PEYRONIES & ED – The connection

[Tim468]

This is Russian language and not available to me - the abstract is intriguing.

Suggest commonalities in those with ED and Peyronie's - increased collagen and odd morphology.

Tim

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Full Text Link Available
UI 20358778
AU Neimark AI.  Klimachev VV.  Gerval'd VIa.  Bobrov IP.  Avdalian
 AM.  Muzalevskaia NI.  Gerval'd IV.  Aliev RT.  Kazymov MA.
FA Neimark, A I.  Klimachev, V V.  Gerval'd, V Ia.  Bobrov, I P.
 Avdalian, A M.  Muzalevskaia, N I.  Gerval'd, I V.  Aliev, R T.
 Kazymov, M A.
TI [Normal connective tissue in penis and its changes in patients
 with erectile dysfunction and Peyronie's disease]. [Russian]
SO Morfologiia.  136(6):75-8, 2009.
AB The aim of this study was to examine the connective tissue of
 penis in normal individuals and in patients with erectile
 dysfunction (ED) and Peyronie's disease (Peyronies Disease) using computer methods
 of image analysis. Penis tissues were obtained from 20 males aged
 20-40 years who died in accidents, penis biopsies were taken from 23
 patients with ED and 9 patients with Peyronies Disease (average age: 51 +/- 11.5
 years). In both groups of patients, the volumetric fraction of
 collagen fibers in the tunica albuginea and corpora cavernosa was
 increased, while that one of elastic fibers was decreased. At the
 same time, the changes of elastic fibers were noted: the fibers
 become thinner and formed "rods". The reduction of the amplitude and
 the wavelength in the collagen fibers of the tunica albuginea in
 patients with ED and the presence of fibrous plaques in corpora
 cavernosa in in patients with Peyronies Disease were registered. The methods of
 computer image analysis may improve the morphologic diagnosis of ED
 and Peyronies Disease.
PT English Abstract.  Journal Article.

[TheLastRobot]

Hi all,

I don't know for sure I had Peyronies Disease - my symptoms came up recently but are a pretty convincing textbook case of it. I have a lump along the middle of the underside of my shaft, mostly painless, and when I get hard I think I have some kind of swelling at the base of my penis too, though I might be imagining that. Twice since I first noticed this a week have I been unable to keep erect - the size of the swelling has been varying and in its largest state is when I can't get hard properly. The only thing that is strange is that I don't have any significant curvature, except that my penis might be slightly twisted to the left!

I am 18 and despite how terrifying the idea of developing some kind of penile disorder that can cause me ED is, I'm trying to keep optimistic - at least I'm not dying! That said, my main interest is minimizing the impact this has on my sex life, if I do indeed have Peyronies Disease.

So, to get to the point:

What in Peyronies Disease prevents a person from getting it up properly? Is it the lumps (scars?) or the curving of the penis itself? And would medications such as viagra, etc, be able to help me? Are they safe?

Thanks so much for any information you can offer.

[LWillisjr]

First of all, Peyronies Disease does not directly mean Erectile Dysfunction. Often times it is the other way around. Meaning, we get a slight case of ED and don't get as hard as we used to. And this makes one more susceptible to trauma (bending) which can then trigger Peyronies Disease.

My advice for you would be to get to a urologist and see what else might be causing your ED.

[Brightdog]

I had an advanced state of Peyronie's with a frightening amount of bend - but NO problems getting or maintaining an erection. That's one reason why it took so long to get serious attention paid to the problem. I had both hourglassing AND a lot of plaque along the left side, leading to a lateral bend of about 160 degrees. Unfortunately, erections HURT. And because I kept having erections, I kept experiencing the pain.

The fact that I did not have ED does not mean yours isn't caused by Peyronies Disease - it only means there is no guarantee that someone's ED is caused by Peyronies Disease.

[BrooksBro]

For me, ED preceeded peyronies by several years.  I believe viagra-enabled intercourse led to tearing inside my penis, which improperly healed, leaving scar tissue behind.  My curve is significant, but it does not preclude intercourse.  My ED requires multiple Rx drugs and supplements, as well as a vacuum pump and tension ring.

[newguy]

It could be that extreme worry caused by this situation has played some role in your ED too. Of course, there may well be a physical basis too. In your position, since you notied this recently, you're in an ideal position to seek help regarding this problem. Viagra, VED use and so on, can all help with ED problems, and the sooner you see a urologist the better.

[TheLastRobot]

I'd like to thank everyone for all the help they've been offering! You guys are great.

