- Make it Straight! How to Treat Peyronie’s Disease?
Make it Straight! How to Treat Peyronie’s Disease?
Peyronie’s disease is a condition that affects the penis, usually causing painful erections, lumps in the penis, and a bend in the erection.
Although it can be progressive, it is not a malignant (cancerous) condition and it is not life-threatening.
What causes Peyronie’s disease?
The cause is not known for certain. A likely explanation is that it is an unusual reaction to injury to the penis, although most men with Peyronie’s do not recall having a specific injury. However the penis is subjected to varying degrees of stress and strain during penetrative sexual activity, and these relatively small injuries may result in some men developing the disease.
Who gets Peyronie’s disease?
The disease affects approximately one man in every hundred, perhaps even more. It is more common in older men, but all ages can be affected. There is an association between Peyronie’s disease and the hand condition Duypetren’s contracture, which causes one or more fingers to bend into the palm. About one in ten men with Duypetren’s contracture have Peyronie’s. However, no-one knows why some men get Peyronie’s disease and others don’t; it appears to be a matter of chance.
What happens in the disease?
Not every case of Peyronie’s disease is the same, but men usually first complain of painful erections or a bend in the erection, or both. Sometimes they notice lumps in the shaft of the penis, although these lumps may not be obvious initially. The symptoms may come on suddenly or slowly.
The symptoms usually get worse over a few months, but then stop progressing. The time course is very variable, but in most cases, the disease stops progressing after 6 to 18 months. In a few unfortunate cases, the disease continues to progress relentlessly, but this is rare.
When the disease stops progressing, the erections cease to be painful. The lumps in the penis may become harder and more obvious, and the bend in the erection stops getting worse. Sometimes the bend actually improves, although unfortunately, this is unusual.
What causes the bend?
The penis is made up for the most part of two big bundles of blood channels (or sinusoids) called the corpora cavernosa, or more simply known as the erectile tissue. These run along the whole length of the penis and on the inside have the appearance of a very fine honeycomb. At rest, when the penis is flaccid, they are empty. When a man gets an erection, large amounts of blood flow into the erectile tissue, filling the blood channels which increases the penile size and gives the penis its rigidity.
In Peyronie’s disease, the fibrous lumps block part of the erectile tissue, preventing the affected area from expanding. The rest of the penis is free to expand, so the erection becomes bent, with the lump at the apex of the bend.
More often than not the lumps are on the top surface of the penis, so the bend is usually in an upwards direction, towards the stomach; but it may be sideways or downwards.
Does Peyronie’s disease cause impotence?
Impotence is the lack of rigid erections, or the inability to maintain a rigid erection. Men with Peyronie’s disease are perhaps more likely to have less rigid erections although the association is not completely clear cut.
Impotence and Peyronie’s disease are both conditions that are more common in older men, so any associated impotence may be simply part of the aging process. Additionally, impotence may be psychological, particularly if the erection is painful, or if intercourse is difficult or impossible because of the bend.
Sometimes, however, the amount of fibrosis in the penis is so great that no blood can get past the fibrotic area to the tip of the penis. In these cases, the base of the penis may be rigid, but the tip is floppy.
How is Peyronie’s disease treated?
Once the disease has stopped progressing, it is perfectly possible to straighten the erection, should that be necessary.
Over the years a multitude of drugs has been tried in an attempt to cure Peyronie’s disease, or at least minimize the amount of deformity the disease causes. The most popular is Vitamin E, which is readily available from chemists and health food shops, and some prescription drugs are reported as being helpful but none has been proved to be of definite benefit in clinical trials.
ESWT (Extracorporeal Shock Wave Treatment)
ESWT or shock wave therapy has gained some popularity in recent years. The technology used is the same as is used to shatter kidney stones (lithotripsy). Multiple shock waves are fired at the lumps within the penis, breaking them up. Three treatments are usually given over a period of a few weeks. ESWT seems to be most beneficial to men who have a lot of pain with their erections.
Priapus Shot (P-Shot)
Also commonly referred to as the P-Shot, the Priapus Shot uses what is known as PRP (platelet-rich plasma) therapy in the treatment of Peyronie’s disease. The treatment has been shown in some cases to result in a very dramatic improvement in both the shape and functionality of the patient’s penis. In certain individuals, there has been a “dramatic” correction to the bend in the penis.
Basically, the procedure involves taking a patient’s own blood and then concentrating the natural “healing factors” found in the blood (such as stem cells and growth factors). After being separated from the red and white blood cells using a specialized centrifuge, the concentrated “healing factors” are then re-injected into the patient’s penile area. The entire procedure can be accomplished in less than twenty minutes at the physician’s office and is not considered to be a surgical procedure.
What is the P-Shot or Priapus shot protocol for treating Peyronie’s disease?
When using the P-Shot in the treatment of patients with Peyronie’s disease, many urologists that are experts in the field also include some or all of the following to their treatment protocols:
- Nutritional Support and Vitamin Supplements – In almost all cases, patients are encouraged to eat properly and include certain vitamin supplements as a part of their diet. Commonly seen are the inclusion of CoQ10 (300mg/day), Vitamin E (1,200 units/day), Vitamin C (3,000mg/day), plus a B-Complex vitamin.
- Hormones – Since low testosterone is often associated with Peyronie’s disease, a hormonal addition to the treatment protocol is often seen. These may include hormones such as testosterone and DHEA.
- Exercise – Many urologists include simply walking an average of about 20 miles a week to their P-Shot protocol. Exercise helps with improving a patient’s circulation and additionally helps with inflammation. This has been documented to improved erection quality, plus makes all the other therapies work better.
- Penis Pump – The use twice daily of an Erectile Dysfunction Vacuum (commonly called the “Penis Pump”) works effectively for many men as part of the P-Shot protocol in the treatment of Peyronie’s.
- Stop Smoking – Smoking is associated with an increased risk of developing Peyronie’s disease and erectile dysfunction, plus decreases the effectiveness of the Priapus Shot procedure.
- Cialis – Many add a daily dose of Cialis to the treatment protocol. If there’s no additional erectile dysfunction present, then 2.5mg/day in the morning is commonly seen. If erectile dysfunction is present, then the dose is commonly 5mg/day in the morning.
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