Peyronie's Disease

Peyronie's disease is a severe curvature of the erect penis. It's named after an Italian physician to King Louis XIV of France. This physician was the first to note the disorder back in the 1700s. While it is somewhat common, it is not often mentioned.

A minor bend in the erect penis is perfectly normal, as few penises are straight as an arrow. In some cases of Peyronie's, however, the penis can bend severely left, right, up or down, or even back on itself, making intercourse impossible.

Treatments and drugs

Some treatments — nonsurgical and surgical — can increase a man's risk of ED.

Oral medications

If Peyronie's disease doesn't improve on its own, your doctor may suggest trying an oral medication. This treatment appears to be effective only for the first 12 to 18 months when plaque is still forming. Oral treatments for Peyronie's include:

Colchicine. This medication inhibits growth of collagen and may improve symptoms of Peyronie's disease. However, common side effects include digestive problems and diarrhea.

Potassium aminobenzoate (Potaba). Taken orally, this prescription medication may help treat Peyronie's disease. However, like vitamin E, more research is needed to determine the medication's effectiveness. The medication is expensive, requiring taking up to 24 tablets daily, and side effects include digestive problems.

Vitamin E. Researchers have reported that vitamin E may improve Peyronie's disease when taken orally, although more controlled studies are needed to verify the effectiveness of vitamin E therapy. Talk to your doctor before taking vitamin E, as it may not be safe in high doses.

Intralesional injections
Your doctor can inject drugs such as collagenase, calcium channel blockers (such as verapamil) or interferons directly into the plaque in your penis. These drugs are intended to break down scar tissue deposits and return the tissue-building process to normal. You'll receive multiple injections over a period of months. The success of intralesional injections varies, and more studies are needed to find out which treatments are most effective.

Surgery
If other methods of treatment don't help and your penis is still curved or bent when erect, surgery may be an option. Doctors usually suggest surgery when unacceptable appearance, pain during intercourse and poor erection quality persist for at least a year. Surgery is generally effective at restoring normal erections, although each surgical method can cause unwelcome side effects such as partial loss of erection or shortening of an erect penis.

Common surgical methods include:

Nesbit plication. Tissue on the unaffected side of the penis is shortened, canceling the bending effect. This type of surgery can shorten the penis. It is generally used in men who have adequate penis length and a curve of less than 45 degrees.
Plaque incision with saphenous vein graft. Several linear cuts are made in the plaque, which allows straightening. The cut plaque is then covered with a grafted vein. This procedure is generally used in men who have a shorter penis, a curve of more than 45 degrees or an hourglass-shaped deformity.
Penile prosthesis. An implanted device is used to straighten and increase the rigidity of the penis. This type of surgery is for men who have trouble maintaining an erection (erectile dysfunction).