It's looking like my problems may be caused by an internal yeast infection (EDIT: Haha, nope, turns out I'm a sucker and that disease is a scam which I totally bought into), lump and all. However, I do have a couple more things to ask:

Firstly: I had a doctor take a look at the swollen area, and she told me that it looks fine and that my penis is fine, etc. This was not a urologist, mind you. Anyway, she seemed pretty convinced that there was nothing wrong in there. Considering my penchant for hypochondria, I'm apt to believe it. But is Peyronie's something that might only get noticed when your penis is hard?

For those concerned (if anyone is), I've been able to get off lately, but my erections don't come on their own. I've kind of lost my libido and it only really comes back when I force it back. Can Peyronie's do that? Because that is one of the factors that, so far, has been corroborating the yeast theory.

[LWillisjr]

For those concerned (if anyone is), I've been able to get off lately, but my erections don't come on their own. I've kind of lost my libido and it only really comes back when I force it back. Can Peyronie's do that? Because that is one of the factors that, so far, has been corroborating the yeast theory.

If you are able to force erections, then it seems to me that your concern/worry may be what is causing your inability to have erections. Generally Peyronies Disease does not directly impact your physical ability to achieve erections. But for many of us, the whole mental impact of having something wrong with our penis has a strong influence on libido.

[poppedknob]

Hello

Does anyone have venous leakage due to peyonies? And if so, and if you have tried Traditional ED medication like cialis and the like, has this helped with erection?

Thanks

[jackp]

Yes, I have peyronies and venous leakage.

The pills for ED did not work for me and the penile injections did little to no good. The injections also caused corporal fibrosis.

Right now the best thing you can do is the VED exercise to help keep your penis healthy.

When you have tried all other options and still can not complete intercourse than the last option is an implant.

Most guys with peyronies and venous leakage also have penile shortening. The implant of choice for us is the AMS 700 LGX. A good graphic is at www.amslgx.com/

Read my history here or go to my blog http://jackp-penileimplant.blogspot.com/ and read my story "One Mans Journey."

Any questions let me know. I will be glad to help.

Jackp

[BrooksBro]

ED is more of a problem for me than is the curve, and venous leakage is the root cause.  Viagra "helps," but I still need to use a VED and a constricting band to maintain an erection strong enough for intercourse.  I did not find Cialis or Levitra to be any more effective than Viagra, perhaps less so.

The erection drugs work by increasing the blood flow into the penis.  The physiology is that as it expands, the veins (carry blood back to the heart) are compressed to hold the blood.  The plaque prevents the tissue from expanding enough to compress the veins and hold the blood.

Either an implant or vascular surgery appear to be the only permanent solutions.

[Ben]

Traction device have done quite good job for my ED. It makes the penis more expandable and since I use extender I have my nocturnal erection back.
The fibrous tissue has not been destroyed but it's somewhat softer.
I was willing an implant but have fear about lifetime of the device. Maybe if I was older I would have choosen it.
Hope that xiaflex and traction will make life easier for us.

[jackp]

BrooksBro

All the cases I have read about vascular surgery are very disappointing. I have not seen a case that turned out satisfactory.

Jackp
http://jackp-penileimplant.blogspot.com/

[Bennett Nash]

Hi,
Over the last 5 years, my sex drive has gradually disappeared until now I have none at all.  Sometime last November 2010, when there was still a very small amount of libido left, I noticed a sudden change in my penis.  It was pretty alarming because I hadn't seen it coming on at all.  I was only getting nocturnal erections when I was asleep at the time.  Maybe that's why it escaped my noticed, because I first saw it one night when I got up to urinate while I still had one of those nocturnal erections.  In my case there's a sharp crease and bend on one side, somewhere between 45 and 90 degrees.  The other side curves around the outside of the bend.  The lump of plaque is visible as a swelling just below the crease.

My urologist said it looked like an early case of Peyronie's disease and will see me in another few months.  In the meantime he's put me on Glucosamine and L-Carnitine, 500mg each twice a day.  

I'm getting to my questions the long way around I guess.  I was wondering if the complete loss of sex drive and onset of Peyronies' are related in some way.  I have no idea what to think about this.  

Something else I noticed. On the night that I first became aware of Peyronies', that nocturnal erection was pushing against my underwear so that my penis was pushed to one side sharply, the side that has the crease in it.  I don't know if this is because the bend was caused by pushing against the underwear the wrong way, or if it wound up in that position because the bend was already there and it was "easy" for it to push in that direction.

So the questions are:

1. Could pushing against the underwear have caused the bend, i.e. essentially breaking the penis, and then Peyronies followed when scar tissue built up?  I sure don't have any memory of any kind of physical trauma.

2. Is the complete loss of my sex drive related to the onset of Peyronies', or vice versa?

Other info: I'm 60 and my testosterone levels are "normal for a male my age".  Both my urologist and MD say the same thing about that testosterone level.  I'm a little confused on that score, because I thought that 60 year old men with "normal" testosterone levels had at least some sex drive.  How is it that I have none?

