Peyronie's disease is characterized by the formation of hardened tissue (fibrosis) in the penis that causes pain, curvature, and distortion, usually during erection. The penis is the male organ for reproduction and urination. It is composed of two columns of erectile tissue (the corpora cavernosa); the corpus spongiosum, which contains the tube that carries urine and semen from the body (urethra); and the sheath that surrounds the erectile tissue (tunica albuginea). In Peyronie's disease, dense, fibrous scar tissue (plaque) forms in the tunica albuginea.

Because Peyronie's disease involves deformity of an erect penis and may impair sexual intercourse, doctors have historically classified the condition as a form of impotence, currently referred to as erectile dysfunction (ED).

Incidence and Prevalence

Causes and Risk Factors

The cause of Peyronie's disease is unknown. Doctors and researchers don't completely understand what causes Peyronie's disease. A number of theories exist, including:

INJURY TO THE PENIS. Trauma to the penis from being hit or bent abnormally while erect or during intercourse (extremely vigorous sexual activity), invasive penile procedures include urethral catheterization, cystoscopy, and transurethral prostatectomy. These injuries cause small tears in the tissue. It may also cause small blood vessels in the penis to rupture and bleed internally. Abnormal healing can result in the development of hard, thickened scar tissue (plaque) under the skin of the penis. With repetitive trauma, the plaque may develop tough fibrous tissue (fibrosis) or calcium deposits (calcification) and result in the deformity. AUTOIMMUNE DISORDER. Some studies suggest that Peyronie's disease may be an autoimmune disorder. A man's immune system may respond abnormally and cause plaque to form in the penis. However, Peyronie's disease isn't related to other autoimmune diseases, such as rheumatoid arthritis or lupus. COLLAGEN ABNORMALITY. Peyronie's disease may be caused by an abnormality in the substance that builds and remodels connective tissue (collagen). Cases of Peyronie's that develop over time may be caused by an inherited abnormality of human leukocyte antigen B7 (HLA-B7), suggesting a genetic link. Also, Peyronie's occurs more frequently in men with family members who have the condition or a connective tissue disorder (e.g., systemic lupus erythematosus). About 30% of patients with Peyronie's disease also develop hardened tissue in other parts of the body, such as the hand (e.g., Dupuytren's contracture) or the foot. MEDICATIONS. Some drugs list Peyronie's disease as a possible side effect. Most of these drugs belong to a class of blood pressure and heart medications called beta blockers. These drugs are also used to treat glaucoma, multiple sclerosis and seizures. Developing Peyronie's disease as a side effect of these drugs is rare. Check with your doctor before discontinuing any prescribed drug.

Microscopic examination of hardened tissue in cases of Peyronie's disease is consistent with cases of severe inflammation of blood vessels (vasculitis), suggesting the condition may have a vascular (i.e., pertaining to blood vessels) cause. Diabetes, which often leads to blood vessel disease, is also considered a risk factor.

The use of the antihypertension medication propranolol (Inderal®) has been found to cause the condition in rare cases. Peyronie's disease has also been associated with vitamin E deficiency.

Signs and Symptoms

Diagnosis

Treatment

Complications

Nutrition

BEFORE AND AFTER PICTURES