Peyronie's disease in men - symptoms, diagnosis, photos

This is a fairly rare disease that affects men between 30 and 60 years of age who are sexually active. At this age, the genital organ is more susceptible to microtrauma, including during sex. In men over 60, the disease is rare due to decreased sexual activity. The disease is named after the man who first described it in 1743. During Peyronie's disease, a man's penis becomes curved due to progressive fibrotic changes in its tunica albuginea.

Peyronie's disease (normal and curvature)

Photo: Patient with Peyronie's disease (Source: ru.wikipedia.org)

Nature and causes of Peyronie's disease

For a long time, experts believed that Peyronie's disease was endocrine in nature, and therefore they tried to treat the disease using hormones from the pituitary gland, adrenal glands and parathyroid glands. However, subsequently, experts increasingly began to be inclined to believe that the curvature of the penis is caused by injuries, for example, during forced sexual intercourse.

Among the reasons are the following:

a wide range of injuries to the genital organ, for example, during sexual intercourse, from a blow or an accidental fall on a hard surface;
microtraumas that are invisible to the eye and not accompanied by pain. They often occur during sexual intercourse;
closed fracture of the penis, in which the integrity of the skin is not violated, but hemorrhage occurs;
abnormalities of the immune system;
diabetes;
taking medications;
the presence of narrowing of the lumen of blood vessels, which is characteristic of a disease such as atherosclerosis;
a wide range of connective tissue diseases;
gout – an increase in the level of uric acid in the blood;
deficiency of vitamin E and calcium in the body;
increased levels of serotonin in the body;
the man's age. As the body ages, tissues lose their elasticity and are more susceptible to injury.

The role of a hereditary factor in the genesis of Peyronie's disease cannot be excluded. At a minimum, this is evidenced by Dupuytren's contracture, which occurs in more than half of patients with Peyronie's pathology.

Classification and types of disease

Peyronie's disease can lead to three types of penile curvature: dorsal, ventral, lateral. In the first case, the penis in men “looks” upward; with ventral deviation, it is directed downward, and with lateral deviation, the lateral deformation of the penis is called. Treatment is not required if the curvature is mild, is not associated with pain and does not interfere with sexual intercourse.

Depending on the stage of its progression, Peyronie's disease is divided into:

pain – men complain of severe pain not only during an erection, but also at rest. Only in isolated cases does the manifestation of pain not bother men, and the reason for contacting a doctor is a well-palpable plaque. Often its size does not exceed two centimeters;
functional - in addition to causing pain, such an illness leads to the inability to lead a normal sexual life.

Since Peyronie's disease has a very high tendency to progress, self-diagnosis and, especially, self-medication are unacceptable here. If pain occurs in the head and body of the penis, you should immediately consult a urologist. Only at this stage is consultation with this specialist effective and can prevent the disease.

Big eggs as a natural phenomenon

After our modest studies in the field of gravitation and cosmology, I wanted to talk about fun, lightweight things to relieve myself. A good topic was suggested by a scientific news feed: why do some male individuals have large testicles, while others have average ones?

“Big eggs” is a sacred theme in the Russian sector of the noosphere. For example, the respected Ksenia Sobchak argues with the no less respected Eduard Limonov about material inequality. And now remarks are heard: businessmen, they say, should receive more hired workers, because they have stronger balls. That is, society is ready to reward carriers of this trait with a ruble. Sometimes it even happens that they say about a girl, wanting to praise: “A woman with balls.” Although this, of course, is in a purely figurative sense, genetics is silent here.

It is curious that in other cultural areas everything can be just the opposite: society is quite capable of appreciating and fully encouraging the opposite phenotypic trait. Recent publications in Scientific American and Nature vied with each other to promote the Atlanta researchers' scientific paper submitted to PNAS. The essence of the scientific result is well conveyed by the headline in Nature: “The best fathers have smaller testicles.”

