On Call: Peyronie's disease
Q. I have an embarrassing problem. Over the past year or so, my erections seem to have become crooked. My sex life is fine, but I want to know if it's a serious problem and if I should see a doctor.
A. It sounds like you have Peyronie's disease, a problem that produces symptoms in about 1% of men, usually between 45 and 60 years of age. Although its cause is unknown, Peyronie's disease is thought to develop from trauma or inflammation in the tunica albuginea. The result is a plaque of scar tissue in this otherwise thin structure that supports and surrounds the corpora cavernosa, the spongy tissue that fills with blood to produce an erection.
The plaque of scar tissue produces a curvature of the erect penis. The plaque can be painful, and the curvature can interfere with sexual intercourse. In most cases, the disease begins gradually and progresses slowly over one to two years. In many cases the process stabilizes, and in a few it appears to resolve spontaneously. Oral therapy with vitamin E is commonly recommended, and potassium aminobenzoate (Potaba) is sometimes prescribed; injections of verapamil, a calcium channel blocker, or dexamethasone, a steroid in the cortisone family, have also been used. Ultrasound treatments are also being tested. The only proven treatment, however, is surgery. Surgery should be reserved for men with significant pain or sexual impairment, and it should never be undertaken until the plaque is mature and the disease has stabilized.