Peyronies disease


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all that u need to know about the peyronies disease

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Peyronies disease

  1. 1. DEPARTMENT OF UROLOGY EDUCATION PEYRONIE’S DISEASE Production Team Dr Abraham Benjamin - Manager Medical Informatics Mr. Naresh Kumar - Coordinator Medical Informatics
  2. 2. What is Peyronie’s Disease ?  Peyronie's disease (also known as indurations plastica penis) is an acquired inflammatory condition of the penis.  The principal manifestation of Peyronie's disease is the formation of a plaque (a segment of flat scar tissue) within the tunica albuginea of the penis.  This plaque can usually be felt through the penile skin. This plaque is not a tumor but it may lead to serious problems such as curved and/or painful erections.
  3. 3. Anatomy of the Male Reproductive System
  4. 4. How does the Penis become erect under normal conditions ?  The penis is a cylindrical organ consisting of three separate chambers. On the upper (dorsal) portion of the penis there are two corpora cavernosae at are surrounded by a tough but elastic layer of connective tissue called the tunica albuginea. The third chamber is called the corpus spongiosum; it is located below the corpora cavernosa and is surrounded by a thin connective tissue sheath. It contains the urethra, the narrow tube that carries urine and semen out of the body.  These three chambers are made up of highly specialized, sponge-like erectile tissue filled with thousands of venous cavities, spaces that contain very little blood when the penis is soft. During erection, blood fills these cavities, causing the corpora cavernosa to balloon and push against the tunica albuginea. While the penis hardens and stretches, the skin and connective tissue of the penis remain loose and elastic to accommodate the changes.
  5. 5. What are the symptoms of Peyronie’s Disease?  The plaques of Peyronie's disease most commonly develop on the upper side of the penis. Plaques reduce the elasticity of the tunica albuginea and may cause the penis to bend upwards during the process of erection.  Although Peyronie's plaques are most commonly located on the top of the penis, they may also occur on the bottom (ventral) or side (lateral) of the penis, causing a downward or sideways bend, respectively. Some men have more than one plaque, which may cause complex curvatures.  In some men an extensive plaque that goes all the way around the penis may develop. These plaques typically do not cause curvature but may cause a "wasting" or "bottleneck" deformity of the penile shaft.  In other severe cases, the plaque may accumulate calcium and become very hard, almost like a bone. In addition to penile curvature, many patients also report shrinkage or shortening of their penis.
  6. 6. What causes Peyronie’s Disease ?  Most experts believe that Peyronie's disease is likely the consequence of a minor penile trauma. The most common source of this type of penile trauma is thought to be vigorous sexual activity (e.g., bending of the penis during penetration, pressure from a partner's pubic bone, etc.) although injuries from sports or accidents may also play a role.  Certain health conditions such as diabetes, tobacco use, or a history of pelvic trauma may also lead to abnormal wound healing and may contribute to the development of Peyronie's disease.
  7. 7. How is Peyronie’s Disease diagnosed?  A physical examination by an experienced Urologist is usually sufficient to diagnose Peyronie's disease. The hard plaques can usually be felt with or without erection.  It may be necessary to induce an erection in the clinic for proper evaluation of the penile curvature; this is usually done by direct injection of a medication that causes penile erection.  In some cases an ultrasound or x-ray examination of the penis is used to characterize the plaque and check for the presence of calcification.
  8. 8. How is Peyronie’s Disease treated?  Men with small plaques, minimal penile curvature, no pain, and satisfactory sexual function do not require treatment. Men with active phase disease who do have one or more of the above problems may benefit from medical therapy.  Oral Medications Oral vitamin E: An antioxidant that is a popular treatment for acute stage Peyronie's disease because of its mild side effects and low cost.  Potassium amino-benzoate: Also known as Potaba. it is somewhat expensive and use of the medication requires taking 24 pills a day for three to six months. This medication has also been associated with a high rate of stomach upset, which leads many men to stop taking it.  Penile Injections Injecting a drug directly into the plaque of Peyronie's disease is an attractive alternative to oral medications. Injection permits direct introduction of drugs into the plaque, permitting higher doses and more local effects. To improve patient comfort a local anesthetic is usually given prior to the injection.
  9. 9. How is Peyronie’s Disease treated?  Because plaque injection is a minimally invasive approach, it is a popular option amongst men with active phase disease and men who are reluctant to have surgery.  Verapamil Injections: Verapamil is a calcium channel blocker usually used in the treatment of high blood pressure. It has also been shown to disrupt collagen production and this property has made it of interest in the treatment of Peyronie's disease. Several uncontrolled studies have suggested that verapamil injection is an effective treatment for penile pain and curvature.  Surgical Treatment of Peyronie's Disease: Surgery is reserved for men with severe, disabling penile deformities that prevent satisfactory sexual intercourse.
  10. 10. How is Peyronie’s Disease treated?   There are three general approaches to surgical correction of Peyronie's disease. Procedures that shorten the side of the penis opposite the plaque/curvature  These procedures are generally safe, technically easy, and carry a low risk of complications such as bleeding or worsening erectile function. One particular disadvantage of these approaches is that they tend to be associated with some loss of penile length. For this reason shortening procedures are generally preferred in men with mild or no ED, mild to moderate curvatures, and long penises. Examples of this type of procedure include the Nesbit procedure, in which small pieces of tunica tissue are excised from the convex (the side opposite the direction of the curvature) side of the penis. The edges of the tunica are then sewed together, causing penile straightening.    Procedures that lengthen the side of the penis that is curved These procedures are indicated when the curvature severe or there is significant indentation causing a hinge-effect or buckling of the penis due to the narrowed segment in the penile shaft. In these cases, the surgeon incises (cuts) the plaque to release tension. In some cases a segment of the plaque may be removed. After the plaque has been incised, the resulting hole in the tunica must be filled with a graft. These procedures can correct severe curvatures, in most cases without significant shortening of the penis.
  11. 11. Important things to know about Peyronie’s Disease? Peyronie's disease is a poorly understood urological condition characterized by penile deformity and pain. Treatment for this condition needs to be individualized to each patient based on the timing and severity of the disease.
  12. 12. Important Information  If you need more information on this test or meet our team of Urologists for Consultation click on the link below. 
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  14. 14. More topics  Circumcision  Blood In Urine  Benign Prostatic Hypertrophy  Vasectomy  Kidney and Urinary stone Medical Treatment  Andrology-Male Infertility  Urodynamics / Uroflowmetry.  CT/MRI Please click the icon to navigate