FAQ - PEYRONIE'S DISEASE
FREQUENTLY ASKED QUESTIONS
Dr. Paulo Egydio CRM 67482 RQE 19514
When is there an indication for surgical correction of penile curvature?
A careful evaluation in the office is essential for the decision of clinical treatment, through oral and/or injectable drugs, or surgical treatment. There are several surgical strategies and the choice of the best technique will depend on each case.
Surgical correction of penile curvature is indicated when the penis is not functional. What is a non-functional penis?
- Penetration is difficult or impossible;
- In movement it escapes easily;
- Difficulty getting or keeping erections.
Is Shock Wave Treatment Effective for Peyronie's Disease?
Scientific studies on the subject, published in international journals, reveal that Shock Wave treatment has not been effective in curing Peyronie’s Disease. The chances of failure are high and, as it is a high-cost treatment, this can be an unnecessary expense.
It is also worth mentioning that the Faculty of Medicine of the University of São Paulo – USP, presented a study proving the inefficiency of the treatment, during the AUA congress in 2008, in Florida, the largest and most important scientific event in the area. The study even proves that treatment with shock waves can produce fibrosis in the tissues of the penis and worsen Peyronie’s disease. See the description of the results of this study:
"This study demonstrates that the ESWT (extracorporeal shock wave therapy) produced tissue injury and can induce Peyronie's-like plaque in normal penis." Em português, "Este estudo demonstrou que o tratamento por ondas de choque produz lesão dos tecidos e pode produzir a Doença de Peyronie."
Source: Can extracorporeal shock wave therapy induce Peyronie's-like plaque in normal penis?. Journal of Urology - J UROL. 179. 257-257. 10.1016/S0022-5347(08)60743-0.
Several articles with similar results have already been published in renowned national and international medical journals. After debating the topic, studies warn that it is necessary to inform the patient about the possibility of treatment inefficiency, since conclusive results have not yet been found. Thus, this treatment has not been shown to be efficient. If you want, check out the links below:
- Extracorporeal shock wave therapy for Peyronie’s disease: exploratory meta-analysis of clinical trials
- Extracorporeal shock wave therapy in Peyronie’s disease: no convincing results
- Questionable efficacy of extracorporeal shock wave therapy for Peyronie’s disease: results of a prospective approach
Penile traction devices (or extenders) correct curvature?
Penile traction devices can correct the curvature, but not all cases are indicated for their use. It is extremely important that, if necessary, use under the guidance of a specialist to avoid aggravation of curvature and even greater problems. I do not recommend using it without medical advice.
Can Peyronie's Disease Lead to Premature Ejaculation?
About exercises for the penis, devices and remedies that promise to correct penile curvature. Do they work? Are they safe?
The orientation is that you do not use exercises, devices and medicines that say they are miraculous without medical guidance and monitoring to avoid aggravation of the curvature and possibly greater problems. Don’t fall victim to advertising appeals.
We have already received patients with trauma to the penis caused by exercises and/or devices purchased over the Internet that promised great results.
What is the highest risk position for penile trauma?
These are the positions where the partner is active in sexual intercourse, as the penis is predisposed to trauma. On the other hand, when the man controls the movements and their amplitude, the possibility of the penis escaping during sexual intercourse and hitting the perineum when leaving the vagina is lower and less subject to trauma.
Does pain during erection improve with treatment?
Yes, right after the inflammatory phase.
How long and how much can the penis bend?
The curvature tends to be progressive and may worsen as the disease progresses. When the curvature is between 3 and 6 months without worsening or improving, it tends to stabilize, unless another Peyronie episode arises. After the penile deformity has stabilized, as long as the curvature, thinning or decrease in size is not interfering with penetrative rigidity, and that sexual performance remains adequate, it is possible to live with this problem. Otherwise, seek the guidance of a urologist to conduct the treatment.
Are there cases of Peyronie's in which there is no curvature?
When fibrosis decreases tissue elasticity in the same proportion on opposite sides, there may be a decrease in the penis without curvature, in addition, if the penis develops only a deep and circumferential fibrosis, it is possible to witness a thinning instead of a curvature.
A face-to-face evaluation with a urologist is essential.
If I get penetration, can my partner experience any discomfort?
Probably yes, when the penile curvature is accentuated. Penetration can be facilitated with the help of the hand, but the partner may experience discomfort during intercourse, so dialogue and complicity are very important so that the partner can report if it is causing discomfort and/or pain. In many cases, the partner may be embarrassed and avoid talking so as not to frustrate the patient. It is also necessary to be very careful, depending on the degree of curvature, when forcing the penis in intercourse can cause trauma that will further aggravate the problem, which can cause a diffuse Peyronie and even a more serious trauma to the penis. If you are having difficulty in penetration, forcing the penis in intercourse, a careful evaluation with a urologist you trust is essential.
Can Peyronie's Disease disrupt the flow of urine and sperm?
It can get in the way if the curvature is more accentuated. It is important to carry out an evaluation with a urologist.
Can I have Peyronie's Disease more than once?
It can happen more than once, so the prevention of trauma is very important to minimize the risk of the appearance of new fibrosis. In some cases, fibrosis can progress, especially when there is an individual predisposition to fibrosis formation. Like for example:
- Diabetics;
- Dupuytren’s disease;
- Ledderhose;
- Keloid predisposition;
- Family genetics where other family members developed fibrosis, related or not to the penis.
A face-to-face evaluation is essential.
Does oral, injectable or topical treatments cure Peyronie's Disease?
In the inflammatory phase of Peyronie’s disease, clinical treatment should be attempted under the guidance of a urologist. A careful evaluation of this professional is essential to define the appropriate treatment, both for the inflammatory phase and for the chronic phase of the disease.
What percentage of men develop Peyronie's Disease?
In Peyronie’s American book (Peyronie’s Disease), which I was invited to write a chapter, I talk about curvature correction and disease statistics. Data has shown that approximately 10% of adult men will develop penile deformity.
When should I see a specialist to treat Peyronie?
The patient should seek the specialist immediately at the onset of symptoms, because when the treatment is started still in the inflammatory phase, the chances of scar formation are lower, with good results, and surgery can be avoided.
Click here to learn about the symptoms of Peyronie’s Disease.
What to do in case of trauma to the penis during sexual intercourse?
In cases of more serious trauma, in which a pop occurs and the penis swells immediately due to the rupture of the tunica albuginea, popularly called penile fracture, an emergency room should be sought immediately.
In cases of trauma without swelling and immediate hematoma, but with pain on erections after the trauma, early medical follow-up is important, as it is at this stage of inflammation that the best results are achieved, using only clinical treatment.
Click here and watch the video about penile trauma!
Is it possible to fix curved penis? How is the size after correction?
The goal of treating a curved penis is to restore and maintain sexual function. The doctor must be aware that the man with penile curvature can have great anxiety and apprehension.
The penis, by bending over, may decrease in size. This decrease may be even greater the greater the curvature.
Traditional surgical techniques can lead to penis shrinkage as it decreases the size of the long side of the penis to the size of the short side.
With the surgical strategy that uses geometric principles, published by Dr. Paulo Egydio, it is possible to reconstruct the short side of the penis and expand it. The objective is to lengthen the short side of the penis until it is the size of the long side, aiming at the recovery of penile size in a surgical procedure.
The surgery is performed in a hospital environment, with anesthesia (to sleep during the procedure), with the possibility of being discharged from the hospital even on the same day. Return to work, physical activities and sexual activity will depend on the evolution of each patient during follow-up and medical evaluation in the postoperative period.
Learn the causes, consequences and existing treatments for penile fibrosis.
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