Peyronie's disease in men
Deterioration of erectile function, discomfort and deformity of the penis, accompanied by the appearance of plaque, may indicate a rare disease - Peyronie's disease. The appearance of such symptoms requires immediate medical attention.
Content:
- Peyronie's disease
- Peyronie's disease symptoms
- Causes of Peyronie's disease
- Disease stages
- Classification of the disease
- Peyronie's disease diagnosis
- Complications
- Peyronie's disease treatment
- Prevention
- Which doctor to contact
Peyronie's disease
Peyronie's disease is also called fibroplastic induration of the penis. With this pathology, the penis is deformed during an erection. Scar tissue forms under the skin of the organ. Most often it grows in the lower part of the organ, although sometimes it begins to form at the top of the penis. During an erection, a man experiences pain, since the scar joints do not have sufficient elasticity. Being in an excited state, the male genital organ begins to deform. This leads to the fact that intimacy becomes impossible. Against the background of the disease, a man begins to suffer from neuropsychiatric disorders.
Thus, Peyronie's disease is a curvature of the penis against the background of the proliferation of fibrous joints. Plaques or benign neoplasms form on the genitals.
Major risk factors
The disease is not often diagnosed. On average, it is detected in 0.5-1% of men aged 35-60 years. The older a man is, the less elastic the tissues of his penis. This leads to the fact that during an erection, the likelihood of microtrauma and rupture increases. In young people, this pathology is rarely found. After the age of 60, the risk of developing Peyronie's disease is also low, since intimacy during this period does not happen often. According to WHO, 1/3 of men over 60 are not at all able to have sexual intercourse.
Peyronie's disease symptoms
The main symptom of pathology is pain, which can be of varying intensity.
In addition, Peyronie's disease is manifested by symptoms such as:
- Curvature of the penis to one side.
- Deterioration of erectile function. During arousal, the penis does not harden to the desired state.
- A lump appears under the skin.
- The penis shrinks as it loses its normal shape.
The early stage of the development of the disease may not manifest itself in anything. Its duration is 6-18 months. The sooner a man pays attention to a developing problem and goes to see a doctor, the more favorable the prognosis.
However, in practice, it happens that the first signs of the disease do not become a reason for visiting a doctor. Most men try to cope with the problem on their own, using traditional medicine methods. This leads to the fact that the disease progresses and it will be difficult to cure it.
Causes of Peyronie's disease
For the first time, the symptoms of Peyronie's disease were described as early as 1561. A little later it was discovered by a surgeon from France, Francois Gigot de la Peyronie. Despite this, the causes of the disease have not yet been fully understood. Only risk factors are known that can provoke its occurrence.
These include:
- Injuries to the penis, for example, from blows or falls.
- Closed penile fractures in which the skin remains intact, but internal hemorrhage occurs.
- Microscopic damage that a man can receive during intimacy.
- Immunity disorders.
- Diabetes.
- The vasoconstriction that occurs with atherosclerosis.
- Hormonal disorders
- Connective tissue diseases.
- Gout, in which there is a high level of uric acid in the blood.
- Deficiency of vitamin E and calcium.
- Hereditary predisposition.
- Treatment of impotence with certain medications.
- High levels of serotonin in the blood.
Peyronie's disease can be either congenital or acquired. The first type of disorder is rare. It manifests itself in the case when the child's urethral canal does not fully develop, or hypoplasia of the tunica albuginea is observed.
With the acquired form of the disease, plaques form on the penis, and benign neoplasms on the urethra. Pathology requires treatment, as it will progress.
Disease stages
There are 4 stages of Peyronie's disease:
- Latent stage. At this time, the man experiences uncomfortable sensations during arousal. The plaque is invisible at this stage, it is impossible to palpate it. The deformity of the penis is just beginning, but it is difficult to detect it. During the examination, the doctor can identify a violation of the blood supply to the organ.
