Dr Antoine Faix, urological surgeon, explains why you should not wait to consult.
A penis that shortens by several centimeters, which gradually becomes deformed… It’s hard to believe, but it’s a reality that many men experience,“3 to 9% of those over 50” according to Dr Antoine Faix, urological surgeon and President of the French Urology Association (AFU). The culprit: a disease that is much more common than we imagine, yet remains largely unknown to the general public.
The corpora cavernosa of the penis are surrounded by a membrane called the albuginea, which is naturally flexible and extensible. It is thanks to this elasticity that the penis can become engorged with blood and increase in volume during erection. The disease appears when a plaque of fibrosis forms on this membrane. “Like a burn scar on the penis shell”explains Dr. Faix. This area then becomes rigid and prevents the tissue from stretching normally: during erection, the penis curves towards the fibrosis area and can even lose length. “2, 3, 4, even 5 cm”says the doctor. Symptoms vary from one patient to another: erection pain, deformation of the penis, reduced rigidity. “Some men have all the symptoms, others just one or two.”
This pathology has a name: Peyronie’s disease. Among the contributing factors, heredity can play an important role: having a father or grandfather suffering from fibrous diseases, “not necessarily at the level of the penis, it can be diseases at the level of the hands (Dupuytren’s disease) and the feet (Ledderhose disease)”. Microtraumas linked to sexual intercourse can sometimes also lead to “poor healing” at the origin of the plaque. Finally, hypertension and diabetes would also be factors favoring the appearance of the disease. Peyronie’s disease is not life-threatening, and although it is rather common, the most advanced and disabling cases remain rare.
However, its psychological repercussions can be devastating. Some patients see their penis curve to 45°, 60°, or even 90°, making sexual intercourse difficult, sometimes impossible. Dr Faix speaks of a “possibly very significant sexual disability”. For a man who had been doing well until then, seeing his body transform almost overnight can trigger profound distress. The urologist gravely confides: “I have patients who are depressed and even have suicidal thoughts. It’s really a disease that has a very psychological impact, but also on the partner.” A heavy burden to bear, especially when we know that some people tend to keep everything to themselves.
If there is no curative treatment, treatment exists and targets the three types of symptoms: pain, rigidity and deformation. For pain, anti-inflammatories, low-intensity shock waves or hyaluronic acid injections can provide real relief. When erectile dysfunction persists, “we can give drugs from the phosphodiesterase-5 inhibitor family such as sildenafil, tadalafil, vardenafil, avanafil”. As a last resort, after at least six months of stability without improvement, surgical intervention to correct the deformity, or even, in certain cases, the placement of a penile implant, may be considered. Dr Faix’s message is clear: “You need to consult and you shouldn’t wait too long. There are therapeutic options to improve the situation and avoid worsening.”
