Peyronie's disease - Causes, symptoms and treatment. MF.

Peyronie's disease - curvature of the penis due to fibroplastic degeneration of its belly coat. To date, pathology is rare. Mostly, among men between the ages of thirty and sixty. For the first time a change in the penis of this type was described by the French surgeon François Peyronie back in 1743, in honor of which the pathology was named.

Causes of Peyronie's disease

To date, none of the world's scientists can name the exact cause of the Peyronie's disease. Nevertheless, microtraumatism of the penis is considered to be the main risk factor in the development of such a pathology. It is believed that with constant irritation of the head and body of the penis, inflammation develops. As a result, the activity of fibroblasts is activated and a connective tissue degeneration of the belly membrane occurs. After that, the skin and tissues of the penis cease to be soft and elastic, but on the contrary, become rigid and immobile.

If the inflammatory process continues against the background of the active formation of connective tissue, then there is a so-called remodeling of the latter. In other words, connective tissue begins to change its own configuration and there is a curvature of the penis.

Anatomy of Peyronie's disease

In addition, the risk of developing Peyronie's disease can increase systemic diseases such as diabetes mellitus, erectile dysfunction, hypertension and lipid metabolism disorders.

Ambiguous is the attitude of scientists towards smoking and alcoholism in the development of Peyronie's disease. At a time when some believe that these factors lead to this disease, others completely refute such information.

We can not exclude the role of the hereditary factor in the genesis of Peyronie's disease. At a minimum, Dupuytren's contracture proves this, which takes place more than half of the patients with Peyronie's pathology.

Symptoms of Peyronie's disease

The clinical picture of the disease depends on the specific stage. At the stage of inflammation, patients, as a rule, notice pain in the body of the penis. It can be observed at rest and strengthened during erection, as well as sexual intercourse. At this stage, there is also the formation of "soft" plaques under the skin of the penis.

The next stage in the development of Peyronie's disease is fibrotic. The clinical picture of this stage is characterized by the formation of a dense infiltrate under the skin of the penis, which can even be calcified. There is a gradual curvature of the penis.

Symptom of Peyronie's disease

After the stage of inflammation, the disease has three development options. Very rarely there is a spontaneous improvement, while the progression of pathology occurs most often. Also, stabilization of the process can occur quite often, which, in principle, does not correspond to recovery. Such patients still have plaques under the skin of the penis and experience some discomfort.

The most significant in the clinical picture of Peyronie's disease is the occurrence of erectile dysfunction, which has mechanical causes due to the formation of calcification in the soft tissues of the penis.

As Peyronie's disease has a very big tendency towards progression, self-diagnosis and, moreover, self-medication here is unacceptable. If there is pain in the head and body of the penis, you should immediately contact a urologist. Only at this stage the consultation of this specialist is effective and can prevent the disease.

Diagnosis of Peyronie's disease

As a rule, the characteristic clinical picture of the disease and the presence of an inflammatory process of the penis in the anamnesis do not leave questions about the diagnosis. For more accurate information on the number, location and structure of plaques, one resorts to instrumental methods of investigation. The results of ultrasound and radiography can become indispensable information when choosing the scope and method of the operation.

Treatment of Peyronie's disease

Principles of treatment for Peyronie's disease include conservative and operational methods. Orally, all patients are assigned vitamin E, colchicine and tamoxifen. Although these drugs can be easily purchased at the pharmacy without a prescription, this can not be done, since the drugs have a large number of side effects and should only be used as prescribed by the doctor.

In addition, among conservative treatment methods, administration of lidase, interferon and hydrocortisone to the penile tissue can be prescribed. As practice shows, local administration of these drugs gives a much better effect than the systemic.

Among non-pharmacological methods, local negative pressure and electrophoresis are used, which is combined with the administration of lidase.

As practice shows, conservative management of Peyronie's disease is permissible only at the stage of inflammation. When the already formed calcified plaques are under the skin of the penis, the only way out of the situation can be only surgical intervention.

The local process removes fibrous plaque through a separate skin incision. In the situation when it is a vast process, they resort to the plasticity of the skin of the penis. For this, a skin flap taken from another part of the patient's body or a pig's graft may be used.

As one of the variants of surgery for total Peyronie's disease, two-stage plastic surgery with the skin of the scrotum was used quite often before. For this, after complete carving of the skin of the penis and subcutaneous calcified plaques, two incisions were made at the base and tip of the scrotum. Through them stretched the penis and in this position left for about a month. After the skin of the scrotum was firmly attached to the body of the penis, cuts were made along the edges of the penis. The operation was terminated by stitching the cut skin on the lower surface of the penis and eradicating the hole in the scrotum.

Similar operation had a lot of complications, the hardest of which was erectile dysfunction. In addition, the growth of hair on the skin of the penis, which greatly interfered with personal hygiene. To date, this operation was completely abandoned, but this did not help to get rid of its complications. Despite the fact that now the defects are replaced by the skin from other parts of the body or even by artificially grown transplants, erectile dysfunction is still quite common. Scientists continue to actively work on this problem.

Peculiarities of Nutrition and Lifestyle in Peyronie's Disease

Despite the fact that in the development of Peyronie's disease there is a place for changing the lipid spectrum of blood, there is no special diet for this pathology. As for the way of life, experts recommend keeping away from masturbation and sexual intercourse during the treatment period, which are traumatic factors and lead to deterioration.

Rehabilitation after illness

Only patients with psychological disorders on this background and patients after surgery are subject to restoration after Peyronie's disease. As for the operated patients, for some time they need wound dressings and complete physical calmness of the penis. The latter is provided by bedding or the imposition of special tires.

Quite often, patients who have sexual problems with Peyronie's disease develop psychological disorders. They are dangerous because even after full recovery, recovery of erectile function does not occur. Such patients need psychotherapy sessions, which are conducted in the office of a sex therapist or psychotherapist.

Treatment with folk remedies

With Peyronie's illness, it is better to stick to traditional methods of treatment, since traditional medicine can not only not help the patient, but also worsen his condition. As a rule, traditional healers use local compresses and lotions, which only intensify the processes of inflammation and exudation in the body of the penis. This is accompanied by the progression of Peyronie's disease. Thus, the use of folk remedies during such a disease is unacceptable.

Complications of Peyronie's disease

As mentioned above, erectile dysfunction is considered the most frequent and serious complication of Peyronie's disease. It is observed in almost all patients who undergo calcification of subcutaneous plaques. To prevent this from happening, it is necessary to seek help from a urologist who can correctly assign the tactics of the disease management.

Peyronie disease prevention

Because the exact causes of the onset of Peyronie's disease are unknown until today, it is very difficult to develop principles for its prevention. Nevertheless, based on the identified risk factors, all men aged thirty years who suffer from coronary heart disease, diabetes, lipid spectrum disorder and erectile dysfunction should prevent Peyronie's disease.

The essence of the prevention of this disease is to eliminate the main factor that leads to its development, that is, treatment of the underlying disease. To reduce the trauma of the penis, it is recommended to use comfortable underwear and loose trousers. It is also believed that masturbation is one of the main causes that lead to microtrauma of the penis. In a situation where masturbation is necessary for medical reasons and can not be abandoned, during this process it is recommended to use neutral oils or a special intimate lubricant.

Rev.doctor urologist Astashin Е.Е.