GAY AREA

Curvature of the Penis

What is Peyronie's Disease? Peyronie's Disease is a condition where the penis bends and is most apparent during an erection. This condition can be painful and can be difficult to treat. Peyronie's disease is thought to occur in about one per cent of the male population and although it is most common between the ages of 45 to 60 it can happen in the young and the elderly. Because men, in general, tend not to seek medical attention unless the condition is severe, it is a condition that is probably under reported.

Signs and symptoms
The onset of signs of the disease can be sudden or slow and can vary in severity. Curvature of the penis is often associated with accompanying pain as the penis becomes increasingly distorted. A bend in the penis, usually at the top of the shaft causes an upward bend.
Curvatures can also appear at the bottom of the penis shaft causing a downward bend. Most angulations are up or down. In rare cases hardening of tissue can occur on the top and the bottom and if this happens the penis may shorten. The hardening of the tissue is in an area called the tunica albuinea, the sheath surrounding the erectile tissue. Unfortunately in some men this condition can cause impotence or an incomplete erection.

The Cause
The cause is unknown but there are a number of factors that are important.
• Injury. Peyronie's disease can develop following trauma or injury to the penis. Injury may happen during very vigorous sexual intercourse, forceful bending of the penis can cause tissue tearing and scarring. The injury may be as a result of a medical procedure, e.g. catheterization in which a tube (the catheter) is passed into the bladder to pass urine, or cystoscopy, when the surgeon looks into the bladder following a prostatectomy (removal of the prostate gland).
• Inherited abnormality. There is thought to be a genetic aspect to this condition. Men with family members who also have the condition or who have a disease called systemic lupus erythematosus (a connective tissue disorder).Thirty per cent of men with Peyronie's disease also develop a condition called Dupuytren's contracture where hardened tissue develops in the hands.
• Vitamin E deficiency has been associated with the condition.
• A rare side effect of an antihypertensive drug called Inderal (propanolol)
• Diabetes where damage can occur to the blood vessels can occur.
• Infection. Inflammation in cases of severe vasculitis further suggests a vascular (blood vessels) cause.

Treatment options
Treatment options are limited and mostly surgical. In general, the aim is to reduce pain and maintain sexual function.
Non-surgical treatments are available but results are not well documented, however it is these that are tried within the first 6 months of the condition becoming apparent.
Better results are achieved if medical intervention can stop the plaque (hard tissue) calcifying. Treatment types include taking Vitamin E and a B complex substance (para-aminobenzoate) for a few months, steroid treatment, chemical agents such as verapamil (a calcium channel-blocker), collagenase (an enzyme that breaks down connective tissue). Low dose radiation treatment to reduce pain has also been tried.
Surgery. Because Peyronie's disease may resolve without any intervention so, in general, surgery is not carried out for one or two years following signs and symptoms of the disease. After this period of time surgery is used in severe cases. The hard deformed tissue can be surgically removed. Penile implants may also be a good option, sometimes in conjuncture with tissue removal. Unfortunately complications are possible and atrophy of the tissue can happen.