Researchers showed male subjects photographs of their children. At the same time, an MRI of their brain was performed: those who were sincerely touched by the sight of a cute baby showed increased activity in a certain lobe of the brain (ventral noradrenergic bundle). Meanwhile, in another room, their friends, mothers of toddlers, were being asked: how does daddy behave? Predictably, the ladies praised those fathers who had more touching brain activity. And finally, biometrics: all this correlates with the volume of the testicles. Q.E.D.

And, in general, there is no sensation: zoologists have long observed that the males of those primates that do not care at all about their offspring (like chimpanzees) have large testicles that produce an awful lot of semen, and so they run from female to female all day long, Well, or they fight among themselves - what kind of parenting is that? With gorillas it’s the other way around: pure paternal tenderness and no left turns. Because walking to the left is encouraged by testosterone and other male hormones, which are partly produced in these indecent places. And people, therefore, have natural variability: some grow huge reproductive appendages and behave like a macho, others devote themselves to their family and try not to get into the thick of things.

It is this very variability that puzzles biologists. It would seem that sexual behavior should be very rigidly fixed by natural selection, then why did nature allow these asexual sussies? And not only in humans: mice, for example, can generally change gender from male to female during prenatal development. This is not to mention the fact that when a pregnant female lives under stress, her baby mice have an increased chance of becoming, uh, ummm, gay - this has been known for a long time, and this, in particular, is the basis for the theory that that homosexual behavior somehow depends on overpopulation and is intended to regulate the birth rate.

My beloved colleague Tata Oleinik recently wrote a very accessible article for Maxim magazine - and the only thing more accessible than articles for this magazine is a game of leapfrog - about where homosexual behavior comes from in animals and people. This, Tata argues, is partly necessary to avoid excessive population growth.

Indeed, if all males run like crazy after females with their genitals at the ready, excessive reproduction cannot be avoided. And this is not the only problem: most likely, they will also darken the peace of their neighbors with endless fights, and problems will arise with the power vertical and with stability. One can easily understand why nature needed something to counteract the inexorable selection pressure that encourages males to endlessly become males (and homosexuality alone is clearly not enough here). But how exactly nature solves this issue is becoming clear literally now.

We are talking about a paper with a boring and long title, published in PNAS by scientists from Cleveland, Ohio (how the deck is weirdly shuffled! Claudia de Rham, whose hypothesis we discussed recently, works at the same university). The researchers, in fact, found out how the SRY gene cassette works - the same one that is located in male humans and male mice on the Y chromosome and is responsible for the development of male characteristics. If she works with all her might, male characteristics (I really don’t want to repeat the word that I used in the title again - well, I used it for advertising, that’s enough) develop without interference, to the fullest. But it turns out that this thing has a clever regulatory mechanism built into it.

The SRY gene product is synthesized in the cytoplasm, and then it needs to enter the nucleus. At the same time, the residue of phosphoric acid is hung on it. Then, apparently, the SRY protein has a little time to sit on that place on the chromosome where it will set off the entire sequence of events leading to the development of one hundred percent macho. But the phosphorylated protein is very quickly removed from the nucleus to the outside. A small shift between exports and imports is enough to upset this fragile balance that determines who the developing individual will become - a macho man or a pathetic henpecked man, forever doomed to play elephant with the kids, never having known the sweetness of adultery.

The essence of the open mechanism is that the effect balances at the level of the sensitivity threshold, and even not very strong environmental factors (intrauterine development) are able to influence the result. Which, in fact, was what Mother Nature needed to combat excessive machismo.

Dr. Michael Weiss, one of the study's authors, explains to The New York Times: "This subtle switch underlies variability in testosterone secretion, producing men with a wide range of gender styles and capabilities that contribute to community survival."

We present these scientific data not only for the amusement of readers, or to once again use the word “eggs” in the title. We really wish the community survival and other benefits. And therefore we say macho: don’t be arrogant, you are such not by your own merit, but by the permission of nature (or rather, the SRY-dependent regulatory mechanism of embryogenesis). And to the henpecked people we say: don’t despair, nature needs you, you are not losers, well, at least look at how sweet your little one is growing. And in conclusion, we say to the ladies: ladies, you see how vulnerable and sensitive we are to factors. At least don't add it.

