FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

SURGERY MAY MAKE A NORMAL SEX LIFE POSSIBLE AGAIN FOR READER

Question: My doctor tells me I have Peyronie's disease. How did I get this disease and is there a chance of my penis going back to normal?

Answer: Because researchers have not yet discovered the cause of Peyronie's disease, I can't tell you why you are one of the unlucky men who have this condition. So far, advancing age is the only risk factor that has been identified. While this malady is more common in those over 50, males of any age can develop it.

Peyronie's disease is characterized by the formation in the penis of a fibrous scar-like area - called a "plaque" by physicians. Usually only one side of the penis is affected, but plaques can form on both sides. This type of plaque can be felt as a firm and non-compressible area inside the penis.

I need to review the way the penis is constructed in order to help you understand the problems caused by Peyronie's disease. The penis can be thought of as being made from three different structures that are wrapped together with connective tissue and skin. Looking at the penis in cross section shows a left and a right sponge-like tissue called the left and right corpus cavernosum and the third structure, located in the bottom center of the penis, called the corpus urethrae. These three parts are wrapped with several layers of connective tissue, which is then enveloped by skin.

The corpora cavernosa are important for the normal functioning of the penis. Their sponge-like tissue becomes filled and swollen with blood during an erection. This is what causes the penis to elongate and become firm. The plaque of Peyronie's disease forms within one or both of the corpora cavernosa. The plaque, being tough and fibrous, doesn't expand with erection. This causes the involved side to expand less than the opposite normal side, thereby resulting in a dramatic curving of the penis during erection. This curving, in addition to making intercourse impossible, is often quite painful.

Although we don't know the cause of Peyronie's disease, there is effective treatment for it. Unfortunately, no medications provide relief from the condition. Today, surgery offers the best chance for the relief of pain and the return of a normal sex life.

There are several different surgical treatments that have been shown to be effective. Some use "high-tech" tools like lasers and artificial implants, while others just utilize the skillful application of more traditional surgical methods. Unfortunately, no one surgical procedure is always successful, but most modern techniques provide relief for 80 percent or more of patients. Talk with your urologist. He or she can advise you best.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.