Peyronie's disease according to ICD 10. Erectile dysfunction - description, causes, symptoms (signs), diagnosis, treatment. Why does the disease develop?

Clinical symptoms of Peyronie's disease occur in 0.39-2% of cases, but this prevalence is only a statistical equivalent of the number of visits for this disease. The true prevalence of Peyronie's disease is much higher - 3-4% of cases in the general male population. 64% of men who suffer from Peyronie's disease are in the age group from 40 to 59 years, with a general occurrence in a fairly large age population - from 18 to 80 years. In men under 20 years of age, Peyronie's disease occurs in 0.6-1.5% of cases.

Causes of Peyronie's disease

The causes of Peyronie's disease remain not fully understood.

The most widely accepted theory is that Peyronie's disease occurs as a result of chronic trauma to the corpora cavernosa of the penis during coitus. According to the post-traumatic theory, inflammatory mediators in the microtrauma zone of the tunica albuginea disrupt the reparative process, changing the ratio of elastic and collagen fibers in the penis. Peyronie's disease is often combined with Dupuytren's contracture and other local forms of fibromatosis, which allows this disease to be characterized as a local manifestation of systemic collagenosis.

There is also an autoimmune theory for the development of Peyronie's disease. According to this theory, Peyronie's disease begins with inflammation of the tunica albuginea of ​​the corpora cavernosa of the penis, accompanied by lymphocytic and plasmacytic infiltration. The infiltrate, as a rule, does not have clear boundaries. Subsequently, an area of ​​fibrosis and calcification occurs in this area. Since during erection the extensibility of the tunica albuginea in the area of ​​the plaque is sharply limited, varying degrees of curvature of the penis occurs.

As a rule, the process of plaque formation and stabilization of the disease occurs 6-18 months after its onset.

Involvement of Bucca's fascia, perforating vessels and dorsal arteries of the penis in the process leads to disruption of the mechanism of venous occlusion and arterial insufficiency of the penis.

Symptoms of Peyronie's disease

The symptoms of Peyronie's disease are as follows:

• erectile deformation of the penis;
• formation of a palpable plaque or “bumps” on the penis

There are different types of clinical course of Peyronie's disease.

Symptoms of Peyronie's disease may be absent and manifest only by the presence of “neoplasms” of the penis, which can be detected by palpation. The clinical course of Peyronie's disease may include severe pain and deformation of the penis during erection. In some cases, especially with the circular nature of the lesion, there is a significant shortening of the penis, and sometimes Peyronie's disease is clinically manifested only by erectile disorders.

During Peyronie's disease, there is an “acute” phase and a stabilization phase, which lasts from 6 to 12 months. Complications that develop during the natural course of Peyronie's disease include erectile dysfunction and shortening of the penis.

Diagnosis of Peyronie's disease

Diagnosis of Peyronne's disease, as a rule, is not difficult and is based on the medical history, the man's complaints and physical examination (palpation of the penis). Rarely, Peyronie's disease disguises itself as carcinoma of the penis, leukemic infiltration, lymphogranuloma, or lesions due to late syphilis. More often, Peyronie's disease must be differentiated from lymphangitis and thrombosis of the superficial veins of the penis.

Examination of a patient with Peyronie's disease, along with general clinical methods, involves:

• assessment of the degree of erectile deformity (photography, injection tests or tests with phosphodiesterase type 5 inhibitors);
• assessment of the anthropometric characteristics of the penis in a relaxed state and in an erect state;
• study of penile hemodynamics (pharmaco-Dopplerography, nocturnal penile tumescence).

It is advisable to conduct sexological testing.

Ultrasound of the penis is widely used in the diagnosis of Peyronie's disease. Unfortunately, identifying a plaque with details of its structure is possible only in 39% of cases, due to its polymorphism and multi-level growth pattern.

An example of a diagnosis formulation

• Peyronie's disease, stabilization phase, erectile deformation.
• Peyronie's disease, stabilization phase, erectile constriction deformity, erectile dysfunction.

Treatment of Peyronie's disease

There is no etiotropic treatment for Peyronie's disease. As a rule, drug treatment and physiotherapeutic methods are used in the acute inflammatory phase of Peyronie's disease. The goal of conservative treatment is to relieve pain, limit and reduce the area of ​​inflammation and accelerate the resorption of infiltrates.

All methods of conservative treatment are aimed at stabilizing the pathological process. Conservative treatment uses oral medications: vitamin E, tamoxifen, colchicine, carnitine, and various NSAIDs.

For local administration of drugs into the plaque, hyaluronidase (lidase), collagenase, verapamil, and interferons are used.

In most cases, combined treatment of Peyronie's disease is carried out, using various methods of physiotherapy (electrophoresis, exposure to laser radiation or ultrasonic waves). Treatment of Peyronie's disease is carried out continuously or in divided courses over 6 months. Data regarding the effectiveness of pharmacotherapy and physiotherapeutic treatments for Peyronie's disease are very ambiguous, due to the lack of a standardized approach to assessing the final results.

Surgical treatment of Peyronie's disease

Curvature of the penis, which prevents or complicates sexual intercourse, erectile dysfunction (impotence), shortening of the penis are indications for surgical treatment of Peyronie's disease. Surgical treatment of deviations of the penis consists of shortening the “convex” part of the corpora cavernosa (Nesbit’s operation, plication techniques), lengthening the “concave” part of the corpora cavernosa (flap corporoplasty), or phalloendoprosthetics.

In 1965, R. Nesbit introduced into practice a simple method for correcting deviation of the corpora cavernosa in congenital erectile deformity, and since 1979, this surgical technique has been widely used for Peyronie's disease. Currently, this method is widely used in the USA and many European countries, both in the classical version and in modification, and many urologists consider it as the standard in the correction of curvatures in Peyronie’s disease. The essence of the Nesbit operation is to cut out an elliptical flap from the tunica albuginea on the side opposite to the maximum curvature. The tunica albuginea defect is sutured with non-absorbable sutures.

Modifications of the classic Nesbit operation differ in the number of resected areas of the tunica albuginea, options for creating an intraoperative artificial erection, and combination with various options for corporoplasty, in particular with plication techniques or in combination with dissection of the plaque and application of a flap of synthetic material.

An example of a modification of the Nesbit operation is the Mikulicz operation, known in Europe as the Yachia operation. The essence of this modification is to make longitudinal incisions in the area of ​​maximum curvature of the penis, followed by horizontal suturing of the wound.

The effectiveness of the Nesbit operation and its modifications (according to the criterion of deformity correction) ranges from 75 to 96%. The disadvantages of the operation include a high risk of damage to the urethra and neurovascular bundle with the development of erectile dysfunction (impotence) (8-23%) and loss of sensitivity of the glans penis (12%). Shortening of the penis is observed in 14-98% of cases.

An alternative to the Nesbit operation is plication of the tunica albuginea of ​​the penis. The essence of this type of corporoplasty is invagination of the tunica albuginea without opening the corpora cavernosa in the zone of maximum deviation. During the operation, non-absorbable suture material is used. Differences in plication methods relate to the options for creating duplications of the tunica albuginea, their number and marking of the levels of overlap.

The effectiveness of plication corporoplasty is highly variable and ranges from 52 to 94%. The disadvantages of this type of surgical intervention include shortening of the penis (41-90%), recurrence of deformation (5-91%) and the formation of painful seals, granulomas, which can be palpated under the skin of the penis.

