Changes caused by the disease in detail
First of all, there is a serious misconception must urgently be cleared up:
Peyronie’s disease is commonly called ‘abnormal curvature of the penis’. That is incorrect. This fact was not just discovered recently. As early as the 16th century, the physicians who first wrote of this disease consciously did not call it deviatio penis plastica (deviatio = curvature) rather induratio penis plastica (induratio = retraction). Curvature of the penis is one of several possible symptoms of this disease and not the only symptom or even the cause of the disease.
This conclusion is very important, as therapies that only deal with the actual curvature of the penis do not solve the actual problem but sometimes even worsen it. More information can be found in the ‘surgical treatment options for Peyronie’s disease‘ section.
(In some places we also use the term ‘abnormal curvature of the penis’, but only so that patients can find us on the Internet.)
There are severe cases of Peyronie’s disease that do not exhibit any sort of curvature but rather significant hardening or shortening of the penis and serious erection problems. The necessary requirements for successful therapy of a disease are to understand it and to recognise the relationships involved.
It is true that curvature of the penis is a common symptom of the disease of Peyronie’s disease, but in addition severe shortening of the penis, significant erection problems, constrictions (the so-called hourglass phenomenon), lumps and other significant impairments of the penis.
Most patients suffer from a significant loss of self-confidence from the effects of the disease, which naturally has a serious effect on their sex lives. The Peyronie’s disease always leads to significant psychological strain. The topics of sexuality and coordination with one’s partner play a large role in the overall view of Peyronie’s disease.
How is Peyronie’s disease caused and what symptoms occur?
The exact cause of Peyronie’s disease is still unknown. Up to 47% of patients with Peyronie’s disease have similar concomitant diseases such as Dupuytren’s contracture or Ledderhose’s disease with hardening in the hands and feet. In some cases, Peyronie’s disease occurs after an operation in the pelvic region, mostly following radical prostatectomy.
Immunological factors also appear to play a major role, so genetic disposition is probable. However, recently there have been increasing indications that it may be caused by an infection (possibly HPV).
Either way, the exact cause is unfortunately still unknown.
What exactly happens to the penis?
The early stages of Peyronie’s disease are characterised by the occurrence of an inflammatory response between the tunica albuginea and the corpora cavernosa it sheaths, mostly on the back, or top, of the penis. This inflammation leads to the formation of collagen (hard fibre) deposits and can lead to lamellar fibrosis (accretion & hardening) that may or may not contain lime scale.
A benign tumour therefore results on the penis. Let us agree to henceforth refer to this benign tumour as a ‘plaque’ to make it completely clear that it does not involve cancer.
These changes can primarily have the following effects:
1. The erectile tissue in the area where this plaque is located can no longer expand fully during an erection. It is therefore shorter than the healthy side. This can lead to a curvature of the penis of up to 90° during an erection. The penis can therefore take a bad turn, to put it plainly. This is not at all a rare occurrence. At the start of the disease, when the erection is still very hard, the great strain on the tissue can lead to significant pain.
2. Depending on its size, the plaque squeezes the blood vessels that are required for an unproblematic erection. This leads to a disrupted valve mechanism and thereby to a decrease in erection hardness.
3. Due to the change, it is not uncommon for a pressure gradient to also occur during an erection which the body must now overcome in addition. A so-called hemodynamic problem results, which can lead to a reoccurrence or increase of the erectile dysfunction after a time.
4. Plaques that are not just located in one spot but rather go all around the penis lead to constrictions. The penis looks very thin and feels hard in this spot while the rest expands drastically. A kink can also occur in this spot.
5. If the plaque is large and exhibits multiple severe hardenings, the surface of the penis can look like a chain of beads. This condition often feels very uncomfortable for the patient as well.
6. Large plaques that affect a significant portion of the penis can sometimes lead to a significant shortening of the penis.
7. Depending on the location of the plaques, there can be a reduction of sensation on the glans penis.