Penile Curvature Surgery:

Congenital erectile curvature is treated by surgically exposing the penis and shortening the side of the penis opposite the curvature to match the other side. This causes the erection to straighten. This operation has a high success rate and may be done as an outpatient surgery.

Disease Overview:

Peyronie's Disease

Peyronie's disease is a noncancerous disorder that produces curved, painful erections due to fibrous scar tissue that forms on the penis. Penises come in a variety of shapes and sizes, and a curved erection isn't always a reason for alarm. In some men, however, Peyronie's illness produces a substantial bend or discomfort.

This may make it difficult to acquire or keep an erection or prohibit you from having sex (erectile dysfunction). Peyronie's illness causes tension and anxiety in many men. Another typical problem is penile shortening.

Peyronie's disease is a chronic infection that seldom goes away on its own. The condition of most men with Peyronie's disease will either stay the same or worsen. Early therapy, shortly after the ailment arises, may prevent it from worsening or even improve symptoms.

Treatment may help relieve annoying symptoms including discomfort, curvature, and penile shortening, even if you've had the problem for a long period.

Disease Signs and Symptoms:

The signs and symptoms of Peyronie's disease might emerge unexpectedly or develop over time. The following are the most prevalent signs and symptoms:

• Scar tissue: The scar tissue linked with Peyronie's disease, known as plaque but distinct from plaque that forms in blood vessels, can be felt as flat lumps or a ring of hard tissue beneath the penis' skin.
• The penis has a major curve to it. Your penis may bow to one side or curve upward or downward.
• Problems with erection. Peyronie's illness can make it difficult to acquire or keep an erection (erectile dysfunction). Men, on the other hand, frequently experience erectile dysfunction prior to the onset of Peyronie's disease symptoms.
• Penis shortening is a term used to describe the process of reducing the size of the penis Peyronie's illness might cause your penis to get shorter.
• Pain. Penile discomfort can occur with or without an erection.
• Another type of penile malformation. The erect penis of some men with Peyronie's disease may narrow, have indentations, or even have an hourglass-like look, with a tight, thin band around the shaft.
• Peyronie's disease can cause penile curvature and shortening, which can get worse with time. The disorder, on the other hand, usually stabilises after three to twelve months.
• Pain during erections normally goes away after a year or two, although scar tissue, penile shortening, and curvature are common side effects. Both the curvature and the discomfort associated with Peyronie's disease can improve in some men without therapy.

Disease Diagnosis:

The exact aetiology of Peyronie's disease is unknown, however several variables appear to be involved.

• Peyronie's disease is considered to be caused by recurrent injuries to the penis. The penis, for example, might be injured during intercourse, sports activity, or an accident. The majority of the time, however, no specific penile trauma is mentioned.
  
• Scar tissue occurs in an unorganised manner during the healing process following a penile injury. This might result in a visible nodule or the development of curvature.
  
• A spongelike tube (corpus cavernosum) on either side of the penis contains numerous small blood veins.
  
• The tunica albuginea, a sheath of elastic tissue that extends during an erection, surrounds each of the corpora cavernosa.
• Blood flow to these chambers rises when you get sexually stimulated. The penis swells, straightens, and stiffens into an erection when the chambers fill with blood.
• When the penis grows erect in Peyronie's disease, the scar tissue area does not extend, and the penis bends or becomes deformed and potentially painful.
  

Peyronie's disease affects some men gradually and does not appear to be caused by an accident. Peyronie's disease may be connected to a hereditary characteristic or specific health circumstances, according to researchers.

Risk Factors

Peyronie's disease is not typically caused by minor injuries to the penis. However, a number of variables can lead to poor wound healing and scar tissue formation, which may play a role in the development of Peyronie's disease. These are some of them:

Heredity. You have a higher chance of developing Peyronie's disease if a family member has it.

Disorders of the connective tissue. Peyronie's disease appears to be more prevalent in men who have specific connective tissue illnesses. For example, a cordlike thickening across the palm of certain men with Peyronie's disease leads the fingers to draw inward (Dupuytren's contracture).

Age. Peyronie's disease can affect males of any age, but it becomes more common as they become older, especially among men in their 50s and 60s.

Curvature in younger men is more usually caused by congenital penile curvature rather than Peyronie's disease. In younger males, a modest bit of curvature is typical and not cause for concern.

