peyronie’s disease

peyronie's disease

What is Peyronie’s disease?

It is the first disease reported by Francois Gigot la Peyronie in France in 1743. The correct pronunciation is Peyronie’s disease, not Peyronie’s disease or Pylonie’s disease. It is also called penile sclerosis or plastic penile sclerosis.
Peyronie’s disease is a benign disease that causes lumps in the corpus cavernosum tunica albugi.

How often does Peyronie’s disease occur?

In 2000, a general survey of 8,000 German men (average age 57 years old) found that the frequency of occurrence (about palpation of lumps) was 3.2%, and by age group, 1.5% in their 30s, 3.0% in their 40s, and 3.0 in their 50s. %, 4.0% in their 60s, 6.5% over 70 years old, which is a common illness among middle-aged and elderly people. Symptoms include penile curvature 84%, erection pain 46%, erectile dysfunction 40.8%, and others 1.03%.

A general survey of 647 Italian men in 2001 showed a frequency of 7.1%, a frequency of 3.7% in 954 men with Brazilian prostate examinations in 2001, 8.9% in 534 American men with prostate examinations in 2004, and Indians in 2006. In a general survey of 2130 males, 2% was reported, with an incidence of 2 to 8.9%.

Does Peyronie’s Disease Get Cancer?

Peyronie’s disease does not cause cancer, but lumps and pain can be cancer. It is difficult to distinguish, and a part of the lump may be removed and a histological examination may be performed to make an accurate diagnosis. It is advisable to see a specialist.

Are there any complications of Peyronie’s disease?

Penile curvature, pain during erection, and erectile dysfunction can cause sexual intercourse disorders. It may also be accompanied by limb contracture (Dupuytren’s contracture: shortening of the palms and soles, thickening, and fibrosis of the fingers).

How to diagnose Peyronie’s disease?

Ask about the history of trauma, the time of onset, the presence of lumps and pain, the presence of penile paresthesia, and the degree of erection hardness. In addition, you will be asked to express the direction and degree of penile curvature at the time of erection with pictures and fingers. It’s even better if you have a Polaroid photo of your erection at home or a photo of your cell phone or digital camera.

The doctor will check the lump and measure the size of the lump. Ultrasonography and MRI can be used to observe the thickness and size of the lump, often confirming calcification. In addition, if there is abnormal penile paresthesia, vibration sensation measurement is performed.

How to treat Peyronie’s disease?

The first treatment is conservative treatment (a method other than surgery), and drug treatment is given until the symptoms stabilize and for 6 months after the symptoms stabilize. Drugs used include vitamin E, oral PG E1 preparation, tranilast (a treatment for keloids and hypertrophic scars), corhitin, oral pentoxyphyllin (not found in Japan), and local injection of the steroid verapamil into the lump.

However, we follow up with oral vitamin E and tranilast and give local steroid injections only when the pain is severe.

There are two surgical methods: plication method and transplantation method (dermis and vein transplantation).
The sewn method is a method that aims only to improve the curvature, and it is easier than the transplantation method to sew the opposite side of the lumpy side, but it cannot improve lumps and pain and shortening the penis is a problem. increase.

The transplant method is a method of removing or incising the lump and extending the shortened penis, and a histological examination is also performed, so a definitive diagnosis can be made.

When is Peyronie’s Disease Surgery?

The first conservative treatment (other than surgery) will be treated with medication for 6 months until the symptoms stabilize and then stabilize. Symptoms stabilize when the lump size, pain, and curvature disappear, and surgery is considered 6 months later.
In most cases, it takes about 6 months for the symptoms to stabilize, so surgery is performed about 1 year after the symptoms appear.

What is the preoperative test for Peyronie’s disease?

In general, bring a digital photo or mobile photo of a complete erection at home taken from two directions (up / down / left / right) for reference, and to be precise, measure it by artificially erection during surgery. There is.

For an accurate preoperative diagnosis, a corpus cavernosum injection of prostaglandin E1 is performed to measure erectile hardness and the angle of penile curvature and penile length. 

The corpus cavernosum injection of prostaglandin E1 is not so painful because it is injected with a needle as thin as a Tuberkrin needle, and the erection is maximized after sexual stimulation and stimulation by one’s own hands are applied so as not to apply stress after injection.

I will take pictures and take measurements when it becomes. Erectile hardness is also measured, but if it is extremely low, consider penile prosthesis surgery.

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