What Causes a Bend in the Penis?

The cause of Peyronie's Disease is unknown, but there are treatments

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Peyronie's Disease is a condition that affects the penis, causing it to curve or bend. Hardening tissue known as "plaque" and scar tissue in the penis causes the distortion. The bend is most apparent during an erection. This condition can be painful and difficult to treat.

Peyronie's Disease is thought to occur in about one percent 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 of Peyronie's Disease

The onset signs of Peyronie's Disease can be sudden or slow, and they can vary in severity.

Curvature of the penis is often associated with accompanying pain as the penis becomes increasingly distorted. Most angulations in the penis caused by Peyronie's Disease are either upward or downward. A bend in the penis, usually at the top of the shaft causes an upward bend; however curvatures can also appear at the bottom of the penis shaft causing a downward bend.

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 albuginea, the sheath surrounding the erectile tissue. Unfortunately, in some men, this condition can cause impotence or an incomplete erection.

Causes of Peyronie's Disease

The exact cause of Peyronie's Disease 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 the result of a medical procedure, such as catheterization in which a tube (the catheter) is passed through the penis and into the bladder to pass urine, or cystoscopy in which a surgeon looks into the bladder following a prostatectomy (removal of the prostate gland).
  • Inherited abnormality: It is thought that there is a genetic component to this condition. Peyronie's Disease is more common in men with family members who also have the condition or who have a disease called systemic lupus erythematosus (a connective tissue disorder). Thirty percent of men with Peyronie's Disease also develop a condition called Dupuytren's contracture where hardened tissue develops in the hands.
  • Vitamin E deficiency: This vitamin deficiency has been associated with Peyronie's Disease.
  • Inderal (propranolol): Peyronie's Disease is a rare side effect of this antihypertensive drug.
  • Diabetes: Diabetes-related damage to the blood vessels in the penis has been associated with Peyronie's Disease.
  • Infection: Inflammation in cases of severe vasculitis further suggests a vascular (blood vessels) cause for Peyronie's Disease.

Treatment for Peyronie's Disease

There is no cure for Peyronie's Disease, but symptoms may subside given time. If your symptoms are not severe or worsening, you aren't experiencing pain and you're able to engage in sex, your doctor may recommend a "watchful waiting" approach, giving the condition time to resolve itself before prescribing medications.

Medication is prescribed to manage pain and reduce the plaque tissue causing the curvature. Collagenase Clostridium histolyticum (brand name Xiaflex) is the medication approved by the FDA for treatment of Peyronie's Disease. It involves a series of injections into the tissue administered by the doctor, along with stretches to straighten the penis.

If symptoms are severe, surgery may be an option. It is usually only considered after curvature of the penis is no longer increasing. Surgery may involve suturing the unaffected side of the penis in order to straighten it, penile implants, or incisions, excisions, and grafting of tissue.

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