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Bent Penis: Treatment of Peyronie's Disease
Peyronie's disease occurs when a man's erection bends in one direction. Several recent reports show that Peyronie's disease can be cured with blood pressure (1) and gout medicines (1A).
The penis contains balloon-like blood vessels that fill with blood to cause an erection. Scar tissue forming in the balloons cannot stretch as much as the balloons do, so the erected penis bends toward the side with a scar. Men most likely to suffer Peyronie's disease often have high blood pressure and high blood cholesterol and uric acid levels, which weaken blood vessel walls (2). Then when a man makes love, the trauma breaks these blood vessels which heal with scarring (3). 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. This procedure doesn't always work. Injections of the blood pressure medication, verapamil, into the scar every weeks for several weeks cures most men with his condition. Colchinine, a drug used to treat gout also can reduce the scarring (1A). For an update of this report see #1241.
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.
1A) MS Anderson, TV Shankey, T Lubrano, JP Mulhall. Inhibition of Peyronie's plaque fibroblast proliferation by biologic agents. International Journal of Impotence Research, 2000, Vol 12, Suppl. 3, pp S25-S31.
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.
Checked 8/9/05