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A Rare Disease - Peyronies
Peyronie's disease is not a disease.
It is a condition that has an effect on the penis. A
plaque or hard lumps are formed either on the upper
or on lower side of the penis in the layers of erectile
tissue. This plaque begins as inflammation i.e. (redness
and swelling) which hardens and turns into a scar. But
it is not cancerous. Researchers aren't sure about the
exact cause for the formation of this plaque. Some believes
that it comes from injuring the penis by hitting it
or bending it, especially during intercourse, but this
doesn't explain why most cases develop slowly or why
many cases go away on their own. Cases of Peyronies
range from mild to severe. Symptoms may develop slowly
or appear overnight. The sexual problems resulting from
this can interrupt a couple's physical and emotional
relationship and lead to lowered self-esteem for the
man. In a small percentage of patients with the milder
form of the disease, inflammation may resolve without
causing significant pain or permanent bending. PD predominantly
occurs in men aged 40-60 years.
One study found Peyronies disease occurring in 1 percent
of men. Men with Peyronies disease usually seek medical
attention because of painful erections and difficulty
with intercourse. Experts usually recommend surgery
only in long-term cases in which the disease is stabilized
and the deformity prevents intercourse. The exact cause
is not known, although it is thought to be caused by
injury to the internal cavity of the penis, which results
in bleeding at the site of the injury, triggering an
over production of scar tissue formation in the corpora
cavernosa. When an injury to the penis precedes the
onset of abnormal curvature, most commonly reported
are sudden injuries occurring during strenuous intercourse,
especially in the woman superior position, followed
by injuries to the penis sustained while participating
in sports activities where an accidental impact occurred.
Notably, Peyronie’s disease is also reported in
men who deny any sexual activity or physical injury.
It is thought that Peyronie’s disease may be hereditary.
Some medical scientists consider Peyronie’s disease
to be a wound healing disorder. Unlike the normally
elastic tissues of the penis which allow for expansion
and contraction during erection, scar tissue is hard
and inelastic. Over time, continued scar tissue production
begins to pull or contract the penis, causing hard lumps
or a curvature deformity.
The disease may cause pain, hardened, cord-like lesions
(scar tissue known as "plaques"), or abnormal
curvature of the penis when erect. In addition, narrowing
and or shortening of the penis may occur. Pain felt
in the early stages of the disease often resolves in
twelve to eighteen months. Erectile dysfunction, in
varying degrees, often accompanies these symptoms in
the later stages of the disease process. The condition
may also make sexual intercourse painful and or difficult,
though many men report satisfactory intercourse in spite
of the disease. Although it can affect men of any race
and age, it is most commonly seen in caucasian males,
ages 40 and up. Peyronie's disease is not contagious,
nor is it related in any way to cancer. The disease
only affects men and is confined to the penis, although
a substantial number of men with Peyronies exhibit concurrent
connective tissue disorders in the hand, and to a lesser
degree, in the feet. Peyronie's
disease is a physically and psychologically devastating
disease. While most men will continue to be able to
have sexual relations, they are likely to experience
some degree of deformity and erectile dysfunction in
the disease process. It is common for men afflicted
with Peyronie’s disease to exhibit depression,
withdrawal from their sexual partners, and unwillingness
to talk openly about their concerns with their partner
and or their physician. Accordingly, seeking out a mental
health professional is often recommended as an adjunct
to medical treatment.
For many men with Peyronies
disease (5% to 40% of cases), the condition never goes
beyond the swelling stage, and this resolves without
treatment within a year or so. For the men who get the
hard plaque, other than surgery there are few established
options. Some researchers have tried vitamin e orally,
but this therapy has not been shown conclusively to
work (needs more testing). Such medications include
acetyl l-carnitine, propionyl l-carnitine, l-arginine,
viagra, cialis (acting through phosphodiesterase-5 inhibition)
and pentoxifylline (acting through tgfß1 inhibition).
In severe cases, after waiting for 1 to 2 years to see
if the problem resolves, a surgeon can either remove
the plaque or cut into it so it spreads open. Then tissue
has to be grafted over where the plaque is/was; this
can be the man's own tissue (from his groin), sterilized
pork tissue, or sterilized tissue donation from a cadaver.
Another option is to leave the plaque but remove or
pinch the tissue on the opposite side of the penis to
cancel out the bending. Men who have this done don't
like it because it shortens the length of the penis.
Both types of surgery may leave a man with problems
having or maintaining erections. A third surgical technique
is the implanting of a device in the penis that can
be inflated. If the bending is not too severe, the implant
itself may straighten out the penis; if necessary, the
plaque will also be removed.
Though this disease seems and sounds but it is not
that hard to treat.
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