Penile Curvature (Peyronie's Disease)
​
​
What is congenital penile curvature (Peyronie's Disease)?
​
Peyronie’s disease, also known as induration penis plastic or chronic inflammation of the tunica, is a tissue disorder involving the growth of fibrous plaques in the soft tissue of the penis affecting 5% of men. In our practice at least 25% of surgical candidates have Peyronie’s plaques prior to surgery. Specifically, scar tissue forms in the tunica, the thick sheath of tissue surrounding the corpora cavernosa (or erectile bodies) causing pain, erectile dysfunction, abnormal curvature, loss of girth, indentation, and shortening of the penis. A variety of treatments have been used, but none have been especially effective.
​
Peyronie’s may cause pain, hardened, big, cord-like lesions or scar tissue known as “plaques”, and abnormal penile curvature when erect due to chronic inflammation of the tunica albuginea. It is a common misconception that Peyronie’s Disease always involves curvature of the penis, however, the scar tissue sometimes causes divots or indentations rather than curvature. The condition may also make sexual intercourse painful and difficult. Progression of the disease will result in complete atrophy eventually.
​
​
​
​
​
How is Peyronie’s disease treated?
​
Among the treatment options in Peyronie’s disease cases; There are two main approaches: drug therapy and surgical treatment. The most important point in the treatment is the stage of the disease at the time of diagnosis.
​
-
Drug treatments: It is typically preferred in the first stage of the disease and in patients who are not suitable for surgical treatment or do not want surgery. The aim of drug treatment is to reduce pain and plaque formation and to minimize penile curvature.
Drug treatments are divided into three main groups;o Oral treatments
- Potassium para-aminobenzoate (potaba)
- Tamoxifen
- Colchicine
- Vitamin E
- L-carnitine
- Pentoxifylline
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Phosphodiesterase type 5 inhibitors (PDE5Is) o Intraplaque injection treatments
- Verapamil
- Nicardipine
- Clostridium collagenase
- Interferon α2B
- Hyaluronic acid
-Botulinum toxino Topical and other treatments
- H-100 gel
- Extracorporeal shockwave treatment
- Traction devices
-
Surgical treatment: Surgical treatments are preferred for patients who have penile curvature that prevents sexual intercourse, who are in the second stage of the disease (chronic phase), who have not progressed in the last six months, whose pain complaint has disappeared, or who have plaque calcification. The appropriate surgical method is determined by the urologist, taking into account the length of the penis, the degree of curvature, the localization of the plaque, the presence of erectile dysfunction, and the patient’s expectation. Although there are differences in practice, there are basically two types of surgical methods.
​
Things To Know Before The Penile Curvature Treatment Surgery
​
In order for the surgical procedure to be performed as planned;
If you are using drugs for diseases such as diabetes, hypertension, heart disease, or COPD; Consult your doctor about medication intake and doses. Since blood thinners usually need to be completely discontinued before surgery; If you are using this group of drugs, you should definitely inform your doctor.
It is very important to inform your doctor if you have complaints such as fever, rash, and cold shortly before the day of surgery because in the presence of such complaints, the surgical procedure will usually be postponed.
​
Things To Know During The Penile Curvature Treatment Surgery Day
​
There are some points to be considered starting from home on the day of the surgical procedure;
You should not eat or drink anything for at least six hours before the surgery
It is recommended to take a bath the night before or the morning of the surgery, but cleaning of the hair in the surgical area should not be done at home.
It is recommended that you take your ID, insurance card and all the medicines you have used with you, bring a minimum amount of money or personal aid devices such as credit cards, glasses, and canes with you in a bag, but leave your jewelry and valuables at home.
After entering the hospital, there are some procedural procedures that you have to perform until you go to the operating room;
You should go to the hospital inpatient unit for hospitalization procedures where your personal information such as identity, address and the phone will be questioned.
After the hospitalization procedures are completed, you will be directed to the relevant service accompanied by the personnel.
After you settle into your room in the service, your blood pressure, pulse, and body temperature will be measured, and then you will be asked to cut your hair in the surgical area.
You will be informed about the types of anesthesia that can be applied during the surgical procedure, and then your approval will be obtained for the type of anesthesia that you, your doctor who will perform the surgery, and your doctor who will administer the anesthesia consider appropriate.
You will be asked to put on a one-piece operating room gown that can be easily put on and taken off after you remove all your clothes, removable prostheses, and jewelry just before your surgical procedure.
When it is time for your surgical procedure, you will be taken to the operating room accompanied by a nurse and auxiliary staff.
Vascular access will be established in order to administer necessary drug and serum treatments before, during, and after surgery.
The type of anesthesia you approve will be applied in the service under the supervision of an “anesthesiology and Reanimation” specialist so that you do not feel pain during the surgical procedure.
You will perform your surgery under safe and sterile conditions, in an operating room that complies with scientific standards, with a team consisting of your doctor, operating room nurse, anesthesiologist, and anesthesia technician.
If your body structure, additional diseases, and some special conditions of your disease are in question, a catheter can be applied to be taken the next day for urine monitoring.
The duration of surgery for penile curvature can vary between 30 minutes and two hours, depending on the surgical technique chosen.
You will be followed up in the post-operative follow-up unit under the supervision of expert teams until the effect of the anesthesia procedure applied after the surgery is completely gone.
Sounds that you are accustomed to hearing during waking up may be perceived as louder, forgetfulness, blurred vision, a feeling of dryness in the throat after general anesthesia, and pain in the operation area may be common.
You are allowed to take food by mouth 4-6 hours after the operation.
The hospital stay after penile curvature (Peyronie's Disease) surgery is usually one or two days. During your stay in the hospital, your vascular access will remain open to ensure your necessary antibiotic treatment and pain control.
​
Things To Know After The Penile Curvature Treatment Surgery
​
As with most surgical procedures, there are some important points to be considered after penile curvature surgery;
After the surgical procedure, the surgical area is usually covered with appropriate sterile bandages and bandages. In the early period, there may be slight swelling or redness in the incision area.
Before touching the incision area, you should wash your hands with soapy water and make sure that the incision area is always clean and dry. Your doctor will tell you when you can take a bath after the surgery.
In the presence of severe swelling, pain, bleeding or discharge at the incision site, you should consult your doctor.
After penile curvature (Peyronie's disease) surgery, patients are usually called for wound healing after 7-10 days and can have sexual intercourse after six weeks. However, in some special cases, this period may be extended by your doctor.
Schedule an Appointment for Peyronie’s Disease Treatment in Istanbul, TR
If you are experiencing issues with Peyronie’s disease, pain or curvature of your penis which prevents you from having sex or is causing anxiety, board-certified urologist, Dr. Kadioglu is here to help. He will take the time to provide you with a comprehensive diagnosis to determine the best treatment option for you. Call our urologic clinic in Istanbul, TR at (+90) 541 385 16 16 today to determine which treatment option is right for you.
