Peyronie’s Disease Treatment in Long Island, NY
Peyronie’s disease is a deformity of the penis, typically a curvature, often associated with pain. It is due to a buildup of scar tissue that forms along the layer (the tunica albuginea) encasing the penis’s spongy erectile tissue. This scar tissue often forms a Peyronie’s “plaque”, and ultimately causes a tethering of the tunica albuginea such that penile curvature and/or indentation forms, as well as shortening of the penis and loss of penile girth.
Dr. Peters is a board-certified and fellowship-trained urologist who specializes in treating male patients with sexual dysfunction using medical and surgical therapies including urologic prosthetics, implants, and reconstructive surgery. Dr. Peters is considered a high volume Peyronie’s disease surgeon, as he performs several reconstructive penile surgeries and penile implant procedures each month.
Symptoms of Peyronie’s Disease
Because Peyronie’s disease will have effects that are both tangible and visible, the symptoms are commonly noticeable to the naked eye. In over 70% of cases, the scar tissue will develop on the top of the penis causing it to bend upwards during an erection. If the scar tissues develops on the bottom or side of the penis, it will bend downward or sideways during an erection. In rare cases, the scar tissue may develop all around the penis, causing the shaft to narrow and become very hard.
If you are experiencing any of the following, you may be experiencing Peyronie’s disease:
- Pain during sex, or pain during an erection.
- Hard spots or lumps in the penis.
- Bends or curves in the penis.
- Narrowing or shortening of the penis.
Any and all of these changes to the penis can be devastating to patients and their partners. It can cause discomfort, embarrassment and lead to the patient and partner wanting to avoid sex. In addition, the curvature can be so severe that the patient is unable to penetrate, or the partner is unable to tolerate penetration. In some cases the deformity is unstable, meaning the penis can bend further upon any force (ie penetration) when applied to the penis. This is dangerous as it can cause further injury and pain to the penis, causing worsening of the Peyronie’s disease and the development of a vicious cycle of injury and deformity.
It’s also worth noting that some patients develop associated Erectile Dysfunction (ED). Dr. Peters will often asses the degree of ED in order to help plan for the best course of treatment.
Causes of Peyronie’s Disease
No one knows for sure exactly why some men get Peyronie’s disease and other do not.
Dr. Peters, like other experts in the field of Sexual Medicine, believes that most cases of Peyronie’s disease are associated with trauma to the penis. However, it is important to distinguish between the different types of penile trauma.
There’s acute trauma, or “macro” trauma, which can cause a “penile fracture” in which the erect penis bends so forcefully that the tunica albuginea tears, causing a “pop” sound and immediate loss of erection, thereby releasing significant amounts of blood from the erectile chambers of the penis. This is often quite painful, and causes significant swelling and bruising, sometimes creating an “eggplant deformity”. Dr. Peters is an expert in surgically repairing this sort of penile trauma, and prompt surgical repair may prevent or reduce significant penile curvature and deformity as well as erectile dysfunction. Unfortunately, many men who experience this trauma are too embarrassed to present to an emergency room in a prompt manner, and Peyronie’s disease may develop as a result.
However, most cases of Peyronie’s disease are believed to be caused by “micro” trauma to the penis, meaning small repetitive injuries to the penis which go unrecognized by the patient and partner during sex. This often occurs in men with erectile dysfunction, which is why Peyronie’s disease is seen in mostly middle aged and elderly men. When a man attempts to penetrate with a penis that is not maximally rigid, the penis may slightly bend with each penetration. This will not typically cause pain or bruising. The theory behind this is that repetitive penetration with “micro” trauma can ultimately result in the development of a Peyronie’s plaque over time.
Diagnosis of Peyronie’s Disease
Every patient at Dr. Peters’ practice with Peyronie’s disease is offered an advanced diagnostic evaluation following a thorough physical exam. This advanced diagnostic evaluation includes an injection into the penis to induce an artificial erection (intra-cavernosal injection) followed by a penile ultrasound which includes not only assessing any penile plaques and scar tissue but also measuring the blood flow of the vessels of the penis.
This type of testing is critical to developing a Peyronie’s disease treatment plan, as certain features of Peyronie’s disease seen on penile ultrasound, or following intra-cavernosal injection, help direct the best course of treatment while also avoiding time-wasted on treatments that are likely to fail.
Dr. Peters’ approach is unique in that he takes the time to evaluate all possible factors before creating a course of action.
How is Peyronie’s Disease Treated By Dr. Peters?
The overall goal of treatment is to reduce pain and strengthen the ability to have intercourse. If you are not experiencing pain, and having very little issues with penile curvature, you may not need treatment until the symptoms progress. In a few cases, the disease will resolve itself without any treatment.
Because there is a risk of erectile dysfunction associated with Peyronie’s disease, you may get recommended a change in lifestyle. This can include decreasing the amount of vigorous sexual activity or aggressive sports and quitting any smoking, illegal drugs, or alcohol consumption.
With medications and therapies, Peyronie’s disease can be effectively managed over time, pending the severity. Your urologist may prescribe a series of medications that may help inflammation or development of scar tissue. These treatments can include:
- Steroid injections.
- Vitamin E.
- Collagenase Injections.
These treatments must be discussed with your doctor prior, as they will be highly dependent on other health factors.
If you are experiencing severe issues with penile curvature or pain, surgery may be recommended. The types of surgery will depend on the severity, but may include grafting or device implantation. Most commonly, the surgeries will include the following:
- Lengthening the area of the penis that curves.
- Placing a prosthetic device inside the penis.
- Shortening the opposite side of the penis from the scar tissue.
Peyronie’s Disease Treatment in Commack
If you are experiencing issues with Peyronie’s disease, contact Dr. Peters today to determine which treatment option is right for you. Dr. Peters will take the time to discuss all of your treatment options and answer any questions you may have. Call (631) 444-6270 to schedule an appointment at our office in Commack or East Setauket, NY today!