Thanks for taking the time to read this message,
Ben Nash

[BrooksBro]

What I write here are general observations, and each person's experience may be different.  

Most of us with this condition have difficulty pointing to a single triggering event.  Weak erections can pre-dispose a man to injury.  Some flaw in the immune system leads to the formation of excessive scar tissue, which is inelastic.  The unaffected side continues to expand, while the side with the scar tissue does not.

What is your current testostone level?  Unmedicated, mine was around 240, and I am 58 years old.  With 100 mg daily topical testosterone gel, I have had mine to nearly 800.  At that level, my sex drive was not noticeably better, but the side effects were.  I recently started weekly injections of 200 mg, but I do not have levels to report.  Overall, I just feel better.

An excessive estrogen level (E2?) in men can suppress sex drive.  So can a high prolactin level.  Neither of these are my issue, yet my sex drive is not what it was 5-10 years ago.  I don't yet have a solution which I can recommend to anyone.  

[LWillisjr]

Ben,

So the questions are:

1. Could pushing against the underwear have caused the bend, i.e. essentially breaking the penis, and then Peyronies followed when scar tissue built up?  I sure don't have any memory of any kind of physical trauma.

I don't think so. I've worn briefs all my life. And whenever I would get an erection when younger, and my penis was in a "cramped" state...  the discomfort this caused was always enough to cause my erection to relax. I'm sure the same happens for my nocturnal erections as well. It is believed the trauma to trigger Peyronies is something more severe. By the way many men on this forum with Peyronies Disease cannot relate any single event as to what triggered their Peyronies Disease.

2. Is the complete loss of my sex drive related to the onset of Peyronies', or vice versa?

As your libido started to diminish over the last few years, I would assume your erections weren't quite as hard. And often during intercourse the classic you move one way and your partner moves another and.... whoops. Ouch... keep going. It has been determined that Peyronies Disease can be triggered at any age. But I think for aging men we all become more susceptible as our erections become weaker. As I was aging I always connected ED with impotence, so I never thought to discuss something like Viagra with my doctor. Now I wish I had. I've since learned that ED can mean anyting from impotence to anyting less than a 100% rock hard erection.

Other info: I'm 60 and my testosterone levels are "normal for a male my age".  Both my urologist and MD say the same thing about that testosterone level.

First, what is normal for one person is not necessarily normal for the next. You can do a serach for testosterone levels on this forum as there have been a number of discussions on leves and what is correct of not. But I've learned that libido is not dependent on testosterone levels alone. Other meds can affect sex drive. Especially blood pressure and anxiety medications. When I was younger and diagnosed as hypertensive, my doctor put me on a medication to lower my blood pressure. My testosterone levels were fine, but completely killed my libido. I simply didn't care if I had sex or not (in my 30's). It was my wife who complained , and I worked with my doctor on this. We went through 3 different medications until I found one that would lower my blood pressure without impacting my drive.

Hope this helps

Les

[Bennett Nash]

What is your current testostone level?  Unmedicated, mine was around 240, and I am 58 years old.  With 100 mg daily topical testosterone gel, I have had mine to nearly 800.  At that level, my sex drive was not noticeably better, but the side effects were.  I recently started weekly injections of 200 mg, but I do not have levels to report.  Overall, I just feel better.

An excessive estrogen level (E2?) in men can suppress sex drive.  So can a high prolactin level.  Neither of these are my issue, yet my sex drive is not what it was 5-10 years ago.  I don't yet have a solution which I can recommend to anyone.  

Hi BrooksBro,
Thanks for that interesting response.  I didn't know about prolactin's role in ED.  Unfortunately, I don't know what my testosterone level is in terms of the raw numbers.  My doctor is one of those who just says "your levels are normal" without telling me what the levels are.  I'm enough of a stump to keep forgetting to ask.

The good news is that you've now motivated me to get that number.  I'll have to wait until Monday but it's on my schedule.

I should add that I was once given testosterone in the form of that gel that you rub on your shoulders and chest.  After only one month, however, I had to stop because my insurance wouldn't pay for it.  As you know, testosterone is pretty expensive stuff.

The problem is that "normal level" judgment.  In order for my insurance to cover testosterone, there has to be a medical reason to receive it.  With that "normal level", I don't have such a  reason.

I was on private health insurance in those days.  I'm on Medicare now, but the rules with regard to testosterone are the same: unless there's a medical reason to require it, Medicare won't pay.

But who knows.  Once I get that number, maybe I can talk about "medical reasons" with my doctor.  Come to think of it, my urologist is a certified genius.  I should really be talking to him about this.