Indications for plication corporoplasty:

• deformation angle no more than 45°;
• absence of “small penis” syndrome:
• no hourglass deformation.

Plication corporoplasty can be performed both with preserved erectile function and with erectile disorders in the stage of compensation and subcompensation, provided that phosphodiesterase type 5 inhibitors are effective. The Nesbit operation is indicated only if erectile function is preserved at the clinical and subclinical levels.

Indications for patch corporoplasty (“lengthening” techniques):

• deformation angle more than 45°;
• "small penis" syndrome:
• change in the shape of an organ (deformation with narrowing).

A prerequisite for performing flap corporoplasty is preserved erectile function.

Flap corporoplasty can be performed with both dissection and excision of the plaque, followed by replacement of the defect with natural or synthetic material. The question of the optimal plastic material remains open. For flap corporoplasty the following is used:

• autografts - venous wall of the great saphenous vein of the thigh or dorsal vein, skin, tunica vaginalis, vascularized flap of the preputial sac: o allografts - cadaveric pericardium (Tutoplasi), dura mater;
• xenografts - submucosal layer of the small intestine of animals (SIS);
• synthetic materials gortex, silastik, dexon.

The effectiveness of patchwork (according to the criterion of correction of deviation) is very variable and ranges from 75 to 96% when using an autovenous graft. 70-75% when using a skin graft. 41% - lyophilized flap from the dura mater, 58% - the tunica vaginalis of the testicle. The main complication of flap corporoplasty remains erectile dysfunction, which occurs in 12-40% of cases.

Experimental studies have confirmed the advantages of using a venous flap compared to skin and synthetic flaps. An operation using a flap of the great saphenous vein of the thigh was proposed by T. Lue and G. Brock in 1993 and is currently quite widely used.

The indication for implantation of penile prostheses with immediate correction of deformity in Peyronie's disease is widespread damage to the penis and erectile dysfunction (impotence) in the stage of decompensation, which is not amenable to treatment with phosphodiesterase-5 inhibitors. The choice of penile prosthesis depends on the degree of deformity and patient choice. It is customary to evaluate the “success” of penile endoprosthetics when the residual curvature is less than or equal to 15. In the case of more pronounced residual deformation, either manual modeling is performed according to Wilson S. and Delk J., or the plaques are dissected with (without) subsequent flap corporoplasty.

Since the curvature can progress to the point of impossibility of sexual intercourse, treatment should begin when the first signs appear.

At the initial stage, if the disease does not develop, folk remedies can be used as an alternative therapy.

Symptoms and signs

Peyronie's disease has an acute stage and a stabilization phase, lasting from 6 months to a year. Symptoms and clinical signs of this disease in men may differ. The most characteristic symptoms:

• deformation of the genital organ during erection;
• pain during sexual intercourse;
• the presence of a plaque (seal, tubercle) under the skin, which is noticeable upon palpation;
• loss of elasticity of the penis and increasing curvature.

Sometimes Peyronie's disease leads to shortening of the penis and erectile dysfunction (complications).

Causes

Peyronie's disease can be triggered by the following factors:

• genetic predisposition in men to excessive collagen formation;
• traumatism (hematomas, microtears, especially if they become chronic);
• treatment of erectile disorders by injection into the penis can also lead to microtrauma;
• autoimmune disorders;
• taking certain medications for hypertension, heart disease;
• age-related changes in the penis.

Peyronie's disease can lead to three types of penile curvature:

1. dorsal;
2. ventral;
3. lateral.

In the first case, the penis in men “looks” upward; with ventral deviation, it is directed downward, and with lateral deviation, the lateral deformation of the penis is called.

If the curvature is not severe, is not associated with pain and does not interfere with sexual intercourse, it may not be treated or you can use harmless folk remedies.

Connection with the possibility of having children

Peyronie's disease can negatively affect fertility if a man's penis is so curved that it cannot fit into the vagina. In this case, the pathology must be treated, and most likely, surgically, and not with medication or at home, if a man wants to have children. But during the period of treatment and recovery, you will need to give up sexual intercourse and be prepared for the fact that after the operation the penis may decrease slightly in size (by 1-2 cm), as well as other possible consequences (weakened erection) and relapses.

Treatment

Treatment of the disease is often carried out with collagenase, anti-inflammatory drugs, vitamins (conservative therapy), as well as surgical intervention if the curvature is significant, and with the help of other additional physiotherapeutic techniques. The doctor may also recommend using folk remedies as an auxiliary therapy.

Drug treatment is carried out by injection into the penis and through oral administration of drugs (potassium aminobenzoate, colchicine, tamoxifen, vitamin E). The dosage, regimen and duration of medication use will be determined by your doctor.

Interferon, hydrocortisone, lidase are used for injections.

The enzyme preparation collagenase, which affects collagen fibers, has also proven its effectiveness. Before the injections, the patient must be given an anesthetic. But during an exacerbation of Peyronie's disease in men, the administration of this drug can lead to an increase in fibrosis.

Conservative treatment should be comprehensive and include, in addition to medications, ultrasound, laser, magnetic laser therapy, phonophoresis, x-ray therapy, percutaneous electrophoresis and other methods of hardware therapy.

Surgical treatment

It is believed that the most effective way to combat the curvature that Peyronie's disease leads to is through surgical methods. In medical practice, the plication method with excision of fibrous plaques or restoration of affected areas using artificial materials, the patient’s own tissue, and prosthetics is widely used.

Therapy at home

You can try to cure Peyronie's disease with folk remedies: herbal decoctions, baths. It is recommended, for example, to drink a decoction of chestnuts before eating. To prepare the medicine, chop 20 g of chestnuts, add a glass of water, then boil for 15 minutes. Drink strained. To sweeten the broth, add honey to it. The course of treatment is 3 months.

A healing effect cannot be excluded from the following collection based on burdock roots, sage leaves, oregano, primrose and toadflax. 1 tbsp. herbs in equal proportions, pour 2 glasses of boiling water in the evening, and the next day drink the entire infusion in several approaches, before meals. Repeat the procedure every day for 3 months.

Therapy with folk remedies also involves the external use of sage as an infusion for bathing. The duration of the procedure is 20 minutes. After the bath you need to lie down, wrapped warmly.

But when treating with folk remedies, do not forget to control the degree of curvature of the penis. If the deformity increases, you should immediately contact a urologist.

Prevention

Disease prevention measures are designed mainly for men over 35, but young people should also adhere to them, especially if there is a hereditary predisposition.

First, you need to eliminate all risk factors, such as injuries during sex. Choose only comfortable positions and do not make love after drinking alcohol or drugs.

Wear comfortable underwear that does not compress the genitals.

Since some systemic diseases, such as diabetes mellitus, can provoke Peyronie's disease, they need to be treated promptly.

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Peyronie's disease - causes, classification, symptoms, treatment and prevention

What is Peyronie's disease

Peyronie's disease is a fibroplastic disorder of the penis with subsequent curvature, as well as the presence of progressive fibrotic changes. The disease is named after the surgeon F. Gigot de Peyronie, who discovered the disease and began research on treatment in 1743.

The pathology is manifested by curvature of the penis, which develops due to progressive fibrotic processes, expressed by changes in the protein structure of the penis. The disease is usually based on organ trauma followed by the formation of a hematoma within the tunica albuginea.

The prevalence of Peyronie's disease is 1-3.7% and is more common in males. Cases of this disease have also been described in young men. The fact of a slight increase in the disease after the start of using Viagra for the treatment of erectile dysfunction was noted.

