Related articles: Peyronie's disease
Definition
Peyronie's disease, also called induratio penis plastica (IPP), consists of the hardening (fibrosis) of the albuginea tunic of the penis. This tissue covers the corpora cavernosa and normally has the task of retaining blood during an erection.
The fibrotic process leads to the retraction of the albuginea, giving rise to an inflection of the penis in erection, sometimes accompanied by pain.
Peyronie's disease occurs more commonly in adult men, for reasons not yet clear. Traumatic events affecting the erect penis (eg repeated bending and bumps) or microlesions repeated over time seem to favor its onset, as they can induce an inflammatory reaction. Furthermore, Peyronie's disease is often concomitant with connective tissue disorders, diabetes, gout, hypertension and atherosclerosis.
Most common symptoms and signs *
- Decline in sexual desire
- Depression
- Erectile dysfunction
- Pain in the penis
- Pain during sexual intercourse
- Painful ejaculation
- infertility
- Nodule
- Curved penis
- Penis size reduction
Further indications
Peyronie's disease begins as an inflammation that leads to the formation of an area of fibrosis on the surface of the penis, which looks like a hardened plaque (or a nodule) and can be easily felt on palpation. The presence of this thickening limits the elasticity of the albuginea and does not allow the male sexual organ to relax normally during an erection. Peyronie's disease can induce a variation in the size of the penis, as well as causing its deviation towards the side affected by the fibrotic process during erection and, less frequently, also in a state of flaccidity.
Peyronie's disease also causes painful erections and, if the curvature of the penis is very pronounced, can prevent penetration. In severe cases, the male genital organ becomes tumescent only up to the point affected by the disease and remains flaccid in the remaining part.
Peyronie's disease is recognized by the doctor simply by palpation. Sometimes, a dynamic echocolordoppler is performed to check the exact characteristics of the fibrotic plaque (position, size and shape) and to assess the blood flows in the penile arteries. This information is useful for treatment planning.
The milder form of Peyronie's disease may undergo spontaneous regression and does not require therapeutic intervention. In other cases, on the other hand, a scar plaque can remain unassailable by medical therapy.
The result of the treatment is not predictable. Surgical removal of fibrosis and its replacement with a graft may have a favorable outcome or cause further scarring and aggravation of the defect. Local injections of corticosteroids and verapamil (calcium-antagonist drug) and therapies using physical means (eg ultrasound and laser therapy) may also be more or less effective. In cases where the erectile function is compromised, the implantation of a penile prosthesis can be considered.