How dangerous is the disease? Symptoms of Peyronie's disease

Peyronie's disease is dangerous not only because it leads to curvature of the penis. The progressive development of fibrous plaques causes pain during erection, which makes sexual intercourse impossible. Ultimately, Peyronie's disease leads to the development of erectile dysfunction.

The most common symptoms of Peyronie's disease are:

Pain in the penis during erection (enlargement and tension of the penis during sexual arousal).
Curvature of the penis to the side, to the side of the abdomen, towards the sac.
The presence of a compacted area under the skin of the penis.
Deterioration of erection. During sexual arousal, the penis does not enlarge and does not harden to the required volume.
Functional shortening of the penis. A decrease in the size of the penis is not due to a decrease in length, but to its curvature.

How does a chronic process manifest itself?

If you ignore the symptoms of an acute condition, then orchitis and epididymitis can become chronic.

Chronic orchitis can only be indicated by pain in the testicle when touched or during active movements. Chronic epididymitis manifests itself with the following symptoms:

constant increase in temperature to subfebrile values;
soreness of the scrotum;
discomfort and even pain in the area of the appendage of the testicle.

In the chronic course, there are no pronounced signs; the man feels a general malaise and periodic moderate pain in the scrotum area, which subsides and then worsens again.

Diagnosis of Peyronie's disease

As a rule, the characteristic clinical picture of the disease and the presence of an inflammatory process of the penis in the anamnesis do not leave any questions about the diagnosis. For more accurate information about the number, location and structure of plaques, instrumental research methods are used. The results of ultrasound and radiography can become irreplaceable information when choosing the volume and method of surgery.

What exactly and how does a urologist andrologist check? Let's take a closer look. First of all, information is collected regarding the time of onset of the first symptoms of the disease and previous illnesses of both the patient and his immediate family. This is done to identify the cause of the expression or confirmation of a hereditary factor. Next, the patient fills out specially designed tests aimed at determining the quality of sexual life; direct examination by a urologist of the genital organ in a state of erection. This process will be accelerated if the patient himself brings a photo of the penis in different projections. An ultrasound of the vessels of the penis is prescribed - it is carried out to assess blood circulation in the area of the lump. If necessary, an MRI of the genital organ is performed - the technique makes it possible to obtain a layer-by-layer image of the tissues of the organ. This is the most informative diagnostic method, allowing you to determine the location of the plaque and its volume. Cavernosography is the introduction of a special contrast agent into the internal structures of the penis and radiography.

Preventing egg allergies in adults at home

– Any prevention and treatment of true allergies is to remove the allergen. If you are intolerant, then you just need to reduce the quantities, says the specialist.

If allergies occur, it is recommended to keep a food diary. Track your actions, how your body reacts to a particular product. Write down what you eat and what symptoms appear. A diary will help you and your doctor quickly identify triggers - what causes allergies.

Prevention of Perioni's disease

Since the exact causes of the disease are still unknown, it is difficult to offer specific prevention of Peyronie’s disease. However, men are advised to adhere to a certain lifestyle to minimize the occurrence of the disease.

Healthy lifestyle (healthy diet, exercise, regular checkups).
Wear comfortable underwear and loose pants.

Article information

Last update	April 21, 2021
Next update	April 21, 2022
Author	Potapov S.A.
Medical editor	Doctor Plekhanov A.Yu.

Bibliography

Guidelines on Penile Curvature; European Association of Urology (2015)
Bilgutay AN, Pastuszak AW; Peyronie's Disease: a Review of Etiology, Diagnosis and Management. Curr Sex Health Rep. 2015 Jun 17(2):117-131. doi: 10.1007/s11930-015-0045-y.
Gelbard MK, et al. The natural history of Peyronie's disease. J Urol 1990 144(6): p. 1376-9.
Jarow JP, et al. Penile trauma: an etiologic factor in Peyronie's disease and erectile dysfunction. J Urol 1997 158(4): p. 1388-90.