Peyronie's disease might be caused by a variety of circumstances, including certain health problems, smoking, and some types of prostate surgery.

Disease Treatment:

Treatment options for Peyronie's disease are determined by how long you've been experiencing symptoms.

Acute stage of the disease. Penile discomfort, changes in curvature or length, or a deformity are all symptoms of penile pain. The acute phase occurs early in the illness and can persist anywhere from two to four weeks to a year or more.

There is a chronic phase. You have no penile discomfort or changes in curvature, length, or deformity, and your symptoms remain stable. The chronic phase of the disease develops roughly three to twelve months following the onset of symptoms.

Treatments for the acute phase of the condition include:

Recommended. Penile traction treatment, when administered early in the disease phase, eliminates length loss and reduces the amount of curvature that develops.

Optional. In this phase, medical and injectable therapy are optional, with some being more beneficial than others.

This is not a good idea. To reduce the need for recurrent surgery, surgery is not indicated until the condition has stabilised.

There are various possible therapies for the chronic phase of the illness. They can be used individually or in combination:

waiting with bated breath

Treatments using injections

Surgery for traction treatment

Oral drugs are not indicated in the chronic phase of the disease since they have not been proven to be beneficial at this time. Human studies haven't proved that shock wave treatment, stem cells, or platelet-rich plasma are effective.

Medications

Oral treatments have been explored to treat Peyronie's disease, but they have not been proven to be as successful as surgery.

Drugs injected directly into the penis of some men have been shown to alleviate the curvature and discomfort associated with Peyronie's disease. You may be given a local anaesthetic to prevent pain during the injections, depending on the therapy.

You'll probably have many injections over several months if you have one of these therapies. Injection medicines might be used with oral medications or traction therapy.

Traction treatment is a type of physical therapy that involves pulling

Penile traction therapy is extending the penis for a period of time using a self-applied mechanical device to enhance penile length, curvature, and deformity.

Traction therapy can be worn for as little as 30 minutes to as much as three to eight hours each day, depending on the device. Treatment efficacy may also be influenced by the equipment utilised.

In the early stages of Peyronie's disease, traction treatment is advised. It's the only therapy that has been proven to increase penile length. Traction therapy can also be utilised in the chronic phase of the condition, either alone or in conjunction with other therapies or after surgery to improve the prognosis.

Surgery

If your penile deformity is severe, uncomfortable, or stops you from having sex, your doctor may recommend surgery. Surgery is typically not indicated until the issue has been present for nine to twelve months and the curvature of your penis has stabilised for at least three to six months.

Suturing (plicating) the unaffected side is a common surgical procedure. Suturing (plicating) the longer side of the penis — the side without scar tissue — can be done in a variety of ways. The penis straightens as a result, however this is usually restricted to less severe curvatures.

Excision and grafting (incision or excision). The surgeon makes one or more incisions in the scar tissue to allow the sheath to spread out and the penis to straighten during this procedure. Some scar tissue may be removed by the surgeon.

To patch the perforations in the tunica albuginea, a piece of tissue (transplant) is frequently sewed into place. A transplant might be made of your own tissue, human or animal tissue, or synthetic material.

Implants in the sperm. Penile implants are surgically implanted into the spongy tissue that fills with blood during an erection. The implants might be semirigid, meaning they're bent down most of the time and up for sexual contact.

Another form of implant is one that is inflated by a scrotal pump. If you have both Peyronie's disease and erectile dysfunction, penile implants may be an option.

The sort of surgery you have will be determined on your medical condition. The location of scar tissue, the severity of your symptoms, and other criteria will be considered by your doctor. If you haven't been circumcised, your doctor may suggest that you be circumcised during surgery.

You may be able to go home from the hospital the same day, or you may need to stay overnight, depending on the type of surgery you had. Your surgeon will tell you how long you should wait before returning to work, which is usually only a few days. You'll need to wait four to eight weeks after surgery for Peyronie's disease for sexual activity.

Other options for therapy

Iontophoresis is a noninvasive procedure that employs an electric current to deliver a mixture of verapamil and a steroid via the skin. The available research on penile curvature and erectile function has produced mixed findings.

Several nondrug therapies for Peyronie's disease are being studied, but there isn't enough information to know how well they work or what negative effects they could have. Shock wave treatment, which uses high-intensity sound waves to break up scar tissue, stem cells, platelet-rich plasma, and radiation therapy are among them.