Bent Penis? How Peyronie’s Disease Affects Your Physical and Mental Health

Man in distress putting hands over face

Peyronie’s Disease, or PD, is an abnormal deformity of the penis that often presents as a bend or curve of the penis, but it may also present as narrowing, indentation, flopping, or ‘hourglassing’ of the penis. Peyronie’s disease or PD is common and affects up to 10% of men over the age of 40. It is often caused by micro-trauma or ‘wear and tear’ of the penis, but it can also be genetic. While not every bent penis needs treatment, it is important to recognize the physical and psychological impact of PD and learn whether your condition needs treatment. Determining whether treatment is needed can often be as much of a psychological question as a physical one. Why? Not all cases of Peyronie’s are painful, and not all instances inhibit a regular and enjoyable sex life.

Many patients are more concerned about the optics and potential worsening of PD than they are about the actual function of the penis, and herein lies the critical decision as to whether it should be treated. Ultimately, most urologists may not be able to offer treatments for PD, and therefore, it is highly recommended that patients see urologists specializing in men’s health.

It’s also essential for patients to understand that PD does not always continue in a linear, worsening fashion. While many cases worsen, a large percentage of them remain unchanged. Overall, it is less likely that this condition improves on its own. As such, consulting with a men’s health specialist can help you make individualized decisions about your condition.

The Continuum of Treatment

While not all PD is painful or problematic, a consultation with a men’s health specialist like Dr. Kapadia may help answer any questions you may have. Not only can we assist the patient in understanding their condition, but also provide objective measures and monitoring of the state of the disease.

If treatment is necessary, we often start with an injection called Xiaflex. This is a series of eight injections performed over 18-24 weeks. The medication is injected directly into the penile plaque causing PD, with the goal of softening it. With proper care, including traction exercises, patients may be able to loosen the plaque and straighten the penis. Xiaflex works in up to 75% of patients, offering up to 34% improvement in curvature.

When injections do not work, surgical therapies such as penile plication, plaque incision, or excision with grafting may be considered. While these can be very effective procedures, there are certain risks with all procedures that Dr. Kapadia discusses further.

Often, due to the age of PD onset (typically 55+), patients may also have concurrent erectile dysfunction. If medications for erectile dysfunction fail to improve the condition, an implant can offer dual benefits of allowing the patient to create an erection on demand while also mechanically straightening the penis via the implant.

A penile implant may seem like an extreme solution to either concern, but it is incredibly effective and well-liked by most patients. Data on implant patients and partners shows that roughly 97% of patients are happy with the outcome of the penile implants, and they offer a reliable erection for up to 10 years. Or even longer. Not only does the function of the prosthesis provide an excellent solution to erectile dysfunction, but it is also discreet in that the erection can be created quickly before intercourse, and most partners do not even notice the implant if they’re not told.

Of course, finding the right solution for your Peyronie’s is very nuanced and individualized, and therefore visiting a men’s health urologist, like Dr. Kapadia, is a significant first step. With the advances in urology and the field of men’s sexual health, many patients are unaware of the advanced and elegant solutions we now have.

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