Peyronies disease


Peyronie's disease

Description, Causes and Risk Factors:

Alternative Names: Penile fibromatosis, van Buren disease.

Abbreviation: PD.

The penis contains two chambers, called the corpora cavernosa, which run the length of the organ. A spongy tissue fills the chambers. The corpora cavernosa are surrounded by a membrane, called the tunica albuginea. The spongy tissue contains smooth muscles, fibrous tissues, spaces, veins, and arteries. The urethra, which is the channel for urine and ejaculate, runs along the underside of the corpora cavernosa

Erection begins with sensory and mental stimulation. Impulses from the brain and local nerves cause the muscles of the corpora cavernosa to relax, allowing blood to flow in and fill the open spaces. The blood creates pressure in the corpora cavernosa, making the penis expand. The tunica albuginea helps to trap the blood in the corpora cavernosa, thereby sustaining erection. Erection is reversed when muscles in the penis contract, stopping the inflow of blood and opening outflow channels.

PD is the disease is characterized by a hard, fibrous layer of scar tissue that usually develops under the skin on the upper or lower side of the penis. When the penis is erect, the scar tissue pulls the affected area off at an angle, causing a curved penis. The plaque, formed by thickened layers of erectile tissue, is noncancerous.

PD usually affects men aged between 45 - 60 years, but can happen at any age. Men with a family history of PD are more likely to develop this problem. It also appears to be more common in white men with Northern European ancestry. It is uncommon in African-American men and rare in Asian men.

The cause of Peyronie's disease is not certain. There's a link to fibrosis or scarring of other tissues in the body such as a condition known as Dupuytren's contracture of the hand. There's also a mild family tendency to the disease.

Many researchers now think the plaque or lump in Peyronie's disease develops following trauma such as hitting or bending that causes localized bleeding inside the penis. This leads to injury of the elastic lining of chambers inside the penis.

Ageing increases the risk as a general reduction in elasticity of the body's tissues increases the chances of injury. If the damaged area heals slowly, the plaque undergoes fibrosis, or formation of tough fibrous tissue, and even calcification (formation of calcium deposits) resulting in a long-term problem.

The research findings that could highlight the specific cause of the disease is about to come in recent years. Probably, by the time men reach their mid-fifties, the inherent connective tissue elasticity is on the wane and it is the median age for the appearance of Peyronies disease. The causes for the Peyronies disease can to be contributed to several factors namely:

    Injury to the penis.

  • Autoimmune disorder.

  • Collagen abnormality.

  • Medications.

Symptoms:

Peyronie's disease begins as a smallswelling or in?ammation which hardensinto a lump on the upper or lower side ofthe penis. It usually develops over timebut sometimes appears very quickly. Itcan be painful, reduce ?exibility, and insome cases shorten or create a bendor hour-glass effect in the penis whenerect. Some men ?nd it dif?cult to getor keep erections, or the penis onlybecomes rigid up to the area of the scarand remains ?accid past that point.

Some common symptoms may include:

    Painful erection.

  • A bent or curve in your penis during erection.

  • Inflammation under the skin of your penis that develops into hardened scar tissue.

  • A thick band of hard tissues on one or more sides of your penis.

  • Narrowing of the diameter of the penis during erection.

  • Impaired ability to obtain an erection (erectile dysfunction).

Diagnosis:

A general practitioner (GP) can generallydiagnose PD based on a physicalexamination. Lumps can usually be seenand felt when the penis is not erect(?accid). However, to determine theextent of the bend, the penis needs tobe erect. To avoid the need to producean erection in the doctor's surgery, itis sometime suggested that patientstake a photo of their erect penis athome. Erectile dysfunction medicineis sometimes given by the doctor inorder to check the erect penis.

Treatment:

A wide variety of medicines have been used to treat the Peyronies disease over the years. The most prevalent ones being Vitamin E, Potaba, Colchicine, Verapamil and Collagenase. Apart from medicines surgical treatments are also prevalent to assist them suffering from Peyronies disease. To go for the surgical treatment one needs to fulfill the basic criteria i.e. severity as further actions are feasible only when bending or deformity is severe enough to seriously interfere with sexual function.

The most common surgical form of treatment is plication of the penis. PD can also be treated through excision of the scar and grafting, and also with implantation of a penile prosthesis.

The three most common operations are:

    Removal or expansion of the plaque followed by placement of a patch of skin or artificial material (`Lue' procedure). This can involve partial loss of erectile function, especially rigidity, and has a higher rate of complications than the Nesbit operation.

  • Removal or pinching of tissue from the side of the penis opposite the plaque, which cancels out the bending effect (`Nesbit' procedure). This causes a shortening of the erect penis.

  • Implantation of a device that increases rigidity of the penis. In some cases, an implant alone will straighten the penis adequately. In other cases, implantation is combined with a technique of incisions and grafting or plication (pinching or folding the skin).

NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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