Thanks once again for your info,
"Big Ben" Nash

(now that I have Peyronies, guess I'll have to work on that nickname)

[Bennett Nash]

Hi Lee,
Thanks for that excellent response.  I was especially inspired about the "My History" page you've compiled.  RE that surgery, did your health insurance cover any part of it?  Per my response to BrooksBro above, Medicare is one of those plans that requires a "medical reason" to pay for something like that.  I doubt I could afford that kind of surgery out of pocket, if you'll pardon the expression.

I don't think so. I've worn briefs all my life. And whenever I would get an erection when younger, and my penis was in a "cramped" state...  the discomfort this caused was always enough to cause my erection to relax. I'm sure the same happens for my nocturnal erections as well. It is believed the trauma to trigger Peyronies is something more severe. By the way many men on this forum with Peyronies Disease cannot relate any single event as to what triggered their Peyronies Disease.

Yes, that's consistent with my experiences.  My urologist told me that I would certainly remember a trauma that could "break" my penis.  That puts me in the category of guys who don't know what triggered it.

As your libido started to diminish over the last few years, I would assume your erections weren't quite as hard. And often during intercourse the classic you move one way and your partner moves another and.... whoops. Ouch... keep going. It has been determined that Peyronies Disease can be triggered at any age. But I think for aging men we all become more susceptible as our erections become weaker. As I was aging I always connected ED with impotence, so I never thought to discuss something like Viagra with my doctor. Now I wish I had. I've since learned that ED can mean anyting from impotence to anyting less than a 100% rock hard erection.

Alas, this brings up some personal history that rules out the intercourse connection.  I haven't had intercourse since the early 80's.  There are psychological reasons for that.  However those reasons never affected my libido.  I was active sexually all right, but it was solely through masturbation.  During all that time, there simply weren't any occasions where any type of damage during intercourse could have occurred.  There was certainly no other occasion where damage could have occurred, and my erection remained straight until the Peyronies appeared.  

Once again, I guess I'm in that category of guys who have no idea why the onset of Peyronies occurred.

First, what is normal for one person is not necessarily normal for the next. You can do a serach for testosterone levels on this forum as there have been a number of discussions on leves and what is correct of not. But I've learned that libido is not dependent on testosterone levels alone. Other meds can affect sex drive. Especially blood pressure and anxiety medications.

Aha.  Meds I definitely take, and many of those could cause the symptoms of ED.  They never did so in the 10 previous to the loss of sex drive. Still, they could have caused a sudden complete cessation of sex drive as my libido decreased normally with age.  Who knows.

But that gives me a new area to explore.  My drug rap sheet includes blood pressure medication and anti-depressants.  It's definitely a recipe for ED.

Thanks once again for that informative response.  You and BrooksBro have given me a number of ideas to explore.

Take care,
"Big Ben" Nash

[LWillisjr]

Yes my insurance did cover it. My surgeon's office worked it our with them. It was covered as a medical issue and not a cosmetic one.

[skunkworks]

I've heard of a few good results from using an interventional radiologist to block of the offending vein.

[Tim468]

Some of us have venous leakage. The easy cure is a constrictor ring and a VED. The VED pulls the blood into the penis, and the ring keeps it there. That allows many men with either abnormal blood flow, or abnormal venous function, to keep the blood in their penis and to use it (bent or not). And to orgasm.

Of note, the use of the constrictor ring is to keep the blood in the shaft. The VED draws the blood into there, and is then removed (women say it feels funny when you leave the VED on).

This is in contrast to the "VED protocol", that leaves the VED on and avoids the use of the constrictor ring. In that case, the allowing blood to leave and to be refreshed is desired, and the prolonged use of the VED is to put a stretch on the scarred tissue in the tunica.

So, totally different uses.

I read your introduction. Sad that we have so much shame about this crap. A vascular surgeon may have been able to help you years ago, or you could have simply gotten a VED.

Tim

[jackp]

Tim

I agree in the early stages of ED and venous leakage a VED induced erection and the use of a constriction ring this is an easy cure.

In my case, as well as many others, as the venous leakage gets worse a lot of times the constriction ring does not hold and/or it is not comfortable because you need a very tight one. Also most women do not like an erection with a constriction ring because it makes the penis feel cold and unnatural. It also must be removed within 30 minutes.

I am thankful that for over 2 years I had a VED and constriction ring. Old Man was a great help with advice.

At the point that the very tight Osborn constriction ring would not hold long enough for sex and the unnatural feeling took the feelings and fun out of sex I was able to get my implant. Problem solved.

The whole story is here in My History or on my blog http://jackp-penileimplant.blogspot.com/

Jackp

[blackseal]

Thank you JackP for a very helpful blog post....

[Noway]

you usually get ed from the plague and the nodules caused by peyronies disease if you get peyronies disease. increasing blood flow and get on medication to help blood flow is best bet.