Peyronie’s Disease – The Acute Stage

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If you have noticed pain on erection,  and a starting of what appears to be a bending of your penis, you could have Peyronie’s disease.

Peyronies disease occurs because of scar tissue in the penis ( you might hear your Urologist refer to it as “ plaque” )

It is this plaque that causes the unnatural bending of the penis on erection.

We see many men at Moorgate Andrology who report remembering a sudden bending of the penis during sexual intercourse. This sudden bending caused a sudden sharp pain, but other than that the moment was forgotten. Then sometime later the pain of erection started and the ending alongside it. For others, there is no such recollection of any such event and they are completely puzzled as to why they have the disease.

Pain on erection and bending of the penis can be very alarming, not least because most men who have Peyronie’s disease have never heard of this condition before they get it.

These symptoms are typical of the so-called “acute stage” of Peyronie’s disease.

This is the first of a two-stage process of Peyronie’s disease. The second phase is the Stable phase, sometimes called “the chronic phase” of the disease.

In the acute phase of the disease, it can be worrying to see your penis bending and getting worse by the week and month. Erection quality can also be compromised with an element of erectile dysfunction creeping in.

When your Peyronie’s disease is in the acute phase,  there are some conservative measures that you can help to improve erection quality and help to minimise, as much as possible, the progression of the disease.

In this stage, it is too early to contemplate surgery as the disease must be in the stable phase before this can be considered.

Firstly, we will focus on improving your erections and there are a couple of measures that we can take to improve this. When your erections are better you will feel better knowing that as much as the disease allows, you can continue to have sexual intercourse.

A medication called Tadalafil is usually prescribed by Urologists to help improve blood flow to the penis. Blood flow to the penis is vital to help maintain good, strong, hard erections, strong enough for penetrative sex. This medication whilst helping with erection quality also helps directly with healing as it provides oxygenated blood to the penis.

The usual dose is 5mg daily. A single tablet is taken once a day. Most patients see an improvement in erection quality quickly.

The other approach to help with erections is a vacuum pump. This is attached to the penis and again helps with generating a good hard erection.

To help with the remodeling of the penis we also recommend a penile traction device. This is worn on the penis for one to two hours each day or night. This device puts the penis in slight traction and helps stimulate new cell production deep inside the corporal bodies of the penis.

If you are experiencing pain on erection then a course of shockwave therapy is usually recommended. This therapy can be very beneficial in reducing pain on erection and helping with the treatment of erectile dysfunction. It is advocated as a treatment to improve the ending but we are not convinced that shockwave therapy is effective in this regard, but it has a role in the acute stage of Peyronie’s disease.

You can of course continue to have sexual intercourse when you have Peyronie’s disease. However, the angle of the curvature can make sexual intercourse uncomfortable for you and/or your partner. Furthermore, the angle at which the penis enters may not be entirely normal and there is a risk of a penile fracture. Care should be taken during penetrative sex until a resolution to the disease is found.

Over the first 12 months, the disease is likely to get worse. It can be really helpful to take photos once a month of the penis in full erection so that you can track the progress of the disease. Eventually, you will find that the curvature stops, and the photos that you are taking look pretty much the same. We consider the disease has moved into the chronic phase when there have been at least three months with no change in the angle of the curvature.

It is at this point that a review of your treatment can be done. We will know at this point just how successful or otherwise the more conservative treatment has been. If the curvature has been quite mild it may be that no further treatment is required. This is indeed the best outcome. However, if the disease has progressed to a significant curvature a surgical approach will then be the only way to make the penis straight again.

For many men, the curvature might be too significant, but the appearance of the penis is erection causes them distress and embarrassment and they progress to a surgical solution.

In the acute phase, it is difficult to assess just how much the penis will curve over the course of this phase. The best way forward at this stage is to embark on conservative treatment and monitor the progress of the disease with the Urologist

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