Does Peyronie’s Disease ever Resolve Itself?
To understand the progression of Peyronie’s disease, it is important to know exactly what it is. Peyronie’s disease is the buildup of scar tissue around the lining of the corpora cavernosa causing the abnormal curvature of the penis – most commonly, upwards. There are various causes of Peyronie’s, but regardless, the change is distressing for most and is a common cause of a visit to a specialized urologist.
Of course, any change in the shape or function of the penis can be worrisome. But is Peyronie’s disease always problematic and is intervention always necessary? The short answer is no, Peyronie’s does not often lead to longer-term problems. We estimate that approximately 20% of patients see improvement in their Peyronie’s (called remodeling), 40% see no significant change and about 40% see a worsening.
For most, Peyronie’s is more of a psychological problem than a physical one. Most cases do not impede proper sexual function other than to stifle a man who may be concerned about the appearance or function of their penis. This can, of course, cause psychosomatic erectile dysfunction or other sexual performance problems.
What Happens Next?
Dr. Engel is one of the foremost authorities on surgical intervention for Peyronie’s. When patients come to see him, two of the most important questions patients must answer are: a) how much pain and discomfort are they experiencing? And b) how does the condition affect their sexual function? If the answer to both is none to minimally, the treatment is usually psychological in nature, reassuring the patient that they have little to be concerned about. Even if some discomfort exists, this usually resolves in time.
If the curvature is truly bothersome or patients are experiencing exceptional discomfort, injection therapy is a good first line of treatment. Injections to soften the tissue combined with traction exercises to loosen the plaque are very successful, with few side effects. However, they are not always the answer. About 50% of patients will see a reduction in curvature and 80% will notice a reduction in pain.
Once the penis reaches a curvature of 50 to 90%, patients often consider surgical intervention. A plication procedure can be used to counteract the curvature, using sutures on the opposite side of penis. However, this does come with the downside of shortening the penis. The most severe cases of Peyronie’s can be corrected with a complex reconstruction for which Dr. Engel is well known.
Of course, the first step to understanding Peyronie’s and its treatment requires a consultation with an experienced and knowledgeable urologist like Dr. Engel. Contact us to schedule a consultation and learn more about your treatment options.