ray: images of the penis may be required when erect to show internal scar tissues and blood flow to the penis and also other forms of abnormalities.
➢ Biopsy: this involves removing some part of the scar tissues from the affected area of the penis for laboratory test to confirm the presence of the disease.
Causes of Peyronie’s disease
➢ Heredity: presence of Peyronie’s disease in a family puts other members of the family at higher risk.
➢ Age: The prevalence of the disease increases with age, in some men who are over 55 years of age.
➢ Connective tissue disorder: this is a form of tissue disorder in which the connective tissues of the body have issues connecting with each other and this in turn affects the penis.
➢ Factors that contribute to poor wound healing: when there is an injury on the penis and the injury heals abnormally, this can cause peyronie’s disease after a while.
Effect of Peyronie’s disease
Shortened penis, penis bending when erect, erectile dysfunction, low libido, Psychological and emotional trauma, pain and discomfort, anxiety or stress about the sexual abilities or the appearance of the penis, primary or secondary infertility,
Treatment and management of Peyronie’s disease
Peyronie’s disease can be managed depending on the cause and severity of the disease in an individual. The doctor examines the disease; its cause and outcome and thus advices a patient on the best solution. Some of the management methods include;
➢ Medications e.g interferon or others as prescribed by your doctor
➢ Radiation therapy
➢ Iontophoresis: using an electric current to administer a combination of verapamil and a steroid non-invasively through the skin of the penis.
➢ A surgical operation which includes removing the plaque and getting the tissue graft in its right place or altering the tissue on the opposite side of the plaque on the penis which puts in place the bending effect on the penis. This surgery is known as incision or excision and grafting.
➢ Shock wave therapy: Intensive sound waves is used to break up the scar tissue
➢ Penile traction therapy: this involves stretching out the penis to its initial length
➢ Penile implants: an implant is surgically inserted into the sponge tissue of the penis which fills it with blood during an erection. The implant is usually bent down most times and bent upward manually for sexual intercourse.
Peyronie’s disease and Infertility
Severe Peyronie’s disease is one of the rare causes of male infertility because it has an effect on the quality of sexual intercourse. Peyronie’s disease causes pain and discomfort during sex and thus sexual intercourse might not be fully achieved. It also causes erectile dysfunction which will make it impossible to achieve and maintain erection and when erection cannot be achieved or maintained, sexual relationship will definitely be impaired and thus causes either primary or secondary infertility in men.
Assisted Reproductive Technology (ART) can be useful for treatment and management of patients going through infertility caused by Peyronie’s disease with erectile dysfunction. Best treatment option will be determined by your fertility specialist.