Penile Curvature – Peyronies Disease
Penile curvature due to scarring of the sheath surrounding the penis is called Peyronies disease. Initially patients will often notice a tender nodule scar tissue along the shaft of the penis. Scar tissue causes contraction as it heals and this can lead to a bend of the erect penis. After several months the nodule becomes less tender however the bend usually remains. Peyronies disease can lead to difficulties with intercourse if the bend is quite pronounced, hinging of the penis at the bend, impaired erections and shortening of the penis.
Why Have I got Peyronies Disease?
Peyronies disease is usually ‘idiopathic’ – which means that you have no underlying condition or risk factor for getting it. It is known to be more common in men who have received treatment for prostate cancer (surgery or radiotherapy), diabetic men, men with a history of penile trauma (such as a sudden painful bend during sex) and men with Duputrens contracture which is a similar condition affecting the hands leading to contraction and flexion of the little and ring fingers.
Can it be treated?
There are several effective options available ranging from self administered daily penile stretching, injection of Xiaflex through to surgery.
Xiaflex is a new office based injection treatment for Peyronies disease. Monthly injections into the penis are performed in combination with daily penile stretching performed by the patient. Up to four cycles of treatment may be required. I have been involved in trials of this medication. The effectiveness of Xiaflex has been proven in two large randomised trials. Typically there is a 30-40% improvement in bend. The side effect profile is favourable with most side effects being local and of mild to moderate severity.