Podcast episode (hosted by Dr. Anne Truong MD) explains what Peyronie's disease is: fibrous scar plaques in the tunica albuginea that prevent normal expansion of the corpus cavernosum and cause penile curvature, pain, and sometimes erectile dysfunction. The episode covers anatomy, causes and risk factors (trauma, medications, genetic and systemic associations), diagnosis including ultrasound, and treatments ranging from platelet-rich plasma and shockwave therapy to surgery for severe cases.
In this episode, I'm going to talk to you about Peyronie's disease, what that is and what causes it. So I'll see you on the inside. So stay tuned.
This podcast is for you. The modern man. I'm Dr. Anne Truong, your host. I'm an intimate health medical doctor and best selling author of the book Erectile Dysfunction Fix. I'll do a deep dive into sexual health and performance and how it affects men of all ages and backgrounds. Sexual so let's get started and be sure to visit my website@sexualhealthformenpodcast.com for more information and resources from the show. See you on the inside.
What is Peyronie's disease? Well, Peyronie's disease is more common than we think and sometimes it is unknown. So we're going to dive into it a little bit today and I'm going to tell you some treatment and some causes of Peyronie disease. If you are watching this on YouTube you can see my slide. I'm going to try to explain this as much as I can and for so that way you can understand. Peyronie disease is actually caused by inflammation which is caused by a fibrous knot or like a scar knot that is in the tunica albuginea. The tunica albuginea is a wrapping that wrap around the poison corpus cavernosum or the two the main muscle of the penis. Really. And think think of a muscle of the penis like a sausage and it has a wrapping on the outside and the tunica albuginea is the wrapping for the sausage. What it does is that because it's fibrous, it's not stretchable. When the penis muscle, which is made out of smooth muscle, enlarges from an erection, it it is compressed against the tunic albuginea. When that happens, the veins that are in the corpus cavernosum or the penis muscle gets compressed and that's how you maintain an erection. It's almost like the blood flows into the penis, the penis muscle engorges and as it engorges, the muscle is compressed against that fibrous lining or the tunica albuginea. And then the blood is stopped. It's like the veins it gets compressed and the blood is stopped from going back outside of the penis. And that's how you maintain an erection. Now ed happens when the veins are not completely compressed or that the vein starts leaking and that's when you start seeing issues of decreased firmness or you have an erection and then you lose the erection. And the majority of ED issues is really due to inadequate veins being compressed. Now Peyronie's disease is that at the lining where the tunic aboriginea, the wrapping that I was talking about, it's a scar tissue in there, like a scar tissue. Think of a scar tissue like a knot that is hard, that is in the wrapping outside the corpus cavadosum. And the knot or sometimes called plaques impair the expansion of the corpus cavadosum or the penis muscle to, to expand. And when it, the knot is there, it causes the penis to bend. And sometimes the penis can bend down or can bend up or bend to the right or to the left. And sometimes it can severely bend from you know, mild to 10 degrees to about 90 degrees. And it could be painful as well too. And there are three stages to Peyronie. It could be an asymptomatic age and, and then going all the way to the painful stage and to the stage that you see a lot is associated with ED. Now 60% of patients with Peyronie's have ED. But when you start having ED is in the latter part of the Peyronie disease at that time. Other causes of Peyronie's disease that is not from, not from inflammation. Inflammation is vitamin E deficiency, taking beta blocking medications like atenolol and Metoprol and usually used for heart disease or even high blood pressure and high levels of serotonin level, excessively high levels and sometimes depression medication raises serotonin level. Now this is no indication to say that hey, you have Peyronie stop these medications. I'm not saying that, I'm just saying that it could contribute to it. And you need to talk with your doctor before you wean yourself off of any medication. And then other common causes from trauma or fracture of the penis or just trauma to the penis from long time ago. And peroneal disease could be genetic. It could also be from Paget disease of the bone. It could be from a condition called dupuytrent contracture. Dupuyn contracture is when you have a knot or scar tissue that is in your palm and it tends to bend your fingers. And sometimes you can't pull it out, sometimes you can and you hear a little click when it goes from when you try to extend it out. And it's also associated with autoimmune like I talk about. And in conditions such as rheumatoid arthritis. It also can be present in patient that has high blood pressure Diabetes, smoking. And the incidence is between 1 to 8% in men ages from 40 to 70. And this is a schematic picture the bending of the penis and of the plaque. What you see the red color and the plaque that, that is part of the, that's the plaque is what is causing the bending of the penis in the tunica albuginea. And this is on YouTube. You can actually see this. You see the buck's fascia there and then you see the white and the picture down below you see the arrow that's pointing to the scar tissue, netunica albuginea. Then this is the picture that is seen on ultrasound and it shows up as a white plague at the curvature. And I can actually see this when I used ultrasound machine to do a penile Doppler ultrasound to assess for blood flow of the penis. But I also look for plaque that are in the tunica albuginea because sometimes the plaque can be small that the man does not notice it. But I can see it on ultrasound. And this happened quite frequently when I'm evaluating man for ed. And we look at the ultrasound, we actually see the, the small plaque that is in there. And then you can actually feel it. And most men can actually feel where the curvature is, that it feels like a knot. It feels kind of fibrous and hard. And sometimes it ranges from a small BB gun type like knot to even like a pea size knot as well. And sometimes it will run along the course of the penis as well. And there has been multiple studies that have shown that Peyronie's disease can actually be treated with injections of platelet rich plasma that I talked about my last episode. Platelet rich plasma is the platelets that come from your blood that the doctor will harvest out of your blood and from a centrifuge and then re inject it again into that knot that I mentioned that was causing the curvature to be smaller and to break up the knot. So it has been shown multiple studies that it has worked and, and that you don't have to live with it. But if the curvature is significant and it does not go away with using platelet rich plasma or PRP and a combination of shockwave therapy. And if you listen to my episode in the past when I'm talking about shockwave therapy, Shockwave therapy is the machine that actually will use sound wave energy will break up the, the scar tissue. If you have such significant peyronie that PRP and shockwave therapy doesn't improve it, then you, you should consider surgery. I recommend doing PRP first and at least six to 12 sessions of shockwave therapy with the Focus Shockwave. Maybe even on top of radial Shockwave as well too. So stay tuned. I'm gonna talk about Shockwave therapy and why that is the next innovation for ed and I'd appreciate you staying with me and drop a comment down below and let me know whether you have Peyronie's or not. And have you seen a doctor about that? I'd love to hear from you. See you in the next episode.
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