ICD-10 code

According to the ICD-10 classification of diseases, Peyronie's disease is included in code N48.6

Causes of Peyronie's disease

Peyronigital injury is a common theory of the occurrence of the disease. Microtraumas of the protein membrane cause hematomas, which lead to fibrous modifications of the tissue of the cavernous bodies. This is Kleiman's theory. Most of these injuries occur during sex.

In addition, the following reasons are possible:

• vascular diseases;
• hormonal disorders;
• inflammatory diseases of the penis;
• taking certain medications;
• autoimmune disorders.

Risk factors for developing the disease are:

• age: with age, the elasticity of the tissues of the penis decreases, which increases the likelihood of injury;
• heredity: if close relatives have Peyronie’s disease, then the risk of the disease increases;
• Connective tissue disorders, such as Dupuytren's contracture: Peyronie's disease is more common in people with this disorder.

Classification of Peyronie's disease

There are three types of penile curvature:

In the dorsal view, the genital organ is directed upward, in the ventral view there is a downward curvature, and in the lateral view there is a lateral deformation of the penis.

Also, curvature of the genital organ occurs:

• acquired: develops as a result of hormonal imbalance or injury;
• congenital: formed as a result of intrauterine disorders.

Stages of Peyronie's disease

At the first stage of the development of the disease, symptoms are either absent altogether or are not expressed by significant deviations from the norm. As a rule, a man is puzzled by the painful sensations that arise during an erection.

After the first stage, gradual deformation of the plaques begins, due to which the size and density of the penis changes.

Over time, the curvature and pain intensify. Acute flow lasts 6-12 months. In the chronic course, there is no pain, the size and compaction of the tunica albuginea of ​​the genital organ are stabilized.

Symptoms of Peyronie's disease

The following symptoms of Peyronie's disease are distinguished:

• curvature of the penis (55-100% of cases);
• pain during erection (70-80% of cases);
• dense plaques palpable under the skin of the penis (80-100% of cases).

The initial symptom of Peyronie's disease is pain during erection. Over time, the pain becomes more pronounced, and curvature of the penis develops. Next, cords and fibrous plaques measuring 1.5-2 cm are felt in the connective tissue. In this case, the patient has no sexual activity due to severe pain.

There are two periods of the disease:

• pain: patients complain of pain in the penis (both during erection and at rest) - in rare cases there is no pain, and the patient consults a doctor because of lumps palpable in the penis area;
• functional: curvature of the penis occurs, which, together with painful sensations, leads to sexual problems - located next to the blood vessels, scars and plaques cause disturbances in the blood supply to the penis and provoke the development of erectile dysfunction.

Treatment of Peyronie's disease

Conservative and surgical treatment is used. For conservative treatment, anti-inflammatory drugs and agents that prevent the formation of fibrous tissue are used. Medicines are injected into the penis. Medicines are also used to prevent calcification of painful areas. Physiotherapeutic procedures are also used.

Drugs

• Potassium aminobenzoate: in an amount of 12 g/day to achieve a therapeutic effect.
• Vitamin E (alpha tocopherol): mg/day in four divided doses (dosage determined by the attending physician) for several months.
• Colchicine: prescribed in an individual regimen, the initial dose is 1 mg.
• Tamoxifen: 40 mg/day, reduces pain in 80% of patients, but this drug does not affect the degree of curvature of the penis.

Physiotherapy

• ultrasound and vibration treatment methods;
• laser-magnetic irradiation of affected areas;
• phonophoresis with ronidase, corticosteroids, lidase.

Surgery

If conservative treatment does not bring any results, then surgical treatment is prescribed. The operation is aimed at eliminating the curvature of the penis and removing the plaque. Treatment of Peyronie's disease and its consequences by surgical methods is indicated only if conservative methods have not yielded results within 1.5 years, and also if the growth of plaques in the protein membrane has stopped.

The use of surgery is an effective method of treatment, but at the same time there are disadvantages: price compared to conservative treatment and morbidity. Methods of surgical treatment of Peyronie's disease are divided into three types of operations.

Operation Nesbit

Nesbit was the first to describe a method of surgical treatment of congenital curvature of the penis. The operation consists of making an incision in the tunica albuginea on the side of the curvature, as well as folding (plication) with sutures on the opposite side. Variants of the Nesbit operation technique for Peyronie's disease.

• Plication: on the opposite side, in the area of ​​the curvature of the penis, folding sutures are placed on the tunica albuginea.
• Corporoplasty: on the opposite side of the curvature, a longitudinal incision is made in the tunica albuginea, which is sutured in the transverse direction, which leads to straightening of the penis.

Nesbit type operations are simple to perform, are not accompanied by serious complications and are indicated for patients with sufficient penile length and mild or moderate penile curvature. The size of the penis becomes a contraindication, since this type of operation shortens the penis.

Replacement plastic surgery

If the plaques are large or the penis has a significant curvature, it is necessary to incise or excise the plaque and replace the resulting defect with other tissue. Although the choice of material depends on the experience and preference of the surgeon, the following are more often used:

Autotransplantation

In this case, the patient’s own tissues are used (usually a section of his own vein). Disadvantages of this technique: the need for a second incision and the tendency for contracture and scarring of the flap.

Synthetic materials

Dacron or Gore-Tex are used. The disadvantage of the method is chronic inflammation, which leads to erosion and an ongoing fibrotic process that spreads beyond the implant.

Biomembranes (porcine skin or pig intestinal submucosa)

Xenografts are ready for use, after opening from the package, they help the development of your own collagen and are not subject to sclerosis.

Penile prosthetics

Prosthetics are used in patients with Peyronie's disease, accompanied by severe curvature of the penis and persistent erectile dysfunction. Prosthetics helps to correct the curvature of the penis on a prosthesis using replacement plastic methods and restore erectile dysfunction.

Postoperative management of patients

In the postoperative period, periodic squeezing of blood from the penis, a pressure bandage for 48 hours, and a Foley catheter for 24 hours are performed. Antibacterial therapy begins in the operating room with intravenous administration of antibacterial agents and continues from the second day in the form of taking tablets until 21 days. Patients are advised to abstain from sexual relations for 6-8 weeks.

Extracorporeal shock wave therapy (ESWT) for Peyronie's disease

For treatment, a lithotripter is used, the intensity of which is a thousand pulses per therapy session. The maximum power involved is twelve to thirteen kV. The course of treatment involves weekly use of ESWT for two to twelve weeks. There is no need for pain relief during extracorporeal shock wave therapy.

For ESWT, the patient lies on the couch with his stomach down, while the penis is located on a special therapeutic pad of the lithotripter and, under the natural influence of the patient’s weight, is pressed to the plane. The airbag pressure increases and gradually reaches a maximum. In this way, the resulting plaques are affected.

As a result of several sessions, men experience pain relief during moments of arousal, the penis takes on a natural appearance, and the plaques become smaller and less dense. With ultrasound examination of the blood flow of the genital organ, there are much fewer vessels surrounding the plaques.

Results are achieved with therapy in the early stages of disease development. In the period up to a year, the tissues are relatively healthy; cardinal changes have not yet occurred in them. Also, constructive treatment is affected by the lack of conservative therapy.

If more than two years have passed since the onset of the disease, the patient was given intracavernosal injections, which caused complications, this treatment is of no benefit. In this case, the first step is surgical intervention. Extracorporeal shock wave therapy does not have an immediate effect and takes time.

