Peyronie malady is manifested by the presence of a tough plaque on the penis. The causes of this condition are less well known. Peyronie’s Disease is formed either on the top of the penis or on the lower one, so that the plaque intersects the tissues involved in the erection. In the final stage it can develop into a hard scar.
This disease can evolve over time or overnight. In severe cases, due to the hardness of the plaque, penile flexibility also reduces, so the pain is accompanied by the penis that during the erection has a bow form. It is possible that the pain may decrease over time, but penile curvature persists, causing difficulties during sexual intercourse.
When men encounter such problems, they often call for help from their doctor when the erections are very painful and are experiencing difficulties during sexual intercourse. The goal of therapy is to keep the patient as active as possible from a sexual point of view. However, for long-lasting cases, it is the surgical resolution of the condition. A short-term remedy is the use of vitamin E, local injections of steroids, verapamil, interferon or radiopathy.
Surgical treatment is indicated when medical treatment has not yielded results or for patients who have complex penile sprains and erectile dysfunction.The operation is done when the disease stabilizes and takes into account the following factors: plaque size, qualification, location, penis shape, cramping degree and erectile dysfunction. Currently there are the following surgical options:
- Bleached follicle
- Incision of plate and grafting
- Penile prosthesis with or without manual penile modeling or plaque incision and grafting
- Bleached follicle It is made on the convex face of the curvature of the penis whose length is reduced to the length of the concave face, which will have the effect of shortening the penis.
It is made on the convex face of the penis curvature whose length is reduced to the length of the concave face, which will have the effect of shortening the penis.
The Nesbit process
The follicular follicle is made after the excision of an elliptical portion of the convex face of the penis, followed by the transverse suture of the defect thus created.
The Yachia process
The follicular follicle is made after the longitudinal incision of cavernous corpus cavernosum on the convex face, followed by the transverse suture of the albuginea mages.
It consists of enveloping the albugaine on the convex face without affecting its integrity.
Incision of plate and grafting
It has the advantage of maintaining the length of the penis, but the risk of erectile dysfunction is greater.The procedure consists in transversal incision of the plaque followed by penile straightening and covering the resulting defect in the albumin with a synthetic (grafting) material: pork intestinal submucosa (SIS), pig skin dermis (Indexen) or bovine pericardium.The procedure is indicated when the penis curvature is over 45 degrees, a small penis and the absence of any erectile dysfunction.
It consists of introducing flexible or inflatable cylinders into the cavernous body to obtain a stiff penis sufficient to achieve sexual contact.In Peyronie disease this technique is indicated when the disease is accompanied by erectile dysfunction.When the penis is under 30 degrees, the insertion of the prosthesis can lead to straightening it. A larger rupture requires, after insertion of the prosthesis, the penis straightening by hand or by incision of the plaque and applying a graft.