Penile curvature: more common than expected

Aug 7, 2018 0 Comments in Male health by

If we say that Peyronie’s disease is the third reason for consultation in our Centres, it is likely that most readers won’t know what we are talking about. This disease is more frequently known as “penile curvature”, and takes its name from its discoverer, Dr François De La Peyronie, who first described this pathology in 1743.

Can the penis bend overnight?

Penile curvature only becomes visible when there is an erection, therefore it cannot be seen when the penis is flaccid. The bending or curvature of the penis does not happen from one day to the next. However, patients usually notice the curvature can develop over the space of several weeks or a few months. It can also appear after an injury during sexual intercourse, known as “coital trauma”; in this case, the swelling is obvious almost immediately and there is an acute pain in the area.

Does it bend because of a tumour? Is it related to cancer?

It is not a tumour and it is not related to cancer in any way. This disease consists of a hardening of certain areas in the penis due to the formation of fibrotic tissue that causes a deformity or curvature and shortening of the penis. The plaques or nodules may or may not be calcified (hence the hardening) within the tunica albuginea of the corpora cavernosa of the penis, and this is what causes a curvature of the penis during erection.

I have always had a slight curvature, should I go to the doctor?

Some men are born with a noticeable curvature (pointing downwards), which can be corrected for aesthetic reasons or because it causes discomfort during sexual intercourse. To rule out whether it is a congenital curvature, we outline symptoms of Peyronie’s disease:

  • the patient suddenly notices that there is a deformity or curvature in his penis that has apparently appeared abruptly
  • he also feels pain during sexual intercourse
  • he suffers from erectile dysfunction

Having a slight curvature in the penis is normal, what is not normal is a curvature that appears all of a sudden, within a few weeks or months, and that causes pain during erection.

I’m afraid to go to the doctor… It may hurt…

The specialist will diagnose the penile curvature by means of a physical examination. Hard plaques can be felt through the skin, with or without an erection, during anatomical palpation. An ultrasound test will help to assess the location and severity of the plaques. The patient should also provide some pictures of the penis in erection, from various angles, so the doctor may assess the degree and angle of curvature. As you can see, none of these tests are painful!

Waiting passively could make the curvature disappear…

The curvature will not disappear by itself. On the contrary: the deformity could worsen as is often the case.

Curvature will improve with Iontophoresis

Firstly, let’s clarify what iontophoresis is all about. . Iontophoresis is a painless treatment that consists of applying low-intensity and low-voltage currents directly on the plaque with a substance known as verapamil, which ionizes. The aim is to slow down the inflammation process, and halt the curvature process. However, this is not for everyone. Several studies show that this treatment is only effective for curvatures of less than 18 months, because as time goes by, the curvature stabilises and the plaques tend to calcify.

Will massages with argan oil improve the curvature?

Argan oil contains vitamin E. Tocopherol is one of the most frequently used drugs to treat Peyronie’s disease. Since it is a fat-soluble vitamin, there is the hypothesis that tocopherol can be used as an antioxidant that reduces oxygen free radicals, which work in the inflammatory process. There are no proven clinical benefits in studies with humans.

Surgery to correct the curvature may shorten the penis

The surgical technique to correct Peyronie’s disease should not shorten the penis, provided that it is performed by an expert. Penile length is usually reduced during the natural course of the disease due to the deformities. Surgery may require the application of grafts or biocompatible patches in order to replace the fibrotic tissue, and provide a uniform contour and aesthetic final result. If the penis has suffered severe shortening due to the disease, the correction surgery may be combined with a lengthening of the penis so the patient may recover some length.

Penis extensors improve the curvature

In some specific cases, the use of extensors is recommended because it may improve the curvature in the first stages of the disease –provided that there is a proper use. In our opinion, medical supervision of the extensor use is essential.

This condition is rare, it only happens to me…

Peyronie disease usually affects men between 40 and 70 years old. However, it may affect young 18-year-old men as well. Some data suggests that complex curvatures with multiple plaques are more likely to appear among men younger than 40 years old. A German transversal study with 8,000 patients aged between 20 and 80 years old showed a prevalence of 3.2%, whilst another study carried out in the US showed a prevalence of 8.9% in 534 North-American men who attended their doctor for a prostate revision.