Folk remedies for treating Peyronie's disease at home

Folk remedies complement the treatment prescribed by the doctor. The following recipes are used:

• Chop 20 g chestnuts, pour 1 tbsp. warm water and boil for minutes, then strain and take before meals. Add honey if desired.
• Herbal tincture is prepared from sage leaves, oregano, burdock and primrose. Chop the herbs, add boiled water, leave for 24 hours, strain through cheesecloth and take before meals.
• Baths with sage are prepared as follows: dried sage (500 g), pour boiling water (10 l), you need to take such a bath for half an hour.

Diagnosis of Peyronie's disease

Diagnosis of this disease involves the use, in addition to the initial palpation of the tissues of the penis, of a complex of modern techniques:

• Ultrasound helps determine the size, location and degree of calcification of plaques in the protein coat.
• CT (computed tomography) and MRI (magnetic resonance imaging) are used in cases where plaques are not visible on ultrasound.
• Spiral computed tomography provides a picture of the disease, including information about the density of pathological areas. Used if surgical treatment is indicated.
• X-ray helps to see the condition of the penis.

Prevention of Peyronie's disease

Since Peyronie's disease is usually caused by microtraumas received during sexual intercourse, to prevent curvature of the penis, restrained sex, not too risky positions, and refusal of sexual intercourse while intoxicated are necessary.

It is necessary to treat concomitant diseases, such as arterial hypertension, diabetes mellitus, etc. The use of medications for cardiovascular diseases only after consultation with a doctor.

Peyronie's disease

Peyronie's disease is a curvature of the male penis that occurs as a result of the proliferation of fibrous tissue due to plaques in the tunica albuginea or benign tumor-like formations of the penis that appear on the back or sides of the penis. This pathology was first noticed in the 16th century, but the first medical observations and justifications for the disease were compiled a little later (in 1743) by the French surgeon Francois Peyronie, and the disease was later named after him.

Currently, Peyronie's disease is relatively rare: it is diagnosed in 0.5-1% of older men. With age, the elasticity of penile tissue decreases, which increases the risk of microtrauma and microtears. In young men (pre-teens), Peyronie's disease is rarely diagnosed. In men over 60 years of age, due to a decrease in sexual activity, the pathology is also rare, because according to WHO, a third of men over 60 years of age are not able to perform sexual intercourse at all.

Symptoms

• Pain in the shaft of the penis. Painful erection.
• Increased pain during sexual intercourse.
• Decreased elasticity of the genital organ.
• Feeling a plaque under the skin.
• Gradual curvature of the penis.

Causes

The exact causes of Peyronie's disease have not yet been established. The main cause is considered to be microtrauma of the protein membrane and hematomas that occur due to mechanical damage, primarily during sexual intercourse. With constant irritation of the penis, inflammation of the glans occurs. This activates fibroblasts, which leads to connective tissue degeneration of the protein membrane. Skin and tissues lose softness and elasticity - they become inactive and rigid. The connective tissue grows to the side and curvature of the penis occurs.

Peyronie's disease can be congenital. The cause of this pathology is hypoplasia of the tunica albuginea or a short urethral canal. With a congenital disease, there are no plaques under the skin, but there are compactions of connective tissue in the cavernous bodies, which causes curvature of the penis. Congenital Peyronie's disease is diagnosed in 1-2% of men and is most often associated with a hereditary factor. The heredity factor is also confirmed by Dupuytren's contracture, which accompanies Peyronie's disease in 60% of patients.

In addition, based on clinical observations, doctors identify a number of factors that increase the risk of this disease:

• Collagenoses are inflammatory diseases of connective tissue.
• Endocrine diseases, such as diabetes.
• Lipid metabolism disorders.
• Cardiac ischemia.
• Arterial hypertension – blood pressure 140/90 mmHg. Art. and higher.
• Smoking and alcoholism have a harmful effect on the elasticity and firmness of the skin.

Peyronie's disease usually develops gradually. The period from the onset of the inflammatory process as a result of microtrauma to the formation of a plaque lasts up to 1.5 years, then the plaque no longer grows, and the curvature of the penis does not increase. However, the curvature does not disappear on its own; the plaques remain, which requires serious treatment.

Diagnostics

At the first signs of penile curvature or painful erection, patients usually turn to a urologist or andrologist. Diagnosis of Peyronie's disease is not difficult; some doubts arise when young men go to the doctor. Already during the initial examination and a few questions to the patient, the doctor has a complete picture of the disease. The patient is examined during an erection to determine the degree of curvature of the genital organ. Upon palpation, fibrous plaques are easily detected - cartilaginous protrusions located separately or merging into one whole, which are even visually different from the skin. The size of the plaques is determined using ultrasound. Additionally, radiography and computed tomography are performed to detect previously undetected plaques, as well as to select the optimal method of treating the disease.

Treatment of the disease

Initially, conservative treatment is carried out; if it is ineffective, surgery is used. Conservative treatment of Peyronie's disease involves the introduction of anti-inflammatory drugs into the penis, as well as orally. Additionally, physiotherapy is used. The following therapy is usually prescribed:

• Introduction of interferon, lidase, hydrocortisone into the tissue of the penis.
• Potassium aminobenzoate – 12 g/day, the drug has an antiphyroplastic effect.
• Tamoxifen – 40 mg/day orally, reduces pain.
• Vitamin E – mg orally 4 times a day for 2-3 months (for each patient determined individually by the doctor).
• Colchicine - initial dose 1 mg per day, the dosage is adjusted by the doctor.
• Ultrasound treatment, laser therapy, x-ray therapy.
• Phonophoresis with lidase, corticosteroids, ronidase.

Despite the fact that most of the drugs listed can be bought at a pharmacy without a prescription and used independently, you must remember that self-medication can be very dangerous! Side effects can only expand the range of problems. Treatment of Peyronie's disease at home makes little sense; this pathology should be treated by a specialist.

As medical practice shows, conservative therapy helps in 50-60% of cases. Conservative treatment gives good results only at the stage of inflammation, i.e. with early diagnosis of the disease. On the one hand, there is a possibility of improvement without surgery, but on the other hand, injections represent further microtraumas that contribute to the further aggravation of the disease, namely the formation of scars and plaques. After the formation of fibrous plaques under the skin of the penis, surgical treatment is indicated.

Surgical treatment is much more effective, since it makes it possible to correct the curvature of the genital organ simultaneously with the removal of plaques. The surgical technique is selected individually. If the curvature is less than 45 degrees, and the length of the penis is greater than the average, then correction is performed by applying folds on the opposite side of the organ. The tissues are sutured, the penis loses a little in length, but the risk of complications is low.

If the curvature is more than 45 degrees, and the length of the penis allows, then the tunica albuginea is excised, and the tissue on the opposite side of the organ is sutured.

In cases where patients do not agree to undergo such an operation or the length of the organ does not allow it to be performed, then dissection of the plaque is performed in combination with plastic surgery using tissue from other places. During the course of the disease with erectile dysfunction, penile prosthesis is performed, and implantation is also used.

Erectile dysfunction is the most common complication of Peyronie's disease (occurs in the vast majority of patients). This problem needs to be treated by a urologist, without taking medications on your own, which are now in abundance in pharmacies. It is worth noting that the earlier Peyronie's disease was detected and the earlier treatment was started, the less likely it is that erectile dysfunction will occur.

