Peyronie's Disease is a connective tissue disorder involving the growth of fibrous plaque on the soft tissues of the penis. In particular, scar tissue is formed in tunica albuginea, a thick sheath of tissue around the corpora cavernosa, causing pain, abnormal curvature, erectile dysfunction, indentation, loss of thickness and shortening. Various treatments have been used, but nothing is effective.
It is estimated to affect about 10% of men. Conditions become more common with age.
Video Peyronie's disease
Signs and symptoms
A certain degree of curvature of the penis is considered normal, as many men are born with this benign condition, usually referred to as congenital curvature.
This disease can cause pain; hard, large lesions, such as the umbilical cord (scar tissue known as "plaque"); or abnormal curvature of the penis during erection due to chronic inflammation of tunica albuginea (CITA). Although Peyronie's popular conception of disease is that it always involves the curvature of the penis, scarring sometimes causes puncture or indentation rather than curvature. This condition can also make the relationship painful and/or difficult, although it is unclear whether some men report a satisfactory or unsatisfactory relationship regardless of the disorder. It can affect men of different races and ages. This disorder is confined to the penis, although a large number of men with Peyronie's connective tissue connective disorder are at hand, and to a lesser extent, in the legs. About 30 percent of men with Peyronie's disease develop fibrosis in other elastic tissues, such as in the hands or feet, including Dupuytren contractures on the hands. Increased incidence in genetically related males shows genetic component.
Maps Peyronie's disease
Cause
The underlying cause of Peyronie's disease is not well understood, but it is thought to be caused by trauma or wound to the penis usually through sexual intercourse or physical activity, although many patients are often unaware of any traumatic events or injuries.
Diagnosis
A urologist may be able to diagnose the disease and advise treatment. Ultrasound can provide conclusive evidence of Peyronie's disease, rule out congenital confinement or other disorders.
Treatment
Without treatment, about 12-13% of patients will spontaneously increase over time, 40-50% will get worse and the rest will be relatively stable. This is based on a survey of 97 men and therefore based on the subjective impression of the patient. There is no objective, long-term natural history through ongoing evaluation of patients who have been recorded to date.
Drugs and supplements
Many oral treatments have been studied, but the results so far have been mixed. Some people consider the use of non-surgical approach to be "controversial".
Collagenase clostridium histolyticum (marketed as Xiaflex by [Auxilium]), a drug originally approved by the FDA to treat Dupuytren contracture, is now an FDA-approved injection drug for the treatment of Peyronie's disease. The drug is reportedly working by outlining the excess collagen in the penis that causes Peyronie's disease.
Vitamin E supplementation has been studied for several decades, and some success has been reported in older trials, but the success has not been repeated convincingly in larger new studies. The combination of Vitamin E and colchicine has shown some promise in delaying the development of the condition.
Several new agents targeting the basic mechanisms of inflammation have been studied in larger clinical trials. These include potassium para-aminobenzoate (Potaba), pentoxifylline (acting through TGF? 1 inhibition), and Coenzyme Q10.
The efficacy of Interferon-alpha-2b in the early stages of the disease has been reported in recent publications, but is found to be less effective in cases where plaque calcification has occurred similar to many treatments.
Surgery
Surgery, such as "Nesbit surgery" (called Reed M. Nesbit (1898-1979), an American urologist at the University of Michigan), is considered the last resort and should only be performed by highly skilled urological surgeons with specialized corrective surgery techniques. Penile prosthesis may be appropriate in advanced cases.
Therapies and physical devices
There is moderate evidence that penis traction therapy is a minimally invasive minimally invasive treatment, but there is uncertainty about the optimal stretch duration per day and per course of treatment, and treatment is difficult.
Counseling
Peyronie's disease can be a physically and psychologically destructive disease. While most men will continue to have sexual relationships, they tend to experience some degree of deformity and erectile dysfunction in the wake of the disease process. Not infrequently men suffer from Peyronie's disease to show depression or withdrawal from their sexual partners.
See also
- Chordee
- Collagenase clostridium histolyticum
- Hypospadias
References
External links
- Overview of Medscape Urology of Peyronie disease
- Peyronie Subreddit Treatment
Source of the article : Wikipedia
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