In this condition, an inflammatory process affects the coverings of the erectile sheath of the penis (known as the tunica albuginea). Once the inflammation becomes established, it leads to scarring which is a tough component that doesn’t allow the erection to stretch over the scarred area. As a result, the penis bends on erection, and often our patients complain that it is bent "like a banana". Often the area of scar can be felt and is known as a plaque
The disease occurs in 2 phases – an early phase in which there is inflammation, characterised by pain on erection, followed by a late phase where there is progressive bending of the penis with pain becoming less of a feature.
Although, previously thought to be rare, it is thought to occur in up to 9% of men. There are some associated conditions such as medication (anti-epileptic), other medical conditions (e.g. diabetes, high cholesterol, high blood pressure) – although they are not thought to directly cause it. Additionally, men who have had prostate surgery for cancer also have an approximately 5 fold higher risk of developing this condition.
Some non-surgical treatments have been assessed by various researchers in managing this condition. These studies have limitations which has led to variable results with even the same treatments offered by various specialist groups. It is therefore a field where a strong level of evidence is not available to guide doctors and patients alike.
Many surgical techniques are available for the treatment of Peyronie’s Disease; they can be broadly separated into two main types. Some of these involve shortening the penis on the opposite side to the bend. In the other form of surgery, the scarred area/plaque can also be incised and a graft placed over the area. All of these types of surgery can result in complications such as shortening of the penis, erectile dysfunction and changes in sensitivity to the glans penis. In some cases patients may require a circumcision particularly if their foreskin is very tight.
A subgroup of patients with pre-existing erectile dysfunction and the more significant bends may require penile implant surgery which deals with both complains - the bend and the erectile dysfunction. As this surgery can be complex, it is essential that patients are thoroughly assessed and counselled on the most appropriate treatment option so that patients are satisfied with the choice of treatment.
We offer a spectrum of surgical and non-surgical treatment options tailored to the individual, taking into account their disease status, their erectile status, other factors such as length and patients’ priorities.
New approved drug available for Peyronies Disease
*** Please note that Xiapex (injection) has been withdrawn from market and this treatment is no longer available in the UK.