During treatment, patients are advised to avoid sexual intercourse and masturbation, which can lead to new microtraumas. You should establish control over your diet: there is no need for a special diet, but you need to limit the consumption of fried and spicy foods, and consume more vitamin-rich vegetables and fruits.

Often, during the detection of pathology, as well as during the treatment period, patients experience psychological problems against the background of changes in their sexual life. Such patients are recommended to consult a sex therapist, psychologist, or psychotherapist.

Treatment with folk remedies

You should resort to folk remedies only as prescribed by your doctor as an addition to the main treatment. Here are some recipes:

• Chestnut decoction – pour 20 g of chopped chestnut nuts into 1 glass of water, boil for 15 minutes, strain. Take 1/3 cup before meals for 3 months. If the taste is too bitter, you can add a little honey.
• Herbal infusion - take equal parts of sage leaves, primrose leaves, flaxseed, oregano, burdock roots, mix everything. Pour 1 tablespoon of the collection with 2 cups of boiling water, leave overnight, then strain. Drink all the medicine the next day in 3-4 approaches, drink before meals. The course of treatment is 3 months.
• Bath with sage – pour 500 g of dried sage into 10 liters of boiling water, leave for 30 minutes, strain. The duration of the therapeutic bath is 20 minutes, then a warming bed rest.

Prevention

Because the exact causes of Peyronie's disease are not known, prevention is based on risk factors for the disease, as well as medical practice. Prevention concerns all men, but especially older men. Since most injuries to the penis occur during sexual intercourse, you should choose comfortable positions and avoid sex while under the influence of alcohol or drugs. It is recommended to wear loose trousers and comfortable underwear. It is necessary to minimize the impact of systemic diseases on the body - treat diabetes mellitus, coronary heart disease, arterial hypertension.

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Before starting treatment, consult your doctor.

Peyronie's disease - symptoms and treatment

Peyronie's disease is a rare pathology of the male genital organ. It manifests itself in the form of proliferation of fibrous tissue due to the appearance of compactions (plaques) in the cavernous bodies of the male genital organ. The disease causes curvature of the penis.

The plaques themselves do not cause discomfort or pain, but over time they are replaced by connective tissue, which leads to a decrease in erectile function and affects the ability to fertilize.

Basically, the pathology develops in men who are sexually active.

Peyronie's disease is a disorder of the connective tissue structure, a type of collagenosis. Elastic soft fibers are gradually replaced by fibrous rough tissue. With this disease, collagen is not produced properly in the patient's body.

Causes of Peyronie's disease

To date, the causes that lead to the disease have not been fully identified, however, there are etiological factors that contribute to the pathology:

• genital injuries;
• disturbances in the functioning of the endocrine system;
• closed fracture of the penis;
• decreased elasticity of the tissues of the genital organ;
• inflammation of connective tissue - collagenosis;
• some abnormalities of the immune system;
• inflammatory process in the urethra;
• taking certain medications;
• metabolic disease;
• narrowing of the lumen of blood vessels, characteristic of atherosclerosis;
• increased levels of serotonin in the body;
• connective tissue diseases;
• lack of calcium and vitamin E;
• arterial hypertension;
• bad habits;
• cardiac ischemia.

In extremely rare cases, the disease may be congenital. For example, with a pathology in the structure of the tunica albuginea, or with an abnormally short urethra. The difference between congenital and acquired is that in the first case there are no plaques. The deformity develops against the background of cords in the cavernous bodies.

Important! Minor deformities are not a serious disease and do not require surgical intervention.

Classification of the disease

Peyronie's disease is classified according to stage, cause and degree of deformity.

Taking into account the cause of occurrence, the following are distinguished:

• acquired form– developed as a result of hormonal imbalance or injury;
• congenital– formed as a result of intrauterine disorders.

According to the degree of deformation, the disease is divided into several types:

• dorsal– the penis is directed upward;
• ventral– the genital organ is tilted down;
• lateral– the penis is directed to the side.

According to the degree of progression, Peyronie's disease is divided into:

• painful– there is severe pain at rest and during erection;
• functional– apart from pain, it is impossible to lead a normal sex life if you have the disease.

Symptoms of Peyronie's disease

The main symptoms of the pathology are:

• pain of varying intensity at rest and during sexual intercourse;
• significant curvature in one direction or another;
• change in penis size due to curvature;
• decreased erection;
• the formation of a compaction under the skin of the genital organ.

As a rule, at the initial stage a man does not feel any symptoms. This period can last up to one and a half years.

Attention! Conservative therapy will be more effective if the disorder is detected in the early stages.

Diagnosis of Peyronie's disease

The first step is to collect an anamnesis. The doctor interviews the patient to identify complaints and the duration of their manifestation, as well as the presence of past inflammatory processes in the pelvis and injuries to the penis. The patient is asked to fill out a special questionnaire that will allow him to assess the quality of his sexual life.

Next, an objective examination of the penis is performed. To do this, an erection is artificially induced using a vacuum erector. In this condition, the doctor evaluates the degree of curvature, the shape of the genital organ, the location of the plaque and its size.

Instrumental diagnostic methods are also used:

1. Cavernosography. During an x-ray, the patient is given contrast to determine the location and size of the plaque. The method allows you to assess the condition of the internal structures of the penis. Confirm the presence or absence of pathology in the corpora cavernosa spongiosum.
2. Ultrasound of the vessels of the penis. The purpose of the method is to determine the presence of pathological blood circulation and the location of the compaction. This study is most effective in the acute stage of pathology.
3. MRI of the genital organ. During the study, the doctor receives layer-by-layer images of a cross section of the organ. The method allows you to absolutely accurately determine the location of the plaque and its size, as well as the presence of problems with blood flow in this place.

Treatment methods for Peyronie's disease

Treatment of pathology is prescribed individually to each patient, after analyzing all the results of the study.

There are several methods of therapy:

• surgery;
• local treatment;
• medicinal;
• shock wave therapy;
• folk remedies.

The first step is to resort to drug treatment. It involves taking anti-inflammatory drugs orally or injecting them into the penis. Additionally, physiotherapy is used.

Drug therapy includes taking the following drugs:

• Interferon, hydrocortisone, and lidase are injected into the penis tissue;
• Potassium aminobenzoate – 12 g/day. The drug has an antiphyroplastic effect;
• corticosteroids, ronidase, phonophoresis with lidase;
• pain is reduced by tamoxifen – 40 mg/day;
• for 2-3 months, vitamin E pomg is prescribed orally 4 times a day;
• colchicine – starting from 1 mg per day. The dosage is adjusted by the doctor.

Important! Most of the drugs listed can be purchased freely at the pharmacy, but remember that self-medication can lead to serious consequences!

If drug therapy does not produce results, surgical treatment is used. It is much more effective, since the operation makes it possible not only to remove plaques, but also to correct the curvature of the penis.

The method of surgical intervention is selected individually. If the curvature is less than 45 degrees and the length of the penis is more than average, correction is performed by applying folds on the opposite side of the organ. The tissues are sutured. The penis loses a little in length, but the risk of complications is significantly reduced.

If the curvature is more than 45 degrees, if the length of the genital organ allows, the tunica albuginea is excised, and the tissue on the opposite side of the organ is sutured.

As an addition to the main treatment, the attending physician may prescribe the use of folk remedies.