- Initial stage. Mild pain begins to bother a man not only with an erection, but also at normal times. The plaque becomes visible, but it does not have a clear border. It can be palpated. During sexual arousal, you can notice the deformation of the penis. The lump is detected during an ultrasound scan, but an x-ray will not provide any information.
- Stabilization stage. The pains are weak, the plaque becomes clearly defined, resembles cartilage in appearance. The organ is severely deformed. The plaque can be visualized both during an ultrasound scan and on an X-ray.
- The final stage. There is no pain, the plaque hardens and resembles bone. The penis is severely deformed.
Classification of the disease
By the degree of flow
Experts distinguish between painful and functional periods of development of Peyronie's disease.
During the painful period, a man experiences discomfort both during an erection and at rest. Pain indicates tissue stretching and plaque formation in the tunica albuginea. The penis begins to deform, this curvature is noticed by the man himself.
The painful period lasts 6-18 months. If at this stage a man seeks medical help, then it will be possible to cope with the pathology without surgical intervention.
The symptoms of the functional period are as follows:
- The erect penis is severely deformed.
- During arousal, a man experiences severe pain.
- The plaque becomes clearly defined.
- The nutrition of the organ is disturbed, an erection suffers. Potency deteriorates in 30% of men.
By type of deformation
Depending on the type of deformation, there are:
- Dorsal curvature - the penis is deformed upward.
- Ventral curvature - the organ is directed downward.
- Lateral - the penis is curved laterally.
Peyronie's disease diagnosis
During the initial appointment, the doctor interviews the patient, listens to his main complaints, and specifies the severity of the symptoms. The doctor then examines the penis using a vacuum erection device. This will allow assessing the degree of curvature, the shape of the organ and the location of the plaque.
To clarify the diagnosis, the doctor will refer the patient to undergo the following diagnostic procedures:
- MRI of the penis. This technique makes it possible to clarify the location of the plaque, to detect existing problems in the blood supply to the penis.
- Cavernosography. This procedure boils down to taking pictures on an X-ray machine. During the study, a contrast agent is used. The method allows you to assess the state of the internal tissues of the penis, to clarify whether there are any changes in its spongy and cavernous body.
- Ultrasound. The method aims to assess the blood flow of the penis. This procedure is prescribed for exacerbation of the disease.
Complications
If a man does not seek medical help in time, this will lead to the development of the following complications:
- Impotence.
- Infertility.
- Depression.
- Intense pain during intimacy and with sexual arousal
Complications can be a consequence of the progression of the disease, as well as the use of folk remedies on oneself. With an advanced stage of the disease, it will not be possible to do without surgery. Its negative consequence is the shortening of the penis.
Peyronie's disease treatment
Treatment for Peyronie's disease has two directions:
- Conservative treatment in which a man will need to take medication. Such therapy is available at stages 1, 2 and 3 of the disease.
- Operative intervention. They resort to it at 4 stages of the development of the disease.
There are no uniform treatment standards; the doctor proceeds from the individual characteristics of the course of Peyronie's disease in a particular patient.
Non-operative treatment
Algorithm for the treatment of patients with Peyronie's disease, which is at an early stage of development:
- Reducing pain.
- Removal of inflammation.
- Plaque absorption.
- Stopping the progression of the disease.
Treatment should last at least six months.
At this time, drugs such as:
- Interferons.
- Vitamin E.
- Preparations from the NSAID group.
- Colchicine.
- Tamoxifen, etc.
Experts do not recommend injecting any drugs directly into the plaque itself. The fact is that even minor damage to the integrity of the penis can increase fibrosis. However, sometimes it is not possible to do without injections.
For this purpose, drugs such as:
- Steroids. They are used only if the person is sick for no more than 1.5 years and the plaque has not formed completely. Hormones are rarely used, as they do not allow achieving the desired effect.
