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While men’s reproductive health issues are extremely common, few things can be more embarrassing for a man than issues with intimacy and sexual intercourse. One issue that can be particularly troublesome is called Peyronie’s disease (PD), which leads to a curved penis that can be a real issue in romantic relationships. At Low T Guru in Frisco, TX, near Dallas, TX, Dr. Jeffrey Buch provides men effective treatment options for this condition.

What is Peyronie’s disease and what are the symptoms?

Peyronie’s disease is a condition that causes pieces of flat scar tissue (plaques) to form beneath the skin of the penis. These plaques can often be felt through the skin of the penis and can be painful, cause the penis to have a bend, curve, or have an indentation during erections.

To understand why these plaques cause curvature or indentations, it helps to know how the penis works and its anatomy. The penis contains three tubes:

  • The urethra, which is used to eliminate urine from the bladder
  • Two corpora cavernosa, which are soft tubes that become full of blood and rigid during an erection to make the penis hard

The tunica albuginea is a sheath that forms around these three tubes, and when plaques in Peyronie’s disease form, they cause the tunica albuginea to lose flexibility. This causes part of the penis to bend in a certain direction, depending on where the plaques have formed. Most of the time, plaques form on the top of the penis and cause it to curve up during erections, but if the plaque forms on the side or bottom, the penis will tend to curve sideways or down. Plaques that encircle the penis may cause an indentation, or a “bottleneck” appearance, or may make the penis shorter.

In addition to leading to embarrassment about the appearance of the penis, these curvatures can cause other issues such as pain during erections and intercourse and inadequate stiffness during erections. In severe cases, sexual intercourse may be difficult or even impossible due to the penis curvature. All of this results in significant mental health consequences: up to three-quarters of men who have Peyronie’s disease are either depressed or under significant stress because of it.

What causes it?

Most often, a minor penis injury is what causes Peyronie’s disease to occur. This can include sports injuries, other accidents, or injuries during sexual intercourse, such as the partner’s pubic bone putting too much pressure on the penis. These injuries can damage the tunica albuginea, which causes scar tissue to develop and form plaques.

Stages and diagnosis

There are two primary stages of Peyronie’s disease:

  • In the acute phase, which can last between six and 18 months, the curvature of the penis worsens as the plaque grows, and you may experience pain and other negative symptoms
  • In the chronic phase, the penis stops curving because the plaque has stopped growing and pain typically subsides

Often, Dr. Buch can tell if you have the condition simply by conducting a physical examination because the plaques can be felt beneath the surface of the skin. Dynamic ultrasound or other imaging studies may be necessary to determine where the plaque is located and how blood is flowing through the penis.

Peyronie’s disease treatment

There are several Peyronie’s disease therapy options available. The right treatment for you will depend on various factors, including whether the condition is affecting your erections and your sexual relationship, whether the curvature is worsening or has remained steady over time, and whether you have pain during intercourse. In general, treatments for Peyronie’s disease fall into four categories:

  1. Medications: One of the most common medications prescribed for Peyronie’s disease is vitamin E, an antioxidant vitamin which may help your body heal the PD, and if you are suffering from erectile dysfunction (ED), then drugs for ED may help with achieving sufficient erections for sexual intercourse.
  2. Injections: The main goal of an injection is to break down the scar tissue that has caused the curvature of the penis. One type of injection therapy is Xiaflex (collagenase clostridium histolyticum), which typically requires a series of injections to help reduce the penis curvature, and in our experience has been painful and can cost more than $3,000 for each of several required treatment cycles.
  3. Gainswave and PRP plus Stem Cells:  Gainswave (GW) is the use of low intensity shock waves delivered by a non-painful non-invasive hand held device that delivers energy to the penis tissues that stimulate a healing response, growth of new blood vessels and softening of the PD plaque over time.  Best results are achieved when combining GW with PRP (platelet rich plasma) and Stem Cells and periodic bending of the penis (penile modeling). This is not painful and results in significant reduction of plaque size, plaque firmness and curvature in the majority of men with PD whom we have treated. 
  4. Surgery: This is typically only recommended in treating Peyronie’s disease that is not responding to less costly and less invasive treatments.  There are a few types of PD surgery, and each type of surgery has pros and cons that Dr. Buch will discuss at length with you to help you decide which is best for your specific needs and preferences or if surgery is even needed.

Non-judgmental, comprehensive men’s reproductive health care

If erections are painful or embarrassing due to a curve in your penis, it is important to know that you don’t have to live with the condition and effective treatment options are available. At Low T Guru, Dr. Jeffrey Buch provides non-judgmental, comprehensive men’s reproductive health care that focuses on treating the underlying cause to help you achieve the best results from your care. If you are a new patient, we encourage you to call our Frisco, TX near Dallas, TX office today at (972) 430-4554. Existing patients can reach us at (972) 612-7131.

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