Peyronie's disease

First described by French physician, Francois de la Peyronie, in 1743, this condition is characterized by a plaque or a patch of scar tissue that forms on the tunica albuginea and penetrates into the cavernous tissue. This plaque, depending on its location, may cause penile curvature (usually dorsal, possibly other directions) or sometimes an hourglass appearance due to indentation in the middle of the shaft, with possible narrowing from the indentation toward the glans penis. This deformity may lead to vascular anomalies, which may result in ED. If untreated for a long time, about 40% of Peyronie's disease cases progress, about 47% do not change, and about 13% spontaneously regress.

Peyronie's disease afflicts about 0.4% to 16% of men worldwide. In one study of 4,432 middle-aged German men, its incidence was about 3.2%. Despite extensive study, its etiology is still unknown, but there are several theories. One is genetic, based on the association of Peyronie's disease with a genetic condition called Dupuytren's contracture of the hands as well as with the presence of certain genes called HLA-B27 subtypes. Other theories include an autoimmune reaction forming antielastin antibodies against the body's own tissue, abnormal wound healing due to a genetic predisposition, and injury resulting in a plaque of collagen.

Currently the most accepted theory of the etiology of Peyronie's disease is that repeated physical trauma during intercourse leads to bleeding, deposition of fibrin (a blood substance involved in the clotting process), inflammation in the tunica or beneath it at the septum dividing the corpora cavernosa, and overproduction of cytokines by inflammatory cells such as T lymphocytes.