Curvature of the penis is an abnormal bend in the penis which occurs during erection. This may cause problems with penetration and pain associated with intercourse.
Causes, incidence, and risk factors
In Peyronie's disease (curvature of the penis), fibrous tissue develops on the tunica albuginea (the lining of the erectile bodies of the penis). The cause of fibrosis is not known. The condition occurs in about 388 of 100,000 men. The fibrous tissue causes a bend to develop during erection that is painful and can make intercourse difficult or impossible. The condition is relatively uncommon and affects men between 40 and 60 years and older. An association has been noted with Dupuytren's contracture , a cord-like thickening across the palm of one or both palms causing the 4th and 5th fingers to pull in toward the palm -- a fairly common disorder of white men over 50 years old. However, only 1 to 2% of individuals with Dupuytren's contracture develop curvature of the penis. Other risk factors have not been identified. Also, there is an association with HLA B27 antigen cross-reactivity. A person with HLA B27 antigen cross-reactivity has a particular type of immune cell marker. This indicates that the condition may be inherited genetically.
Signs and tests
Physical examination is sufficient to diagnose curvature of the penis. The hard plaques can be felt with or without erection. It may be necessary to use injectable medications to induce an erection for proper evaluation of the penile curvature. The patient may also provide pictures of the erect penis for evaluation by the physician. Ultrasound of the penis may demonstrate the lesions in the penis, but is not necessary.
Treatment
Symptoms may be decreased somewhat with radiation therapy or corticosteroid injections into the fibrous band of tissue. Topical verapamil, an oral medication used for high blood pressure, has recently been shown to improve the disease, and has been approved for use in treating Peyronie's. If medical therapy fails and intercourse is not possible secondary to the curvature of the penis, surgery may be utilized to correct the curvature. Surgery is reserved for severe cases where intercourse is not possible due to the high risk of the surgery causing impotence.
Expectations (prognosis)
The condition is typically progressive and leads to inability to have intercourse. The disease is also associated with development of impotence.
Complications
The condition may make intercourse difficult, painful, or impossible. Surgical correction may also lead to impotence.
Calling your health care provider
Call your health care provider if symptoms indicating curvature of the penis occur, particularly if erections are painful.