Disorders that affect the penis include Peyronie's disease, balanitis, phimosis, paraphimosis and penile cancer.
What is Peyronie's disease?
Peyronie's disease is a condition in which a plaque, or hard lump, forms on the penis. The plaque may develop on the upper (more common) or lower side of the penis, in the layers that contain erectile tissue. The plaque often begins as a localised area of irritation and swelling (inflammation), and can develop into a hardened scar. The scarring reduces the elasticity of the penis in the area affected.
Peyronie's disease can occur in a mild form that heals without treatment in 6 -18 months. In these cases, the problem does not progress past the inflammation phase. In severe cases, the disease can be permanent. The hardened plaque reduces flexibility, causing pain and forcing the penis to bend or arc when erect.
In addition to the bending of the penis, Peyronie's disease can cause general pain as well as painful erections. It also can cause emotional distress, and affect a man's sexual desire and ability to function during sex.
What causes Peyronie's disease?
The exact cause of Peyronie's disease is unknown. In people whose disease develops quickly, lasts a short time, and goes away without treatment, the likely cause is trauma (hitting or bending) that causes bleeding inside the penis. However, in some people, Peyronie's disease develops slowly and is severe enough to require surgical treatment. Other possible causes of Peyronie's disease include:
- Vasculitis. This is an inflammation of blood or lymphatic vessels. This inflammation can lead to the formation of scar tissue.
- Connective tissue disorders. About a third of men with Peyronie's disease also develop disorders that affect the connective tissue in other parts of their bodies, such as the hands and feet. These conditions generally cause a thickening or hardening of the connective tissue. Connective tissue is specialised tissue -- such as cartilage, bone, and skin -- that acts to support other body tissues.
- Heredity. Some studies suggest that a man who has a relative with Peyronie's disease has a greater risk of developing the disease himself.
How is Peyronie's disease treated?
There are two ways in which Peyronie's disease can be treated: surgery or non-surgical treatment.
Because the plaque of Peyronie's disease often shrinks or disappears without treatment, most doctors suggest waiting one to two years or longer before attempting to correct it with surgery. In many cases, surgery produces positive results. But because complications can occur, and because many of the problems associated with Peyronie's disease (for example, shortening of the penis) are not corrected by surgery, most doctors prefer only to perform surgery on men with curvatures so severe that sexual intercourse is impossible.
There are two surgical techniques used to treat Peyronie's disease. One method involves the removal of the plaque followed by placement of a patch of skin or artificial material (skin graft). With the second technique, the surgeon removes or pinches the tissue from the side of the penis opposite the plaque, which cancels out the bending effect. The first method can involve partial loss of erectile function, especially rigidity. The second method, known as the Nesbit procedure, causes a shortening of the erect penis.