Penile curvature is a deformity caused by the development of the connective tissue in the male genitalia in a different way than normal. This condition, which is also called Peyronie’s disease in the medical literature, can cause serious problems such as difficulty in sexual intercourse and inability to control an erection. In addition, it negatively affects the quality of life by creating psychological stress. This condition occurs in 1 to 4 out of every 100 men between the ages of 40 and 70. However, there may be younger patients who experience this condition severely.
The spongy tissue in the penis consists of blood vessels and provides an erection. The development of this spongy structure may be retarded in the fetal development process in the womb. In Peyronie’s, during erection the penis bends towards the area where the development is retarded.
Deformities in the penis are usually seen in advanced ages due to Peyronie's disease. Peyronie's disease is a condition of the spongy tissue and surrounding calcifications of the erectile bodies in the penis. In this disorder, which is usually seen after the age of 50, pain is experienced first and then deformity is observed.
The symptoms caused by the curvature, differ according to the area and size of the tissue. In patients with penile curvature, this tissue may wrap around the penis. In such cases, which are not treated, this tissue may harden even more, causing serious damage to the penis and causing pain. Symptoms of penile curvature are as follows:
- Difficulty in sexual intercourse
- Reduction in penis size
- Difficulty in maintaining erection
- Experiencing severe pain during erection
- General erection problems
- Presence of hard tissues on the penis shaft
- Abnormal appearance of the penis in shape
The curvature of the penis occurs on the dorsal part of the body of the penis. This may occur due to traumas in the fibrotic tissue and bleeding in the subcutaneous tissue, as well as some genetic factors or diseases. Normally, in a healthy man, with sexual stimulus, the vascular spaces in the penis fill with blood and begin to expand. The penile sheath surrounding the vascular spaces regresses and an erection begins. However, in people with Peyronie's disease, the fibrotic connective tissue puts pressure on the erectile bodies that provide the erection of the penis and prevents erection or maintaining an erection.
Curvatures in the penis may be congenital or may occur due to certain conditions in the person's later life. Hypospadias disease is among the causes of penile curvature seen after birth. People who experience this condition have less development of the tissue in the urinary tract.
Penile curvature, also known as Peyronie's disease, consists of two stages. These phases are as follows:
1. Acute inflammation phase: It lasts for an average of 6-18 months. During this period, the patient continues to complain of pain. At this stage, plaque formation is observed in the penis and there is a slight curvature in the penis.
2. Second period or chronic stage: In this stage, there is a significant curvature of the penis. However, the plaque size does not change. The problem of erection in the penis is also experienced at this stage.
In the initial assessment of the person's condition, the doctor observes the general health status, current symptoms experienced and risk factors. On the physical examination required for diagnosis, hard plaques are felt. In addition, visual methods are also used in the diagnosis phase. In order to evaluate the curvature experienced by the person and the severity of this curvature, the doctor requests and examines pictures of the penis in erection. In addition, dynamic ultrasound is also used for diagnosis. With ultrasound, the location of the plaque, blood flow in the penis and whether there is calcium depositions are observed.
Treatment of penile curvature is carried out in two different ways as chronic and acute phases.
Treatment of acute penile curvature: In this period, drug therapy is preferred, since plaque formation that creates curvature in the penis does not fully develop. In addition to drugs that prevent plaque formation, injection of collagen synthesis inhibitors and shock therapy are among the methods applied.
Treatment of chronic period penile curvature: The treatment of chronic period peyronie's, can be performed by injecting substance into the lesion area or applying shock therapy. However, surgical treatment is usually preferred at this stage. Penile prosthesis, that is, happiness stick, is applied to people who have erection problems in order to eliminate the disorder.
In the case of penile curvature, simple plication techniques are used to correct the curvature. In this technique, the penis is sutured from the opposite side of the curvature and the curvature is corrected. In more complicated cases, plaque areas are covered with graft materials to correct the curvature. However, in cases where this correction is not possible, penile prosthesis is applied. The duration of penile curvature surgeries varies according to the method of application and the condition of the patient. In the case of congenital penile curvature, surgeries are usually performed with a simple surgical method. This process takes an average of 1 hour.
Only follow-up is applied to people with mild symptoms related to penile curvature. The main approach of the preferred treatment for these patients is to remove the connective tissue causing the disease. In people with a curvature of more than 30 degrees, drug treatment is applied with the penile injection method in order to dissolve the connective tissues. Another treatment method is iontophoresis, which is the sending of an electric current through the skin. During the treatment process, which includes all these stages, it is extremely important for the patient to help the connective tissues in the penis dissolve by doing various exercises. In addition, the patient should take a break from smoking and alcohol habits during this period. Additionally, a balanced diet and an active lifestyle should be adopted during this period.
In the treatment of the condition, it is preferred to give vitamin and mineral supplements such as vitamin E, carnitine and coenzyme Q10, as well as conventional treatment methods. In case of prominent and severe penile curvature, surgical treatment is applied as all these treatment methods are insufficient and ineffective. At least 1 year is waited before this surgical treatment and the situation is followed up with other treatment methods. In the surgical procedure, lengthening is applied to the contracted area of the penis and the area extended by the tissue is shortened.
Surgery is required for people with a penile curvature of more than 30 degrees and a curvature that may cause problems in sexual intercourse.
PENILE CURVATURE (PEYRONIE'S DISEASE) SURGERY PRICES
The prices of Peyronie surgery, also called penile curvature, vary according to the scope of the procedure, the experience of the surgeon, the hospital where the procedure will be performed, and the quality of the materials used in the procedure. The anesthesia method to be applied with the information given by the doctor and the approval of the patient and the additional procedures to be applied are determinative on the prices as well.
AFTER PENILE CURVATURE (PEYRONIE'S DISEASE) SURGERY
Patients who have undergone surgery with symptoms of penile disease should pay attention to some points after the operation. It is very important that the patient who has undergone surgery does not experience the curvature again after the operation. For this reason, the person should not have sexual intercourse for 4 weeks after the surgery. Otherwise, the erection before intercourse may cause the stitches in the penis to open.
