A fairly common affliction in men is Peyronie's disease, in which the penis bends up, down or to one side during an erection. A recent study from Aviano, Italy shows that the most likely causes are infection and trauma (1). Men who have had a tube inserted in the bladder by a doctor are 16 times more likely to suffer Peyronie's disease. Those who had genital trauma are three times as likely. Other associations include burning on urination, high urine uric acid levels seen in gout, and high blood cholesterol and pressure levels (2).
Men have balloon-like blood vessels in their penis that fill with blood when they have erections. Sometimes the blood vessels are damaged by trauma or cholesterol, and scar tissue forms in the balloons (3). Scars cannot expand as much as balloons do, so the erected penis bends toward the side with the scar. Men with Peyronie's disease are usually told to live with it unless the erection becomes painful or the bend is so great that the man cannot engage in sexual relations. Then the usual treatment is to cut out the scar and replace it with a graft. Needless to say, this procedure doesn't always work. Bi-weekly injections into the scar of the blood pressure medication, verapamil, for 24 weeks cured most men with his condition (4).
1) MP Carrieri, D Serraino, F Palmiotto, G Nucci, F Sasso. A case-control study on risk factors for Peyronie's disease. Journal of Clinical Epidemiology 51: 6 (JUN 1998):511-515.
2) Muralidhar, S.; Kumar, B.; Sharma, S.K.; Sharma, M.; Mandal, A.K. Etiologic factors in Peyronie's disease. International Journal of Dermatology. AUG 1997;36(8):579-581.
3) "Jarow, J.P.; Lowe, F.C. Penile trauma: An etiologic factor in Peyronie's disease and erectile dysfunction. Journal of Urology. OCT 1997;158(4):1388-1390.
4) Levine, L.A. Treatment of Peyronie's disease with intralesional verapamil injection. Journal of Urology. OCT 1997;158(4):1395-1399. Using a multiple puncture technique, 10 mg. of verapamil diluted to 10 cc were distributed throughout the plaque every 2 weeks for a total of 12 injections.
5) J Rehman, A Benet, A Melman. Use of intralesional verapamil to dissolve Peyronie's disease plaque: A long-term single-blind study. Urology 51: 4 (APR 1998):620-626. PABA, Ace inhibitors and calcium channel blockers (drugs to treat high blood pressure), prostacyclin E1 and a protein building block called L-arginine have been shown to decrease scarring and help treat Peyronie's disease, heart valve damage associated with the diet drug, fenfluramine, duPuytren's contracture of the tendons in the palm, and so forth). Most also generate a chemical called nitric oxide that relaxes smooth muscle to cause an erection. If you have a painful bent penis, wait a while, you may get better by yourself. If you want to be treated, the most promising treatment is injections of verapamil every other week for 24 weeks.
6) D Chevallier, E Benizri, P Volpe, J Amiel, J Toubol. Peyronie's disease: Review of historical, epidemiologic, and physiopathologic data. Diagnosis and therapeutic approach. Revue de Medecine Interne 18: Suppl. 1 (1997):S41-S45.
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