Peyronie's disease is a disorder of the penis that involves scarring, painful erections and penile curvature. Individuals with Peyronie's disease may also experience a decrease in the quality or duration of their erections (erectile dysfunction). It affects less than 2 percent of the male population and typically occurs in caucasian males over age 40. Peyronie's disease is named after Francois de la Peyronie, who described the penile curvature characteristic of the disease in 1743.

PEYRONIE'S PLAQUE

The main structures that contribute to erections are the paired corpora cavernosa, which contain a spongy, vascular tissue. These structures have a casing or covering called the tunica albuginea. Normal tunica albuginea is elastic and can stretch. During erection, blood fills the corpora cavernosa, which expand to the size of the membranes containing them, allowing the penis to become firm enough for penetration.

In Peyronie's disease, a scar or plaque develops within the tunica albuginea. This scar is not elastic like normal tissue, and can cause a deformation as the penis becomes erect. Imagine an empty ballon with a thick piece of tape on one side. As the balloon expands, the taped area does not stretch, while the area around it does.

The cause of the scarring is not known. It may result from injury to the penis, perhaps during sexual intercourse, and may be related to a specific event or repeated trauma. Other theories suggest that it is an autoimmune disorder or that it is inherited. It may be related to another fibrotic (thickening) disease called Dupuytren's contracture, which can affect the hands.

Many Peyronie's patients have pain with erections or intercourse during an initial, "immature" phase. During the course of six to 12 months, the inflammation of this phase generally subsides. At that point, pain and any curvature may also resolve. However, the curvature may increase as the size and elasticity of the plaque changes.

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