Peyronie’s Disease

The Birmingham Prostate Clinic specialises in Peyronie’s disease treatment. Peyronie’s disease is a condition which affects the penis, usually causing painful erections, lumps in the penis and a bend in the erection.

Although it can be progressive, it is not a malignant (cancerous) condition and it is not life-threatening.

What causes Peyronie’s disease?

The cause is not known for certain. A likely explanation is that it is an unusual reaction to injury to the penis, although most men with Peyronie’s do not recall having a specific injury. However the penis is subjected to varying degrees of stress and strain during penetrative sexual activity, and these relatively small injuries may result in some men developing the disease.

Who gets Peyronie’s disease?

The disease affects approximately one man in every hundred, perhaps even more. It is commoner in older men, but all ages can be affected. There is an association between Peyronie’s disease and the hand condition Duypetren’s contracture, which causes one or more fingers to bend into the palm. About one in ten men with Duypetren’s contracture have Peyronie’s. However no-one knows why some men get Peyronie’s disease and others don’t; it appears to be a matter of chance.

What happens in the disease?

Not every case of Peyronie’s disease is the same, but men usually first complain of painful erections or a bend in the erection, or both. Sometimes they notice lumps in the shaft of the penis, although these lumps may not be obvious initially. The symptoms may come on suddenly or slowly.

The symptoms usually get worse over a few months, but then stop progressing. The time course is very variable, but in most cases the disease stops progressing after 6 to 18 months. In a few unfortunate cases the disease continues to progress relentlessly, but this is rare.

When the disease stops progressing, the erections cease to be painful. The lumps in the penis may become harder and more obvious, and the bend in the erection stops getting worse. Sometimes the bend actually improves, although unfortunately this is unusual.

What causes the bend?

The penis is made up for the most part of two big bundles of blood channels (or sinusoids) called the corpora cavernosa, or more simply known as the erectile tissue. These run along the whole length of the penis and on the inside have the appearance of a very fine honeycomb. At rest, when the penis is flaccid, they are empty. When a man gets an erection, large amounts of blood flow into the erectile tissue, filling the blood channels which increases the penile size and gives the penis its rigidity.

In Peyronie’s disease the fibrous lumps block part of the erectile tissue, preventing the affected area from expanding. The rest of the penis is free to expand, so the erection becomes bent, with the lump at the apex of the bend.

More often than not the lumps are on the top surface of the penis, so the bend is usually in an upwards direction, towards the stomach; but it may be sideways or downwards.

Does Peyronie’s disease cause impotence?

Impotence is the lack of rigid erections, or the inability to maintain a rigid erection. Men with Peyronie’s disease are perhaps more likely to have less rigid erections although the association is not completely clear cut. Impotence and Peyronie’s disease are both conditions which are more common in older men, so any associated impotence may be simply be part of the aging process. Additionally, impotence may be psychological, particularly if the erection is painful, or if intercourse is difficult or impossible because of the bend. Sometimes, however, the amount of fibrosis in the penis is so great that no blood can get past the fibrotic area to the tip of the penis. In these cases the base of the penis may be rigid, but the tip is floppy.

“Peyronie's disease affects approximately one man in every hundred, perhaps even more. It is commoner in older men, but all ages can be affected.”