Traditional medicine recipes for Peyronie's disease:

• chestnut decoction. Chop 20 g of chestnuts and pour a glass of water over them. Boil for a quarter of an hour and strain. Take 1/3 cup before meals for 3 months;
• sage bath. Half a kilogram of dried sage is poured with ten liters of boiling water and left for half an hour. Strain and take a bath for 20 minutes, after which they immediately go to a warm bed;
• herbal infusion. Take equal parts of sage leaves, burdock roots, primrose, oregano and flaxseed. Mix. Pour two cups of boiling water over a spoonful of the mixture and leave overnight. Strain. Drink the infusion in three doses before meals. The course of treatment is three months.

Prevention

Prevention measures for Peyronie's disease:

• do not have sex while under the influence of drugs or alcohol to avoid injury to the penis;
• between the ages of 30 and 60, undergo annual preventive examinations;
• lead a healthy lifestyle;
• control body weight;
• monitor the pressure level;
• wear comfortable underwear;
• exercise regularly.

If any disorders of the reproductive system occur, you must immediately contact a urologist to diagnose and begin treatment.

Radevich Igor Tadeushevich, sex therapist-andrologist, 1st category

The information is provided for informational purposes only. Do not self-medicate. At the first sign of disease, consult a doctor. There are contraindications, a doctor's consultation is required. The site may contain content prohibited for viewing by persons under 18 years of age.

Peyronie's disease: symptoms and treatment

Peyronie's disease - main symptoms:

• Weak erection
• Pain during intercourse
• Pain in the penis
• Curvature of the penis
• Plaque under the skin of the penis
• Changing the size of the penis

Peyronie's disease is a pathology characteristic only of the male half of humanity. The disease is characterized by pain during erection, which occurs against the background of fibrous changes in the tunica albuginea. The disease is rare, and it is more common in males aged between forty and sixty years.

The main cause is considered to be the formation of plaques in the membrane, as well as benign neoplasms on the penis or urethra. Since such a disorder tends to progress, it can reach an extreme degree - the complete impossibility of sexual intercourse.

In some cases, such a disorder can negatively affect conception, but this is only present in cases where the sexual organ is curved to such an extent that it cannot enter the female genitalia. That is why it is necessary to seek the help of specialists when the first symptoms occur (the presence of a small lump that is easy to detect by touch, pain during sexual intercourse, deformation with each erection). The basis of treatment is surgery. There is a lot of controversy among specialists about the effectiveness of therapy carried out with folk remedies at home.

Etiology

The causes of Peyronie's disease are not fully understood, but there are a number of etiological factors that contribute to this anomaly:

• a wide range of injuries to the genital organ, for example, during sexual intercourse, from a blow or an accidental fall on a hard surface;
• microtraumas that are invisible to the eye and not accompanied by pain. They often occur during sexual intercourse;
• closed fracture of the penis, in which the integrity of the skin is not violated, but hemorrhage occurs;
• some abnormalities on the part of the immune system, when the body begins to attack itself;
• diabetes;
• taking certain medications;
• the presence of narrowing of the lumen of blood vessels, which is characteristic of a disease such as atherosclerosis;
• a wide range of connective tissue diseases;
• gout – an increase in the level of uric acid in the blood;
• deficiency of vitamin E and calcium in the body;
• the use of certain drugs aimed at treating impotence;
• increased levels of serotonin in the body;
• the man's age. As the body ages, tissues lose their elasticity and are more susceptible to injury.

Very rarely, such a disease is congenital, for example, with pathologies in the structure of the tunica albuginea or with an abnormally short urethra. The main difference between a congenital and an acquired disease is the absence of plaques, and the deformation develops against the background of cords in the cavernous bodies. However, minor deformations are not a serious problem and do not require surgery. Globally, approximately three percent of the male population suffers from congenital Peyronie's disease.

Varieties

According to the degree of deformation, this disease is divided into several types:

• dorsal – the genital organ is directed upward;
• ventral – the penis is tilted down;
• lateral - the penis will “look” to the side.

Depending on the stage of its progression, Peyronie's disease is divided into:

• pain – men complain of severe pain not only during an erection, but also at rest. Only in isolated cases does the manifestation of pain not bother men, and the reason for contacting a doctor is a well-palpable plaque. Often its size does not exceed two centimeters;
• functional - in addition to causing pain, such an illness leads to the inability to lead a normal sexual life.

Symptoms

In addition to painful sensations of varying intensity during sexual intercourse, the symptoms of this disorder are:

• significant curvature in one direction or another;
• decreased erection - during the period of arousal, the sexual organ does not enlarge and does not fully harden;
• the formation of a compacted area under the skin of the organ;
• change in size - the decrease is not associated with a decrease in length, but is caused by the curvature of the penis.

At the initial stage of the disease, a person may not feel any symptoms at all. This phase lasts from six to eighteen months. The earlier the disorder is identified, the more effective conservative therapy will be. In most cases, it happens that even after expressing the signs, a man is in no hurry to see a doctor, but makes attempts to independently eliminate the discomfort using traditional medicine. This should not be done under any circumstances, since they will not bring results, but will only aggravate the course of the disease.

Complications

Due to a delay in seeking help from a specialist, every male suffering from Peyronie’s disease may experience the development of the following consequences:

• impotence;
• male infertility;
• prolonged depression;
• severe pain during sexual intercourse and erection. With this disease, this is not only an unpleasant symptom, but also an undesirable complication, often from treatment with folk remedies;
• shortening the size of the genital organ is a complication after surgery.

Diagnostics

When making a final diagnosis of Peyronie's disease, the specialist uses data obtained during:

• collecting thorough information about the time of onset of the first symptoms of the disease and previous illnesses of both the patient and his immediate family. This is done to identify the cause of the expression or confirmation of the hereditary factor;
• patients completing specially designed tests aimed at determining the quality of sexual life;
• direct examination by a urologist of the genital organ in a state of erection. This process will be accelerated if the patient himself brings a photo of the penis in different projections;
• Ultrasound of the vessels of the penis - is carried out to assess blood circulation in the area of ​​​​the seal;
• MRI of the genital organ - this technique makes it possible to obtain a layer-by-layer image of the tissues of this organ. This is the most informative diagnostic method, allowing you to determine the location of the plaque and its volume;
• cavernosography - introducing a special contrast agent into the internal structures of the penis and performing radiography;
• additional consultation with a specialist such as a urologist-andrologist.

After receiving all the research results, the doctor prescribes the most effective way to treat Peyronie's disease. Before choosing a tactic, the patient must be informed that he should not attempt independent therapy with folk remedies.

Treatment

Treatment of Peyronie's disease is carried out individually, depending on the degree of curvature and the manifestation of pain. There are several methods of therapy:

• Surgery is the most effective way to eliminate the disease. The basis is several measures - eliminating the plaque and creating special folds from the membranes of the penis on the opposite side of the lesion, thanks to which it is possible to achieve its alignment. In some situations, penile prosthetics or dildo implantation may be necessary;
• the use of medications is carried out in several cases when it is impossible to carry out medical intervention or in the early stages of the disease. Vitamin E is often prescribed, substances that reduce the likelihood of plaque formation and promote their resorption. But in this case, there is a high probability of relapse of Peyronie's disease. The prescription of medications that reduce the content of fibrinogen, cell division and collagen, anti-inflammatory substances, as well as drugs that reduce the activity of the immune system is also indicated;
• introduction of medicinal substances directly into the places of formation of compactions;
• physiotherapy - electrophoresis and the use of laser radiation.

Since the disease develops rather slowly, there is a misconception that when the first signs appear, it is best to use traditional medicine in order to avoid medical intervention. But it is important to remember that surgery is the only way to treat Peyronie's disease.

