Source: Hatzimouratidis K et al: Eur Urol 2012; 62:543-52

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Congenital curvature Peyronies disease and penile fracture


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The institute study urological diseases in collaboration with the Center for Sexual and Reproductive Health created a infographic on "Congenital curvature Peyronies's Disease and penile fracture" Learn for types of penile curvatures, the congenital penile curvature and the Peyronies's Disease. By reading it you will learn the implications, diagnosis and treatment of these two diseases that afflict men by reducing the pleasure of sexual life.

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Congenital curvature Peyronies disease and penile fracture

  1. 1. CONGENITAL CURVATURE PEYRONIE’S DISEASE & PENILE FRACTURE Source: Hatzimouratidis K et al: Eur Urol 2012; 62:543-52 Levine L and Burnett A: J Sex Med 2013; 10:230-44 TYPES OF PENILE CURVATURES ACQUIRED CURVATURE (Peyronie’s disease) SCAR CONGENITAL CURVATURE (born with curvature) Curvatures -of different severity, deviation angle and direction- appear only during erection rendering sexual intercourse difficult or impossible Curvatures are anatomical -structural alterations in the tunica albuginea, which is the part of penis covering the 2 corpora cavernosa CONGENITAL PENILE CURVATURE It is a rare condition that does not affect quality of erection CONSEQUENCES There are major psychological consequences, as it concerns young men who avoid having a sexual life exactly because of their aesthetic problem DIAGNOSIS History and self-photography of erect penis TREATMENT Exclusively surgical treatment (plastic repair) PEYRONIE’S DISEASE – PENILE FRACTURE ETIOLOGY CAUSE MECHANISM The penis bends, resulting in either partial (Peyronie’s disease) or total rupture (fracture) of tunica albuginea Injury during sexual intercourse ONLY 20-30% of patients remember it Α. Failure of penis to insert the vagina Β. Abrupt and violent movements during sexual intercourse or masturbation CHARACTERISTIC FEATURES It usually occurs after the 5th decade What ca n be obs erved in the pe nis Rare spontaneous cure In 3-9% 3-13% of men Pain during erection is the first symptom in (only wh e n erect) (10-180 ο) Curvatur e Erectile disorder in Rotation 50% (usually 13cm) 35-40% Reductio n of length Deformit y e.g. hourg like inden lasstation) Progression of the disease with increase of penile curvature or rotation in 30-50% of patients (within 12 months) Characteristic in the final stage is the palpable hard plaque formation inside the penis RISK FACTORS PSYCHOLOGICAL EFFECTS Agitation- anxiety about potential progression (fear for cancer) Dupuytren’s disease (collagen disease) Diabetes Mellitus Emotional problems (his and his partner’s) Hypertension Dyslipidaemia DysthymiaDepression (1 out of 2 men) Smoking Low testosterone Medical history Sexual history Patient selfphotography of erect penis Physical examination Penile U/S (ultrasound) Penile Triplex with drug-induced erection TREATMENT Pharmacotherapy IS INEFFECTIVE Penile Traction Devices and Vacuum Erection Device MAY HELP PARTIALLY REDUCE CURVATURE Surgery PROVIDES THE SOLUTION, in case impairment is stabilized for >3 MONTHS THERE ARE 3 SURGICAL OPTIONS: 1. 1.Excision or plication of tunica albuginea - procedures that do not usually affect penile function 2. 1.Placement of grafts within tunica albuginea - this procedure though often leads to relapse and may impair erectile function 3. 1.Placement of penile prosthesis, if patient has erectile dysfunction that does not respond to pharmacotherapy TUNICA ALBUGINEA PENILE FRACTURE Full rupture of tunica albuginea, which is rarely accompanied by urethral injury CAUSED BY CHARACTERISED BY CHARACTERISED BY Injury of the erect penis during sexual intercourse (usually with partner on top) or during masturbation (rare cases) a cracking sound and sudden sharp pain a cracking sound and sudden sharp pain EMERGENCY Conservative treatment is usually accompanied in 6 to 8 hours Within the first it must be treated surgically Immediate surgical treatment protects erectile function Visit 50-80% by erectile dysfunction with or without penile curvature and get informed on SEXUAL PROBLEMS and their solutions