Bend in penis is a common sexual ailment among males. In medical terms, this disorder is known as Peyronie's disease, which is named after a French surgeon, francois de la peyronie, who found this disease in 1743. It is a penis disorder wherein, there occurs hardening of cells, under the skin on one side of the shaft. According to a survey, over 50% of males possess curvature in shaft to some extent. This ailment is characterized as an abnormal angulation of the shaft. Curvature in itself is not harmful, but causes a lot of problems during the intercourse.

This disease is characterized by the plaque, or hard lump, formed inside the male organ. Plaque is formed in the layers of erectile tissues at the upper and lower portion of shaft. It can start as a localized inflammation and gets converted into a hardened scar. If a plaque is on the top of the penile shaft, it causes the shaft to bend upwards, and if the plaque is on the underside of the penile shaft, it causes the male organ to bend downwards. If the plaque develops on both top and bottom, it causes shortening of penis. This sexual ailment causes a great deal of difficulty in the intercourse, making the entire process painful. It further causes significant emotional stress.

Causes

The factors responsible for development of this disease ranges from mild to severe. The symptoms may develop overnight and at a slower pace. The formation of plaque reduces the flexibility, causing severe pain and makes the shaft bent into an arc shape during the erection. In certain cases, the pain subsides over a period of time, but bend in the penis causes a lot of problem during the intercourse process. It effects the physical and emotional part of the relationship.

The plaque in non-cancerous in nature. It effect intercourse greatly by causing pain, bleeding and emotional stress. This aliment occurs mainly in the middle age, but younger and older males can also develop it. Most of the males with Peyronie's disease develop fibrosis in other elastic tissues of body. One of the common problem which occurs due to this aliment is Dupuytren's contracture of the hand. Some of the important causes of this disease are listed below -

• Injury that causes bleeding inside the shaft
• Ineffective immune system functionality
• Abnormality in men's collagen (Tissue binding substance)
• Hereditary

The main cause of this disorder is not very well understood, and therefore the doctors treat this disease empirically. Which means that they believe in continuing with the method that give better results. The main aim of the therapy is to maintain the sexual activity of an individual, by providing a proper education about the disease and its course. In cases where the bend becomes stabilized and deformity prevents the intercourse process, surgery is the recommended treatment. It has now been established that the erectile dysfunction is only a factor associated with this disorder, which may be may present at times and may not be present.

Course and Diagnosis

It has been believed by the researchers that Peyronie's disease is caused due to some kind of wound or trauma, which may result in localized bleeding inside the organ. There are two chambers running across the length of the penile shaft called as corpora cavernosa. There is a sheath of elastic fiber, on the inner surface membrane of the chamber. Septum attaches the two chambers at the top and bottom. If the shaft is bent beyond usual limit, then the portion of septum is stretched beyond certain limit, which eventually ruptures the lining of the erectile chamber and ruptures the blood vessels. With the increasing age, the elasticity near the point of attachment of the septum is decreased which increases the chances of injury. The healing process takes a long time due to repeated trauma and minimal blood flow. If the healing takes place on time, then the plaque does not persist beyond the initial inflammatory phase, but if the healing process takes a longer time, then the plaque undergoes fibrosis or deposition of calcium.

Peyronie's disease can be diagnosed only by the process of physical examination. The plaque can be seen during erection as well as during flaccid state. A proper treatment requires a complete examination during erection to determine the extent of this disorder. Erection can be caused by injecting medicine into the organ or by self-stimulation. The medical examination may include an ultrasound scan of the male organ to determine the location and extent of the plaque. This is done to determine the blood flow throughout the shaft.

Treatment

Bent to a some extent can be corrected by proper exercises. For gradually straightening the curve, more emphasis needs to be placed on development of the shorter of the two chambers in the penile shaft. Some specific stretching exercise that are capable of over stimulating the weaker and shorter side. A minor curve can be completely cured by such exercises in a couple of months. For penis with more than 30 degrees of curve, a takes a few more months to fully develop the weaker section of the erectile chamber.

Experimental Treatments - Certain research indicated that consumption of vitamin E orally can cause a great amount of improvement in the Peyronie's diseases. Some other chemicals like para-aminobenzoate, a molecule of B-complex family, are also effective in improving this disorder. Steroids, like cortisone, when used produces unwanted side-effects, such a atrophy or death of healthy tissues. Use of a painless current of electricity to deliver some agent under the skin into the plaque is also considered to be effective. Radiation therapy, where in high energy rays are aimed at the plaque, also helps in treating this disorder.

Surgery - Peyronie's disease can be effectively treated by surgery. In this either the plaque is removed completed and followed by placement of a patch of skin, or removing the tissues from the side opposite to the plaque, which reduces the bending effect. The first method can cause partial loss of erectile function and second can cause shortening of the male organ.

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