14 May 2019 Author : Bruno Graça La Peyronie disease is a disease of the penis, of unknown cause, characterized by the formation of a fibrosis plaque (hard tissue) in one or more areas of the penis, causing penile deformity / curvature. It is thought that it may be associated with recurrent microtraumatism of the corpora cavernosa of the penis. Stages of La Peyronie disease This disease has 2 stages in its evolution: Acute, in which there is pain in the erection and progressive curvature and which, on average, can last 6 to 18 months; Chronic, in which erection pain disappears and penile curvature is stable. This definitive bending may be sufficient to impair normal penetration. Sometimes, there can also be simultaneous erectile dysfunction. Diagnosis The diagnosis of La Peyronie disease is based on clinical history. Photographs of the curvature that the patient can make can also help the evaluation in the medical consultation. In some cases, medical tests may be necessary, such as penile ultrasound, injection of vasodilators, penile echo-doppler or, more rarely, magnetic resonance imaging (MRI). Treatment of La Peyronie disease Drug treatment In the acute phase, treatment with drugs may be indicated, which, however, has a very limited success rate. There are also some very limited results with the use of vacuum devices or penile extenders to control curvature. The use of a collagenase injection in the penile plate was also recently approved to reshape the curvature, pending long-term results. Treatment with surgery In the chronic phase of La Peyronie disease, if curvature makes normal penetration difficult, usually when there is an angle of more than 20 degrees, surgery may be the indicated treatment. However, a minimum period of 3 to 6 months without aggravation is necessary for it to be possible. Surgical correction can be done using a graft if the curvature is very significant (usually more than 60 degrees). Surgical correction aims to allow an erection without curvature or with minimal curvature (less than 20 degrees), so that there is no difficulty in penetration. Any surgical correction can result in penile shortening and sometimes erectile dysfunction, so it is essential to follow a rehabilitation protocol after surgery to obtain the best possible results. In cases of La Peyronie disease with associated severe erectile dysfunction, the surgery used is the placement of a penile prosthesis to solve both problems. More about the urology service team at Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
