Peyronie’s disease, characterised by a bent penis, is a secretive medical condition that often remains unheard of until it directly affects individuals or their partners. In fact, most people have never heard of it. Despite its relative obscurity, this major condition impacts up to 1 in 10 men in the UK, casting a devastating shadow over relationships and men’s overall sexual and mental well-being.
Understanding Peyronie’s Disease:
Contrary to the ominous undertones of its name, Peyronie’s disease is not fatal, you cannot pass it on to someone else, and does not jeopardise one’s general physical health. However, this seemingly benign medical condition profoundly affects men who grapple with its life-changing consequences, especially in connection with their sex lives.
The Chief Culprit: Deformation of the Male Organ:
The hallmark of Peyronie’s disease is the progressive deformation of the penis, occurring suddenly or gradually. The deformity is indiscriminate, with the most common being an upward curvature, ranging from a subtle banana-like bend to an acute angle of 90 degrees or more. However, it can manifest as a curve or bend in any direction, including sideways or downwards. Some unfortunate individuals even experience a double bend in different directions. Additional symptoms include indentation, creating a chunk-like appearance in the erect penis, or an hourglass shape, where the middle narrows like an hourglass.
The Symptoms Don’t Stop There:
Beyond the visible deformities, many men experience weakening erections, full-blown Erectile Dysfunction, and shrinkage. In severe cases, the erect penis can shrink in length by between 25% tp30% and lose significant thickness. Peyronies disease can lead to partial or severe erectile function as well as a lack of hardness after the bend or deformed area. Pain is common in the early stages, ranging from severe to slight throbbing, and sexual sensitivity often diminishes. The condition can progress over and extended 18-month period, before it stabilises.
The Psychological Toll:
For those afflicted, the ramifications extend beyond the physical, rendering sexual activity exceedingly challenging and, in many cases, sadly impossible. The psychological impact is staggering, with studies indicating that 90% of men with Peyronie’s disease suffer from depression. This emotional distress can be attributed, in part, to the embarrassment associated with possessing a deformed penis—a concern ingrained from early adolescence, when societal emphasis on manhood creates undue pressures.
Causes and Prevention:
Understanding the causes of Peyronie’s Disease is important. The most common trigger is injury to the penis, resulting in scarring or fibrosis deep under the skin. Sexual injuries, especially in men in their 50s, can lead to acute pain and deformity. Sporting injuries, such as those in rugby or impacts from cricket balls or karate kicks, are also common contributors. Certain medical conditions, such as Dupuytren’s Disease, Lederhosen Disease, diabetes, and high blood pressure, increase susceptibility. Surgeries impacting penile blood flow, like prostate cancer surgery, can also lead to Peyronie’s Disease.
Seeking Answers and Advice:
For those recently diagnosed or waking up with a bent penis, seeking information and advice becomes paramount. The UK Forum run and moderated by Peyronie’s disease sufferers provide valuable insights. However, NHS resources may offer limited information on treatment options available only within the NHS.
Navigating Treatment Options:
In the UK, the first step usually involves consulting a local General Practitioner. However, expectations of extensive knowledge on Peyronie’s disease from General Practitioners may be unrealistic, leading to referrals to Urologists. Unfortunately, NHS Urologist wait times, exceeding two years in some cases, pose a significant challenge. Private sector Peyronie’s disease clinics, like MansMatters in Knightsbridge Central London, may provide more diverse treatment options.
Surgical Approaches:
Nesbit Technique, Penile Implants, and Surgical Grafting are the three main surgical approaches. Nesbit involves shortening one side of the penis to match the scarred side, resulting in a straighter but shorter erection. Penile implants, reserved for cases with severe deformity Erectile Dysfunction, involve surgically implanted prostheses that create an erection and straighten the penis permanently. Surgical grafting, much less common today, removes scarring and replaces it with a graft, with reported risks of developing Erectile Dysfunction.
New non-invasive treatments
Beyond NHS options, many new treatments have emerged in the last decade which include extracorporeal shockwave therapy, Electro Magnetic Transduction Therapy (EMTT), NanoVi, penile injections, and stem cells. All of these treatments offer hope without the need for surgery. Today we will concentrate on one treatment that is making traction all around the world: shockwave therapy.
Shockwave therapy originated as a treatment for conditions like kidney stones and musculoskeletal injuries such as tendinitis and plantar fasciitis. Its efficacy in these areas spurred further exploration into its applications for other conditions where calcium deposits or scarring needed to be broken down, leading to its use in urology and sexual medicine. The regenerative and vasculogenic properties of shockwave therapy made it an innovative approach for conditions like Peyronie’s disease (PD) and erectile dysfunction, which has transformed the landscape of sexual health treatments. Now many men, who previously would have undertaken surgery opt for shockwave therapy as an alternative treatment.
The concept of shockwave treatment for Peyronie’s disease was introduced in 1989, with researchers hypothesising its similarity to shock wave lithotripsy (kidney stones), breaking down plaques associated with PD. The advent of Low-Intensity Extracorporeal Shockwave Therapy (Li-ESWT) sparked renewed interest, with the first case-control study in 2000 reporting promising results. Numerous subsequent studies have prompted the European Urological Association to endorse this treatment for alleviating penile pain associated with Peyronie’s disease and now today Peyronie’s disease is the most popular, non-surgical treatment available to sufferers of this condition.
Peyronie’s Shockwave Therapy employs low-intensity sound waves targeted at the affected area of the penis, stimulating healing processes, enhancing blood flow, and breaking down fibrous plaques. As early as 2003, the National Institute for Health and Care Excellence (NICE) recognised its efficacy, citing benefits such as pain relief and reduction in penile curvature.
This non-invasive treatment is administered over multiple sessions, and its effectiveness depends on the severity of the condition and individual response. A notable advantage of Peyronie’s Shockwave Therapy is its non-invasive nature, offering a more appealing option for those averse to surgical procedures. It does not require incisions or anaesthesia, making it a preferable choice for individuals seeking alternatives to invasive interventions. Today shockwave therapy is often combined with electromagnetic transduction therapy, the Nanovi, a penile pump and medications and supplements. This multi treatment approach, significantly improves outcomes.
Moreover, the therapy assists in reducing pain and penile curvature associated with PD. A study in the Asian Journal of Andrology in 2022 showcased improvements in penile curvature from 31° to 17° using Low Intensity ESWT (LiESWT), along with a decrease in penile pain and plaque size in patients treated during the acute phase of PD.
There are a number of clinics in the UK that offer shockwave and EMTT technology for Peyronie’s disease and Erectile Dysfunction. Shockwave Clinics ltd in Knightsbridge, central London have been undertaking these treatments for over 10 years. Their Urology specialists have refined techniques based on client age, other conditions suffered and condition severity. Despite scepticism fuelled by early machines’ partial effectiveness, recent advancements in equipment and concentrated treatment protocols show significantly improved results. The latest Swiss-engineered Shockwave equipment, with an energy transfer of 1.24, surpasses all others, and Shockwave Clinics Ltd, clinicians’ extensive experience ensures optimal results based on hundreds of successful treatments.
