The main structures in the penis that contribute to erections are the paired corpora cavernosa. These structures that course along the penis deep to the skin are composed of a casing or covering called the tunica albuginea, and contain spongy vascular tissue. Important arteries and nerves that provide blood supply and sensation to the head of the penis travel along the top of the penis between the tunica albuginea and the skin.
Normal tunica albuginea is elastic and can stretch. During erection, blood fills the corpora cavernosa, and these structures enlarge and become rigid. In some ways, the penis is similar to a water balloon. Imagine a balloon that is almost empty. The balloon will be very flexible. If the balloon were to be filled with water, as the rubber expands, the elastic balloon will become longer, wider, and more rigid. In the penis, there is elastic tunica albuginea instead of rubber and the penis fills with blood instead of water. There are also many tiny veins within the penis that occlude, or pinch off during an erection, allowing the blood to stay within the penis.
MEDICAL TREATMENT:The FDA has approved the first drug for treating Peyronie’sdisease,Xiaflex. It is believed to work by breaking down the scar tissue that causes the curvature.
Some studies have shown that vitamin E improves Peyronie’s disease. Similar studies have been done on para-aminobenzoate, a substance related to B-complex vitamins, but the results have been inconclusive. Both of these substances theoretically decrease or inhibit the scar tissue (plaque) formation.
Other approaches to treating Peyronie’s disease that have yet to be confirmed as effective include the injection of chemical agents directly into the plaque or radiation therapy. However, because radiation therapy can only relieve pain associated with Peyronie’s disease and pain frequently disappears without treatment, it is seldom performed.
Since the severity of the condition varies from person to person, talk to your doctor about what treatment strategy is right for you.
In the majority of men with penile pain due to Peyronie’s disease, the discomfort usually will resolve on its own as the penile injury heals and matures over time. This process may take as long as six to 18 months. In certain instances, the calcium channel blockers Calan or Isoptin may be effective in decreasing the pain related to Peyronie’s disease when injected directly into the penile scar or plaque.
Most experts recommend against surgery during the early inflammatory phase of Peyronie’s disease. Your doctor might suggest surgery if the deformity of your penis is severe, especially bothersome, or prevents you from having sex. Surgery usually isn’t recommended until the curvature of your penis stops increasing.
Surgical methods include:
The type of surgery will depend on your condition. Your doctor will consider the location of scar tissue, the severity of your symptoms and other factors.
Oral and injectable medicines are effective only in the early or initial phase of the disease.
For stable/ permanent curvature of penis surgical procedure has success rate more than 95%.
In patients with erectile dysfunction and peyronie’s disease penile implant with surgical correction leads to good quality and painless erection in more than 80-85 % of patients.