- Enzymes (collagenase). This tool allows you to soften scar tissue, as it breaks the peptide bonds of collagen. The drug is injected into the plaque perpendicular to the penis. In 65% of cases, it is possible to reduce the curvature. The treatment lasts 6 weeks. Injections are given 2 times every 7 days. The procedure should be carried out by a professional, since an overdose of the enzyme is dangerous with hemorrhages and the appearance of new areas of fibrosis.
- Interferon. To date, there is no exact data on the effectiveness of using this drug.
- Verapamil. This drug is injected into calcified plaques and areas of fibrosis during an acute inflammatory process. It helps to dissolve such areas.
For oral administration, drugs such as:
- Vitamin E. It slightly reduces organ deformation and helps to reduce the intensity of pain.
- Colchicine. The drug inhibits the production of collagen and activates its own collagenase, and also helps to reduce pain and inflammation. However, during admission, many patients begin to suffer from loose stools.
- Tamoxifen. This drug has antiestrogenic and anticancer effects. Thanks to its reception, T-lymphocytes and macrophages die.
- Potaba. This drug aims to slow down the production of fibrin.
- Pentoxifylline. In a patient receiving this drug, the blood supply to the organ improves, and the content of nitric oxide in the blood increases. This stops the progression of the disease and even contributes to its reverse development.
- Propionyl L-carotene. This drug reduces the degree of deformity and reduces the intensity of pain.
In addition to the use of drugs, a man can be recommended a physiotherapeutic effect on a diseased organ:
- Magnetotherapy.
- Using diadynamic currents.
- Laser treatment.
- Mud treatment.
- Electrophoresis.
- UHT. In this case, a special device is used, which is a source of impulses. The doctor directs them directly to the site of fibrosis. This will soften the plaque and straighten the penis. To be able to implement UHT, the curvature should not be more than 45 degrees.
It is important to remember that it is prohibited to use any drug on your own! This can lead to the development of serious complications and health problems.
Surgery
The operation is resorted to when conservative therapy has not allowed to achieve the desired results.
Indications for surgery:
- Curvature of the penis more than 45 degrees.
- Erection problems.
- Plaque calcification.
The operation can be of 3 types:
- Shortening of the penis. In this case, the doctor removes a section of the tunica albuginea from the side opposite to the curvature. The penis is flattened but shorter. This method is used if the curvature does not exceed 60 degrees.
- Excision of plaques. All fibrous structures are removed, and the resulting voids are filled with biological or synthetic material. This procedure is carried out when the curvature exceeds 60 degrees. The technique is associated with the risk of complications, therefore, it is not often used.
- Falloprosthetics. This method is used when a man's erection is impossible. The doctor does not touch the plaque itself, but instead of the cavernous body, an implant is implanted.
Prevention
Peyronie's disease prevention measures:
- Keeping healthy lifestyle.
- Refusal to have sex while under the influence of alcohol or drugs, as this increases the likelihood of injury.
- Proper nutrition, adherence to the daily regimen. Food should saturate the body with vitamins and minerals.
- Blood pressure monitoring.
- Sports activities.
- Weight control.
- Regular visits to the doctor by patients with diabetes mellitus, as well as men aged 30-60 years.
If a person notes discomfort in the penis area, you need to contact a urologist and not try to cope with the problem using traditional medicine.
Which doctor to contact
Peyronie's disease is treated by an andrologist and urologist. Also, a man may need the help of a surgeon, rheumatologist, physiotherapist.
An andrologist is a doctor who specializes exclusively in "male problems". He treats diseases of the male reproductive system.
The urologist is engaged in the identification and elimination of pathologies of the genitourinary system and male genital organs.
Video: Doctor-surgeon, urologist-andrologist Anar Kurbanovich Kerimov about peyronie's disease:
Author of the article: Lebedev Andrey Sergeevich | Urologist
Education: Diploma in the specialty "Andrology" received after completing residency at the Department of Endoscopic Urology of the Russian Medical Academy of Postgraduate Education in the urological center of the Central Clinical Hospital No. 1 of JSC Russian Railways (2007). Postgraduate studies were completed here by 2010.
