Men's health issues, especially Peyronie’s disease (PD) and erectile dysfunction (ED), remain riddled with prejudice. These conditions are widely misunderstood across society, yet millions of men suffer from their physical and emotional tolls in silence. The stigma surrounding PD and ED is pervasive; to help destigmatize these topics and discuss them openly, host Dr. Joe Pazona — who is a board-certified urologist — and his guest Ken Mitchell, a physician assistant specializing in men’s sexual health, discuss in a new edition of the Balls Deep podcast. Here’s what you should know about the diagnosis, treatments, and more about Peyronie’s disease and erectile dysfunction:
What is Peyronie’s Disease?
Midlife changes marked by trauma or surgical injuries can lead to Peyronie's disease. PD is characterized by penile curvature due to accumulation of plaque that comprises fibrous tissue within the shaft. Its symptoms include pain, reduced intimacy stemming from complications with erections or loss of length, and a major devastation disrupts psychosocial well-being.
How is Peyronie’s Disease Diagnosed?
Diagnosis comes through a thorough investigation that straightforward and respectful:
- Physical Exam: A specialist examines curvature, lumps, or bumps.
- Photo Evidence: Yes, if you need to bring a private photo of your erection to assist in assessing the curvature, then “dick pics” are indeed welcome.
- Erection Induction: Replicating an erection with an injection for visualization of the issue during office visits is possible.
- Penile Doppler Ultrasound: Examining blood flow and plaque location simultaneously.
"It’s not as bad as you think," Mitchell says. "Men almost always say it wasn’t painful.”
What About Online Creams & Pills?
In short: save your money.
Most internet remedies are lacking effectiveness. Despite this, there is a new topical verapamil formulation that has promise which may assist in the early inflammatory phase (first 6-12 months) of the disease process.
The Gold Standard: Collagenase (Xiaflex®)
Xiaflex is the only FDA approved medication for treating Peyronie’s disease.
- How it works: This enzyme is injected directly into scar tissue (collagen) which scars.
- Criteria: 30° or more curvature, symptoms for at least 6 months, ideally no pain.
- Treatment Cycle: Two injections per cycle accompanied by stretching exercises outside of the clinical setting.
- Post-Cycle: No sexual activity for 4 weeks.
Stretching increases tissue pliability facilitating the straightening process aiding compliance essential in avoiding complications after injections.
Traction Devices & Vacuum Therapy
RestoreX’s traction devices and vacuum erection devices (VEDs) are mechanical aids that serve to stretch and lengthen the penis. Sometimes they are used with injections or as standalone methods for milder cases.
- Improve outcomes
- Some covered by FSA/HSA
- Should be used under clinical supervision
Surgery: A Last Resort, But Effective
Surgeries may be done in advanced situations or when previous treatments have not worked
- Plication Surgery: This surgery can straighten penises by shortening them through tissue removal on the convex side.
- Plaque Excision & Grafting: This procedure takes out some plaque and puts a patch to fill the space.
- Penile Implants: For patients suffering from severe ED and PD, these implants provide restoration in both function and form permanently.
Experience Matters: Choose the Right Provider
Not every urologist or clinic is specially suited for such problems.
- Men’s sexual health specialists tend to have deeper knowledge alongside many years of practice dealing with these conditions.
- For non-invasive treatments, nurse practitioners and physician assistants have undergone more training which enables them to perform those procedures.
- While qualifications matter, compassion, skill, volume performed, and experience make a world of difference.
Final Thoughts: You Do Not Have to Bear the Burden Alone
Receiving appropriate treatment and help makes Peyronie’s disease manageable. With guidance and support, there is no need to suffer alone.
“Torture is not doing something about it,” says Mitchell. “That’s torture.”
Diagnosis and treatments for Peyronie’s disease are more simple than you may expect. For more information about this condition, take a look at our guide to Peyronie’s disease.
Disclaimer: This blog is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for personalized guidance.
