Peyronie’s Disease

Peyronie’s disease is diagnosed and treated by the Urology Division of Premier Medical Group.

What is Peyronie’s disease?

Peyronie’s disease (PD) is a connective tissue disorder that causes hard scar tissue (plaque buildup) to grow in the penis. Though not visible, this plaque can result in decreased elasticity within the penis at a curvature of 30 degrees or greater.

What is Peyronie’s disease?

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Peyronie’s disease (PD) is a connective tissue disorder that causes hard scar tissue (plaque buildup) to grow in the penis. Though not visible, this plaque can result in decreased elasticity within the penis at a curvature of 30 degrees or greater.

What causes Peyronie’s disease?

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Researchers are still unclear as to what exactly causes PD, but many believe that it can develop after there is trauma that causes bleeding inside the penis, or is genetically linked or inherited. A number of medications list Peyronie’s disease as a side effect, but the chances of developing PD from these medications is so low that there is no substantial evidence to support these claims.

What are the symptoms of Peyronie’s disease

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Like other diseases, symptoms of Peyronie’s disease may develop over time, or may appear overnight. The most common signs and symptoms include:

  • Scar tissue: Scar tissue that develops as a result of Peyronie’s disease can easily be felt on the penis. It will feel like a flat lump or a long band of hard tissue.
  • A curve to the penis: A significant curve to the penis, whether it upward or downward, is an indication of PD. Sometimes when the penis is erect, you may also notice an “hourglass” appearance, where there is a tight, narrow band around the shaft.
  • Erection problems: If you begin experiencing erectile dysfunction, it may be a symptom of Peyronie’s disease.
  • Shortening of the penis: Your penis may lose some of its length due to PD.
  • Pain: You may experience painful erections or pain when your penis is touched.

When should I see a doctor?

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You should make an appointment with your doctor if you begin experiencing any of the signs listed above. Your doctor will be able to provide a proper diagnosis, or rule out other causes of your symptoms. They can also determine the best treatment for Peyronie’s disease.

What is the treatment for Peyronie’s disease?

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The only FDA-approved medication for Peyronie’s disease, Xiaflex is the best treatment in many cases. Premier Medical Group is excited to announce that our Urology Division is one of the first in the area to offer this newly approved, nonsurgical treatment for Peyronie’s disease.

How is the treatment of Xiaflex administered?

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“[Nearly] 250,000 men in the United States have some degree of [PD].Until recently, we had [many] different medications that we would try, all off label and with varying degrees of response but the way to really fix it was surgery,” stated Dr. Evan Goldfischer in an interview with 101.5 WPDH Radio. Xiaflex (collagenase clostridium histolyticum) is an FDA approved prescription medicine that is administered by a trained professional only. Xiaflex is injected directly into the hardened tissue in two courses, and the area is massaged to successfully break down the scar tissue. It is the first non-surgical treatment that can be administered in the doctor’s office. “Finally we have an FDA approved medication that for many patients will avoid the need for major surgery and we’re hoping that patients now will come in earlier,” concluded Dr. Goldfischer.

What are the side effects of Xiaflex?

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Xiaflex does have side effects, some which may be serious. Side effects include pain, swelling, or blisters at the injection site, tenderness, painful erections, changes in the color of the skin on your penis, or pain during intercourse. Allergic reactions include hives, swollen face, or chest pains. If you experience any of the side effects listed, contact your physician right away. Visit the manufacturer’s website for a complete list of side effects.

Does my insurance cover Xiaflex treatments?

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Xiaflex is currently covered by a number of insurance companies to treat Dupuytren’s contracture, a hand deformity in which the fingers bend toward the palm and cannot be fully extended. Xiaflex has only recently been approved by the FDA for the treatment of PD, and while some insurance companies may not yet cover it, it is expected to be covered by most major insurance companies in the near future. If a patient does not have insurance, financial assistance will be available to eligible patients contingent upon program criteria requirements.

Is there a surgery for Peyronie’s disease?

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Yes, there are multiple kinds of surgery for Peyronie’s disease, but each of these options carry significant risk of disappointing results and/or unintended consequences. For this reason, surgery for Peyronie’s disease is usually only recommended for the most severe and treatment-resistant cases. Even then, the pros and cons should be weighed carefully.

  • Suturing. Also known as plicating, there are several variations of this  procedure which involves cutting and reattaching the longer, unscarred side of the penis. Nesbit plication is one of the most common examples of this procedure. This will straighten the penis in cases with less severe curvatures, but may result in penile shortening. In some cases, this type of surgery also causes erectile dysfunction.
  • Incision/excision with grafting. With this type of surgery for Peyronie’s disease, one or more cuts are made to the scar tissue itself. The surgeon may remove some of the scar tissue altogether. This surgery allows the sheath to stretch out and the penis to straighten. A piece of tissue or synthetic material is then grafted into place to cover any gaps. This procedure is generally used with more severe curvatures or when deformities are also present. However, this procedure also carries a greater risk of erectile dysfunction when compared to suturing.
  • Penile implants. These implants replace the tissue that fill with blood when the penis is erect. The implants are often semi-rigid and may be manually bent down normally but also bent upward for sexual intercourse. Another type of implant allows for inflation with a scrotal pump. Penile implants might be considered if you have both Peyronie’s disease and erectile dysfunction. Additional procedures may be performed if the curvature needs further improvement.

 

Are there other treatment options for Peyronie’s disease?

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Other treatment options for Peyronie’s disease are being studied but are still rarely recommended for patients in most cases. Pentoxifylline is sometimes prescribed as an oral medication, but it must be taken for several months to reduce the amount of scar tissue and may have limited effectiveness. Non-approved, off-label medications that may be injected directly into the penis include verapamil (used for high blood pressure) and interferon (special protein). A technique known as iontophoresis uses an electric current to administer a combination of verapamil and steroid through the skin. Nondrug treatments include shock wave therapy, radiation therapy, and penile traction therapy.