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  Peyronie's Disease  
 
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Peyronie's disease is characterized by a plaque, or hard lump, that forms on the penis. It may develop on the upper or lower side of the penis in layers containing erectile tissue. The penis contains balloon-like blood vessels that fill with blood to cause an erection. Scar tissue forming in the balloons cannot stretch as much as the balloons do, so the erected penis bends toward the side with a scar. The plaque often begins as a localized inflammation that may develop into a hardened scar. Generally, when the disease heals within a year or so, the plaque does not advance beyond that initial inflammatory phase. When the disease lasts for years, the plaque often becomes a tough fibrous tissue, and calcium deposits may form.

Most experts believe that Peyronie's disease is likely the consequence of a minor penile trauma. The most common source of this type of penile trauma is thought to be vigorous sexual activity (e.g., bending of the penis during penetration, pressure from a partner's pubic bone, etc.) although injuries from sports or accidents may also play a role. Injury to the tunica albuginea may trigger a cascade of inflammatory and cellular events resulting in a process called fibrosis, a medical term for formation of excessive scar tissue. This abnormal scar tissue in turn forms the plaque of Peyronie's disease.

Not all men who suffer occasional mild trauma to the penis develop Peyronie's disease. For this reason, most researchers believe that there must be genetic or environmental factors that contribute to the formation of Peyronie's disease plaques. Men with certain connective tissue disorders (such as Dupuytren's contractures or tympanosclerosis) and men who have a close relative with Peyronie's disease have a greater risk of developing the condition. Certain health conditions such as diabetes, tobacco use, or a history of pelvic trauma may also lead to abnormal wound healing and may contribute to the development of Peyronie's disease.

Peyronie's disease was first described in 1743 as a form of impotence. Impotence is recognized as one factor associated with the Peyronie's disease, but is not always present. Men most likely to suffer Peyronie's disease often have high blood pressure and high blood cholesterol and uric acid levels, which weaken blood vessel walls.

Men with Peyronie's disease are usually told to live with it unless the erection becomes painful or the bend is so great that the man cannot engage in sexual relations. In general, the goal of treatment is to keep the patient with Peyronie's disease sexually active.

Recent demographic surveys have reported that Peyronie's disease can be found in up to 9% of men between the ages of 40 and 70. The condition is rare in young men but has been reported in men in their 30s. The actual prevalence of Peyronie's disease may be much higher than 9% due to patient embarrassment and limited reporting by physicians.
 

 
 

Recommendations for Peyronie's Disease:
 
 
Drug  Conventional Drugs / Information
 The most favorable nonsurgical treatment for Peyronie's involves injecting medication directly into the plaque in the attempt to soften the hardened tissue and decrease the pain and curvature. Injection medications include steroids, collagenase, verapamil and interferon. It is not yet clear which of these substances works best, although collagenase and verapamil appear the most promising at this time.

Skin

  DMSO Topically
 Like many treatments, no studies have been done to measure the efficacy rate of using DMSO to treat PD. However, there have been anecdotal reports of everything from excellent improvement to no improvement at all.

As stated before, the use of DMSO for therapeutic applications is controversial, but some evidence indicates that DMSO has anti-inflammatory properties and alleviates pain when applied to the skin. These effects have been reported particularly with connective tissue diseases. DMSO applied to the affected area appears to reduce pain by inhibiting transmission of pain messages by nerves and may also soften the abnormal connective tissue associated with disorders such as Dupuytren's contracture, keloids, Peyronie's Disease, and scleroderma.

Surgery/Invasive

  Surgery
 Peyronie's disease often occurs in a mild form that heals without treatment in 6-15 months. It is not clear why this occurs without intervention. However, once a plaque has calcified, it is unlikely to resolve and surgery is the only solution.

Vitamins

  Vitamin Paba
 PABA has been suggested for diseases in which abnormal fibrous tissue is involved, such as Peyronie's disease. However, no double-blind studies have been performed. [Tech Urol 3: pp.135-139, 1997]
 
 


KEY
May do some good
Likely to help







GLOSSARY

Calcium:  The body's most abundant mineral. Its primary function is to help build and maintain bones and teeth. Calcium is also important to heart health, nerves, muscles and skin. Calcium helps control blood acid-alkaline balance, plays a role in cell division, muscle growth and iron utilization, activates certain enzymes, and helps transport nutrients through cell membranes. Calcium also forms a cellular cement called ground substance that helps hold cells and tissues together.

Cholesterol:  A waxy, fat-like substance manufactured in the liver and found in all tissues, it facilitates the transport and absorption of fatty acids. In foods, only animal products contain cholesterol. An excess of cholesterol in the bloodstream can contribute to the development of atherosclerosis.

Contracture:  An abnormal, often permanent shortening, as of muscle or scar tissue, that results in distortion or deformity, especially of a joint of the body.

Diabetes Mellitus:  A disease with increased blood glucose levels due to lack or ineffectiveness of insulin. Diabetes is found in two forms; insulin-dependent diabetes (juvenile-onset) and non-insulin-dependent (adult-onset). Symptoms include increased thirst; increased urination; weight loss in spite of increased appetite; fatigue; nausea; vomiting; frequent infections including bladder, vaginal, and skin; blurred vision; impotence in men; bad breath; cessation of menses; diminished skin fullness. Other symptoms include bleeding gums; ear noise/buzzing; diarrhea; depression; confusion.

Scar Tissue:  Fibrous tissue replacing normal tissues destroyed by injury or disease.