Peyronie's Disease

Peyronie's disease is also known as "penile induration" and "plastic induration of the penis". Peyronie's disease was first described in the medical literature in 1742, and chiefly involves middle-aged and elderly men. Typically, a patient with Peyronie's disease will complain of painful erection, curvature of the penis, and poor erection distal to the area of curvature or plaquing. The deformation of the penis may become so severe that vaginal penetration is prevented. In the non-erect state, the patient has no complaints of penile pain.

The plaques of Peyronie's disease are dense and fibrous, and usually occur near the dorsal midline of the shaft (the part of the penis closest to the abdomen when the penis is erect.). Multiple plaques may be seen, and in severe cases these plaques may even calcify (become filled with calcium) so that they may be seen on X-rays. The origin of these plaques is not completely understood, but microscopically they appear to have been caused by severe vasculitis (inflammation of blood vessels). In addition, the fibrotic plaques of Dupuytren's contractures, which cause tendon stiffening in the hand, also appear identical microscopically to those of Peyronie's disease.

Approximately 50% of cases of Peyronie's disease resolve spontaneously. Older treatments for the condition involved the use of Vitamin E and/or p-aminobenzoic acid tablets for several months. The treatments of the last 15 years have centered on a surgical correction of the curvature of the penis. One of the oldest treatments is known as the Nesbit procedure, and involves plicating (tucking together) the tissue on the ventral (underside) of the penis so that the penis straightens out. The Nesbit procedure produces a satisfactory result between 82-88% of the time. Occasionally, the Nesbit procedure results in a small amount of penile shortening.