Talk about a sore subject for men.
A little-known condition that can lead to penile shrinkage and a host of other undesirable symptoms is in the spotlight thanks to HBO’s newest crime drama, “DTF St. Louis.”
David Harbour’s character, Floyd, suffers from Peyronie’s disease (PD). Believed to affect 1 in 10 men, PD is characterized by the formation of fibrous scar tissue or plaque under the skin of the penis.
This scarring causes the penis to curve, resulting in painful erections and even a shrinking or shortening of the phallus when erect.
While curvature in the penis is not necessarily cause for concern, the bend can be extreme and excruciating for PD sufferers.
Each side of the penis has a spongelike tube that features many tiny blood vessels, per the Mayo Clinic.
The blood flow to these chambers increases with sexual arousal, causing the penis to straighten when stiff. But in cases of PD, the scarred area doesn’t stretch when the penis becomes erect, causing the member to become disfigured and possibly painful.
While the causes of PD aren’t completely understood, these bent bones generally come from repeated injury to the member during sex, masturbation, sports or a freak accident.
In some cases, the askew penis develops gradually over time, and the disease is more common as people age, with the average age of onset clocking in at 57.
Experts believe the condition is underreported, with patients citing embarrassment or fear of treatment as roadblocks to reporting their symptoms.
Indeed, a 2021 study in the Journal of Men’s Health found that 27% of PD sufferers had clinical depression.
PD has two phases — active and passive.
During the active phase, which can last for over a year, the scar tissue is still forming, and the penis is gradually becoming more crooked. In this oft-painful interval, intervention is futile, as the member will continue to bend.
During the passive phase, the penis ceases to bend, and the pain may disappear entirely. It’s in this window of time that the shaft can and should be righted.
PD rarely resolves itself without medical intervention. Typically, the condition will remain steady or slightly intensify over time.
PD is often a key indicator of vascular and metabolic health, and acompanying conditions include high cholesterol, diabetes and high blood pressure.
Due to these dangerous associations, seeking early treatment for PD is critical.
Patients with PD are typically treated by injecting the penis with Xiaflex (or collagenase), which, over the course of several months, breaks up the penis plaque. Side effects include swelling, bruising and pain at the injection site.
Patients can also straighten the phallus with traction devices such as RestoreX.
In rare cases, the surgical implantation of a penile prosthetic is necessary to restore erectile function.
Symptoms of PD
- Scar tissue: Also known as plaque, the accumulation of scar tissue under the skin of the penis can feel like flat bumps or a hard band.
- Curvature of the penis: The member might curve upward, downward or bend to one side.
- Erectile dysfunction: PD can compromise a man’s ability to get or maintain an erection. PD patients often report symptoms of erectile dysfunction that precede other penile symptoms.
- Shortening of the shaft: The penis might become shorter during erections.
- Painful reminder: Pain may occur with or without an erection.
- Other changes in how the penis looks: For some PD patients, the penis might change shape, appearing narrower, indented or assuming an hourglass profile with a tight, narrow band forming around the shaft.
Experts urge anyone experiencing symptoms of PD to seek health care as soon as possible.
For patients who have been experiencing symptoms for some time, a checkup is recommended to address any pain or changes affecting their quality of life.
