Peyronie’s disease is characterized by the formation of an induration in an area of the penis (plaque) that causes the curvature of the penis to the side where the hard area lies. The disease sometimes occurs mildly disappearing spontaneously in 6-18 months. It is not a malignancy.
In severe cases the plaque hardens even more producing pain and an inclination so important that it prevents the performance of the sexual act (coitus). If the plaque occurs in the upper and lower part of the penis, it may be shortened.
One study found that Peyronie’s disease occurs in 1% of men. The most common is that it occurs in the middle age (40-50 years), although it can be observed in young people and in the elderly. It could be a hereditary disease since some cases have been observed in members of the same family.
Usually, the patient consults for pain and difficulty in having sex. Sometimes sexual impotence can occur. Although the causes that cause it are not clear, some researchers think that is caused by a trauma in the area that would produce a bleeding inside the penis (corpus cavernosum). This would produce an inflammation that would slowly heal. If another bleeding occurs before it is resolved, the inflammation could be made chronic, resulting in permanent tissue hardening (fibrosis), even leading to calcification.
As for treatment, as sometimes and without knowing exactly why the plaque disappears spontaneously, it is advisable to wait between one and two years before trying to solve it surgically.
Non-surgical treatments have not been shown to be effective for this disease. Some doctors recommend the use of vitamin E or vitamin B complex orally. Some researchers have tried injecting directly into the plaque of chemical agents such as collagenase, corticosteroids, dimethylsulfoxide, etc., without observing encouraging results. The use of low-dose radiation therapy on the penis has also been tested without benefits but instead has undesirable effects.
The surgical treatment is two: complete removal of the plaque by placing a patch of skin or artificial material or removal of a strip of tissue from the opposite side of the plaque without acting at all on the plate itself. This last intervention is known as the operation of Nesbit in honor of the surgeon who described it and is the most used today. The patient should know that with this intervention a shortening of the penis up to 2 centimeters can occur. In cases where there is sexual impotence you can place a penis prosthesis (silicone cylinders that are placed inside the penis, one on each side).