Prevention

Preventive measures for this disorder are the following rules:

• maintaining a healthy lifestyle;
• Never make love while under the influence of alcohol or drugs. Because the highest probability of injuring the penis is in such conditions;
• rationalization of diet and quality of nutrition. Eat food enriched with vitamins and nutrients;
• strictly monitor blood pressure levels;
• exercise regularly;
• exercise control over body weight;
• undergo preventive examinations in the clinic for diabetes mellitus, as well as for men aged thirty to sixty years.

In addition, it is necessary to promptly contact a urologist if any disorders of the reproductive system occur. Never self-medicate with folk remedies.

If you think that you have Peyronie's disease and the symptoms characteristic of this disease, then doctors can help you: urologist, andrologist.

We also suggest using our online disease diagnostic service, which selects probable diseases based on the entered symptoms.

Impotence (erectile dysfunction) determines the relevance for a man of such violations of his sexual functions in which he is unable to complete sexual intercourse. Impotence, the symptoms of which indicate an inability to maintain an erection at the level required for sexual intercourse or an inability to achieve ejaculation, or a combination of both conditions, can be characterized by either a complete inability to achieve ejaculation or an erection, or a short duration of maintaining an erection.

Kidney stones are one of the most common forms of urolithiasis, in which salt stones, the actual stones, form in the kidneys. Kidney stones, the symptoms of which manifest themselves in the form of attacks of renal colic, pyuria (pus in the urine), hematuria (blood in the urine) and lower back pain, can be eliminated both through conservative therapy, the effect of which allows them to dissolve, and through surgical intervention, in which stones are removed surgically.

Prostate fibrosis (another name for prostate sclerosis) is a disease that often affects representatives of the stronger half of humanity. It develops in men from different age groups. It is characterized by inflammation of the urinary system, which develops as a result of the rapid proliferation of connective tissue. The more it grows, the more the seminal and urinary canals will be compressed. All this is fraught with disruption of the urination process, as well as problems in sexual life.

Vulvovaginal candidiasis is an inflammatory process that develops in the vagina and external genitalia. As a rule, it manifests itself in older women or little girls. As for children, the disease manifests itself even in newborns. The reason for this may be simple lack of hygiene.

Candidal balanoposthitis is a disease that affects the male genitourinary system. Caused by Candida fungi. They penetrate the mucous membranes and skin of humans, resulting in the formation of multiple filamentous forms. This disease affects men of all ages.

With the help of exercise and abstinence, most people can do without medicine.

Symptoms and treatment of human diseases

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Questions and suggestions:

The painful condition is manifested by the appearance of extraneous sclerotized plaques in the erectile (protein) tissue, leading to the bending of the penis during potency. Patients with sexual ailment usually have several foci of connective tissue growth, however, the bend of the crooked penis is observed predominantly upward, although bending slightly to the right and left is also possible. Changes are often diagnosed in patients over 50 years of age, but detection of curvature is possible at an earlier age.

Reference! Alternative names for Peyronie's disease are penile fibromatosis and van Buren's disease.

Why is it called that?

The development of a foreign tissue fragment was discovered by the French surgeon Francois Peyronie in the first half of the 18th century.
The discovery made it possible to name the disease in honor of the outstanding doctor, who also determined the dependence of the direction taken by the penis during an erection on the location of the “tumor” in the penis.

Curvature in the presence of a plaque on the right side also leads to a deviation in direction in this direction(to the lesion). Therapy in those days was limited only to mercury rubbing and mineral compresses, which were occasionally beneficial.

Already in the 18th century, Peyronie associated a high risk of developing the disease after suffering from venereal diseases.

Does it pose a threat to the man's life?

Curvature of the male penis does not belong to the group of diseases that can be life-threatening, but the displacement significantly worsens the quality of life of a man. Strong changes in the direction of the penis complicate sexual penetration and bring discomfort to the partner - as a result, the patient is forced to reduce the number of sexual contacts.

Disease code according to ICD-10

According to ICD-10, this disease has the numerical designation N48.6, which belongs to the group of urological diseases, which also includes balanitis and plastic induration of the penis.

Percentage probability of developing the disease in childhood

Incorrect distribution of the cavernous and protein membranes during fetal formation leads to the occurrence of congenital Peyronie's disease. The pathology is observed in six children per 1000 boys born (0.6%), although earlier (40 years ago) this ratio was only 2 children (0.2%) who had a curvature of the penis to the above-described number of those born.

Prerequisites for the disease

Doctors attribute abnormal development of the fetus due to the influence of careless behavior of the mother - smoking, hormonal therapy or stress during the period up to 15 weeks of pregnancy. Peyronie's disease often develops in babies who have been exposed to intrauterine infection.

Increased risk of development in other congenital diseases:

• cryptorchidism;
• inguinal hernia;
• hydronephrosis.

Prerequisites for the development of the disease are also created in the presence of a hereditary factor that can affect several generations in a row. The difficulty of diagnosis in children lies in the appearance of stable erections only in adolescence, so the child or his parents may not immediately notice the curvature. The exception is significant lesions, which are noticeable even when examining a member in a calm state.

During adolescence, active lengthening of the penis also begins., forcing the owner of the disease to quickly identify signs of abnormal development of the genital organ. If a child has a congenital deficiency of the skin of the penis, then the curvature is formed not due to the presence of a plaque, but to pathological stretching of the skin during erection. This condition is not Peyronie's disease.

Medical fact. The risk of the fetus acquiring congenital changes in the penis increases with in vitro fertilization.

What are the symptoms and manifestations of a crooked penis?

Once a patch of connective tissue appears within a year, the body can eliminate it naturally, but if this does not happen, it remains for life. Every year the patient's condition worsens due to an increase in the angle of curvature of the penis.

Signs of Peyronie's disease:

• feeling of a lump under the skin;
• pain during friction;
• reduction in penis length;
• decreased potency.

The last negative consequence is diagnosed due to the gradual compression of the vessels feeding the penis by growths. Without enough fluid flow, the crooked penis remains soft, leading to the inability to maintain full sexual activity.

Attention! The chronic fibrotic stage develops immediately after the acute stage of the disease, during which severe pain is observed in the penis area.

Possible reasons

The mechanisms of development of changes in the tissues of the penis are diverse - from autoimmune to mechanical. Usually they are connected: after trauma to the penis, the body begins to perceive certain tissues as unwanted and begins to “attack” them. The desire to engage in rough sex often leads to microtraumas that can create a focus for the formation of fibrous changes. Especially A fracture of the penis is dangerous, which causes severe damage due to the resulting hemorrhage.

Urologists also highlight the high probability of the influence of drugs from the group of beta blockers used to correct cardiovascular diseases, as well as hypertensive medications used for hypotension. It is also possible to acquire the disease due to the deliberate creation of excessive pressure on the genitals, an example is the use of devices, weights and extenders to increase the length of the penis.

People with gout, atherosclerosis and diabetes mellitus are more likely to suffer from Peyronie's disease.

Complications when refusing medical intervention

In the initial stage, the plaque actively grows, therefore it retains the semblance of flexible cartilage, during the transition to the chronic stage, it is gradually saturated with calcium, so it quickly becomes hard.

In advanced cases, upon palpation it resembles bone - resorption of such a fragment is impossible, therefore only surgical removal of the growth is indicated. The presence of a dense foreign body can also create a curvature of up to 90 degrees.

