Peyronie’s Disease
19 April 2024
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Peyronie’s Disease
Peyronie’s disease is a connective tissue disorder that affects the tunica albuginea of the penis. Recent studies suggest that this pathology is due to an inflammatory process with abnormal cicatrization in the tunica albuginea caused by microtraumas during intercourse.
It presents as indurations or plaques, particularly painful with the erection, and also causes a retraction and curvature of the penis. Peyronie’s disease prevents or hinders sexual activity in its late stage, either by significant curvature or by erectile dysfunction.
The evolution of the disease has two phases: The first is the early or inflammatory phase manifests itself with pain and curvature of the penis during erection, It also presents a palpable nodule or induration. This stage of the disease will last approximately 12 to 24 months. In recent studies, it was shown that in 94% of the patients, there was a resolution of coital pain at 18 months. A small percentage of patients present a resolution without sequelae at the end of the inflammatory process.
In the next phase, if the inflammation does not resolve, the tissue involved becomes calcified. This phase is characterized by stability of the curvature, pain and in many cases the presence of sexual dysfunction.
Diagnosis
Currently, the interrogation and physical examination provide valuable information to be able to diagnose the disease. Every patient should be evaluated with a broad clinical history where it is essential to know how the symptoms started, the time of evolution, associated factors, and the family and psychosexual history detailed.
The physical examination is the most important tool, the penis in a state of flaccidity appears completely normal to inspection. in most cases. It is the palpation, which allows doctors to determine the size, position, consistency, and number of indurations. Approximately one-third of patients will develop scarring or calcified plaque that can be observed by ultrasound or simple radiography.