Penile curvature: is surgery the only option?
Penile curvature: is surgery the only
option?
The majority of men have a very slight curve or sideways "hang"
to the penis. But about 400 men in every 100,000 suffer from the
condition of severely bent or curved erect penis, so extreme
that it makes intercourse painful for both partners or
completely impossible. The erect penis may bend in a "J" or "U"
shape, or may have a series of bends that create an almost
corkscrew-like appearance. This condition is referred to in the
medical community as Peyronie's Disease, and is also sometimes
called fibrous caverositis as a description of the condition of
having fibrous scar tissue building up in the layers of erectile
tissue (cavernosa).
Physicians disagree about the exact cause of Peyronie's. It's
clear, however, that the condition occurs when inelastic plaque
or scar tissue replaces the normally elastic tissue of some part
of the penis. Normally, an erection expands the elastic tissue
of the penis more or less symmetrically, producing a straight
erection. But because scar tissue is not elastic, or stretchy,
but rather hard, it stays put while other parts of the penis
engorge, resulting in curvature or severe bending. If the scar
tissue extends all the way around the shaft of the penis, the
result is either "bottleneck" or pinching-in at that location,
or even a drastic shortening of the penis.
This unfortunate circumstance may begin with injury,
inflammation, or trauma of some sort to the erect penis, such as
forceful bending. Some men have developed Peyronie's after
attempts to treat erectile dysfunction via injection (the most
common drug used for this purpose is called Caverject).
Physicians also suspect that other medical conditions may
influence the onset of Peyronies, such as high blood pressure,
hardening of the arteries or diabetes, which may be linked to
other rare genetic causes. Currently, though, the most likely
culprit is believed to be trauma followed by slow or abnormal
healing.
As for treatment, it's important to understand that every case
of Peyronie's is different. For some men, surgery is a logical
option, though physicians generally tell patients to wait at
least a year or two before surgical attempts to correct it are
made. During that waiting period, most patients will try other
treatments first, with the thought that surgery is a
last-resort, drastic choice (if you doubt this, do a search
online with the keywords "penile curvature surgery," though you
should be warned that these graphic photos are not for the weak
of heart or stomach and can be very disturbing).
In some cases, men improve spontaneously without treatment
within a year or two, and scar tissue may even disappear. About
40% of men see no change within that time frame, though, and
another 40% may even see worsening of conditions. One of the two
most-performed surgeries, called the Nesbit procedure, often
results in a shortening of the penis by 1 to 2 inches; the other
procedure in which scar tissue is replaced with grafted tissue
may result in partial or complete loss of erectile function. In
these cases, prior to surgery and during the "waiting period,"
alternative treatments are certainly worthwhile and more
effective than doing nothing at all, and are infinitely
preferable given the extreme nature of the surgical
treatments.
Right now, the best-documented and most successful
self-treatments available are in the form of traction devices,
perhaps combined with a course of Vitamin E therapy. Highly
successful corrective devices like the ProExtender