Other threats:

• impotence;
• depression;
• infertility;
• blockage of blood vessels.

Destructive transformation leads to a slow displacement of the opening of the urethra, which shifts towards the focal lesion, mainly in the area of ​​the coronary sulcus.

In such men, sperm is not released directly, but to the side, which creates inconvenience when finalizing sexual intercourse without a condom. By creating tension in the tissues of the penis, the disease also leads to dysplasia of the foreskin - “hood syndrome” - and the creation of tingling in the opening and adjacent areas of the mucosa.

Narrowing of the lumen of blood vessels leads to the inability to correct a weak erection with stimulants: Blood flow remains limited even in this condition. The most dangerous condition involves necrosis of penile tissue, caused by insufficient cell nutrition for a long time.

Important! The presence of only one plaque often does not lead to curvature of the penis.

Review of Treatment Options

The choice of an effective correction method depends on the stage of the disease, determined by laboratory tests - ultrasound, MRI or CT scan of the penis. It is easy to diagnose the presence of seals using palpation.

1. Superficial impact. Rubbing is used at the initial stage of the disease and is often associated with folk recipes (baths with sage, use of ointments with horse chestnut). Sometimes leeches are even used, but official medicine recognizes such methods as ineffective.
2. Oral administration. Conservative treatment includes the use of vitamin E (strengthens the immune system and reduces pain), Tamoxifen (inhibits the development of scar tissue), Colchicine (relieves inflammation).
3. Minimally invasive intervention. The introduction of a solution that promotes tissue dissolution includes injections of Lidase and Hydrocortisone. Lidocaine injections are given to relieve pain, and interferon-based drugs are given to strengthen the immune system. Verapamil is used to prevent the accumulation of calcium in the plaque (effective for men with a curvature angle of up to 30 degrees). In European countries, injections with the enzyme collagenase are also increasingly being used.
4. Physiotherapy. Tissue resorption is facilitated by electrophoresis sessions with Chemotrypsin and Lidocaine. Ultrasound is also used, which increases the likelihood of destruction of destructive tissue.
5. Surgical correction. Straightening with a scalpel is carried out when other methods are ineffective and the disease has stabilized (transition to the fibrotic stage). There are 3 possible options for the surgeon - complete removal of the protein tissue, lengthening (straightening of the plaque) and endoprosthetics of the penis.

Endoprosthesis replacement is carried out by replacing a pathological area with an implant if the patient experiences a weakening or absence of erection.

The surgical straightening method is contraindicated in the presence of balanoposthitis, orchitis, urethritis and other inflammatory diseases of the genitourinary area.

Useful video

Let's watch an interesting video about Peyronie's disease:

Conclusion

Curvature of the penis is an unpleasant condition that is recommended to be treated immediately after detection. Delay leads to an increase in the inclination of the penis and the development of destructive changes in fibrous tissue, which becomes increasingly difficult to eliminate over time.

Despite this nuance, the treatment prognosis is favorable, since with surgical intervention the restoration of the correct geometry of the penis is diagnosed in more than 95% of cases.

Peyronie's disease (ICD code 48.6) is diagnosed when foci of fibrosis are detected in the tunica albuginea of ​​the penis (fibroplastic induration). These formations cause deformation of the organ, which manifests itself during an erection. In a number of sources, the pathology is known as “penile fibromatosis”. The disease is rare and occurs mainly in men aged 35 to 70 years. It almost never occurs in young men. Peyronie's disease not only distorts the appearance of the penis, but is also accompanied by pain during erection, depriving a man of intimate life.

Peyronie's disease manifests itself with the following symptoms:

• the appearance of compactions (plaques) and fibrin strands under the skin of the penis, a decrease in its turgor (elasticity);
• pain during erection, increasing during friction. The symptom is caused by the pressure of the seals on the blood-filled corpora cavernosa;
• gradually increasing degree of deformation of the erect penis. There are three types of curvature: dorsal (up), ventral (down), lateral (sideways).

In the acute form of Peyronie's disease, pain and a pronounced change in the shape of the penis occur already at the initial stage, which lasts from 6 to 18 months, then the pain subsides and the chronic phase begins.

In most cases, the pathology develops slowly. For a long time, the only symptom is barely palpable single or multiple lumps under the skin of the penis. A dull pain may come and go periodically. As the disease progresses, the intensity of pain symptoms increases; the curvature of the penis during erection can reach 60-90 degrees.

Complications

Although Peyronie's disease is not fraught with the development of life-threatening complications, without diagnosis and treatment this pathology makes intimate life impossible. Infertility, relationship breakdown, severe depression and neuroses - this is an incomplete list of negative consequences.

From the moment the plaque originates until the completion of its formation, approximately one and a half years pass. The disease tends to progress. Pathology resolves spontaneously only in 13% of cases. A big mistake is trying to self-medicate with medications, physical influence or injections. This can lead to new compactions, hematomas, suppuration, and stricture (narrowing) of the urethral canal.

Reasons for development

Injury to the shaft of the penis leads to ruptures and displacement of collagen fibers, damage to blood vessels, and the formation of hematomas. Normally, tissue regeneration occurs without consequences, but in some cases, fibroblast cells are activated, producing fibrin in large quantities. Gradually, the inflamed area is replaced by scar tissue, which over time “matures,” calcifies and becomes hard (osteogenic degeneration).

Injuries are considered the most common cause of onset of the disease. In 70% of patients with Peyronie's disease, damage to the penis occurred during sexual intercourse when the partner was on top.

A significant part of specialists in the field of urology are inclined to the autoimmune origin of the disease, believing that the cause of scar formation is an attack of one’s own immunity on the tissue of the tunica albuginea. This pathology is not systemic in nature, like lupus or arthritis.

Peyronie's disease– a rare disease characterized by the formation of fibrous plaques on the tunica albuginea of ​​the cavernous bodies of the penis.

Causes of Peyronie's disease

Although the exact causes of Peyronie's disease are unknown, some experts believe that scar tissue is caused by injury to the penis (such as being bent or bruised).

Types of Peyronie's disease

Curvature of the penis can be congenital or acquired. They are characterized by the absence of plaques in the tunica albuginea of ​​the cavernous bodies. However, in the cavernous bodies themselves there are strands of connective tissue (chordas), which cause curvature of the penis.

Main symptoms of Peyronie's disease

This is a benign disease of the tunica albuginea of ​​the cavernous bodies of the penis, which consists of the formation of plaques or compactions in the tunica albuginea of ​​the cavernous bodies of the penis. These plaques and lumps are most often felt on the back of the penis, less often on the sides and on the side of the urethra (urethra). It is also possible for fibrosis (overgrowth of scar tissue) to form in the corpora cavernosa, which occurs in approximately 30% of those suffering from Peyronie's disease. These changes can cause erectile dysfunction, severe pain during intercourse and significant curvature of the penis, which can even prevent sexual intercourse. It is with such complaints that patients most often turn to the doctor.

Treatment of Peyronie's disease

Treatment is usually not necessary as long as Peyronie's disease does not cause pain or interfere with sexual function. Peyronie's disease is often mild and sometimes resolves without treatment.

Most men with this disorder manage to remain sexually active. Consulting a sex therapist can help couples maintain an active sex life.

Surgery may be considered as a treatment option for men who experience severe pain, have a severely curved penis, or experience sexual dysfunction due to Peyronie's disease.

Peyronie's disease in the ICD classification:

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