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.

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
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