Peyronies or not?!

[Gerald12345]

Hi everyone. Glad I found this forum and see that I am not the only person having problems with my penis. I am 37 years old an about 4 weeks ago I noticed two solid structures in my penis (lumps). They are both at the very end of the cavernous bodies right under the glans. They seem to be pretty much symmetrical and are easily palpable when flaccid. Until now, they have not caused any pain, although I can say that it does feel different than before. So I feel a slight tingle every now and then. There is no visible curvature other than the one I was born with. Over the last 4 weeks the lumps have become more firm but did not change size (round and maybe 5mm diameter).

So as I got a little scared I went to see the first urologist. He palpated the penis and did an ultrasound. There was nothing to be seen on the ultrasound. His diagnosis was basically that I shouldn't worry and it should go away. He said he was pretty sure it was not Peyronies. As he was not able to say what it was I went to another urologist 2 weeks later. He did the same examination (didn't see anything on the ultrasound) but said that it could be Peyronies. He was hesitant to subscribe any medication as he said he was not sure. I should come back in case my penis would get curved. OK, after this I felt totally depressed as I had read that medication works best in the first weeks. So I ordered some Cialis and some supplements (arginine, carnitine etc.) to do at least something. And I went to a third urologist who again did the same examination and that he does not think it is Peryronies but that he could not rule it out either. I might just have had rough sex and this caused a wound inside the penis.

So here I am as smart as before. I have no clue if it makes sense to go to an urologist again in a few weeks. They don't seem to care a lot and already said they might subscribe some PABA and that's it. I don't even know if it makes sense to go on taking the supplements and the Cialis (couldn't hurt taking them I think). I might just need to be more relaxed and see how things develop...

However, I was wondering whether other members of the forum have experienced something similar ==> two symmetrical palpable lumps/plaques that cause neither bending nor significant pain? Also did some of you also experience no visible results on the ultrasound despite very palpable structures? Probably if it is not Peyronies someone of you might have a clue what I really have?

[Pfract]

Hello and welcome aboard. The symptoms you reported are shared by many on the board. Sometimes there is progression of their symptoms, others it resolves and most often than not it does not keep progressing.

How your ultrasound is (flaccid or erect) and who does it also plays a big role in it. A flaccid ultrasound gives no indication of your blood flow and if you read papers about penile ultrasounds and (peyronies) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6124582/

PEYRONIE'S DISEASE

Peyronie's disease is characterized by fibrotic thickening of the tunica albuginea, which can lead to curvature of the penis and difficulty in achieving an erection(5). Penile fibromatosis (Peyronie's disease) is marked by the formation of fibrous plaques identified as areas where the tunica albuginea is thickened(1). Although plaques are more common on the dorsum of the penis, they can also be seen on the ventral face, lateral face, or septum.

The typical finding on ultrasound is hyperechoic focal thickening of the tunica albuginea. Due to associated calcifications, the imaging of patients with Peyronie's disease shows acoustic shadowing(5), as illustrated in Figures 6 and ​and7.7. Less common findings, attributed to earlier stages of the disease (still mild fibrosis), are hypoechoic lesions with focal thickening of the paracavernous tissues, echoic focal thickening of the tunica without posterior acoustic shadowing, retractile isoechoic lesions with posterior attenuation of the beam, and focal loss of the continuity of the tunica albuginea.(5). In the Doppler study, increased flow around the plaques can suggest inflammatory activity and the absence of flow can suggest disease stability(6). Ultrasound is useful not only for the identification of lesions but also to determine their relationship with the neurovascular bundle(1). Individuals with Peyronie's disease can present with erectile dysfunction, often related to venous leakage, due to insufficient drainage at the site of the plaque(5).

Everything suggests that for a more complete study of your situation the exam should be done in erect state with under medication (caverject, etc).

PABA has no benefit for this. Please have a look at the most and best up-to-date treatment resource guideline for peyronies:

https://malefertilityandpeyroniesclinic.com/peyronies/treatments/

You should also have a look at posts on the forum that look similar to yours to see what people's experience has been.

[Nolte94]

Hey Gerald,
your symptoms don't sound like it's Peyronies Disease, but you should document the size and shape of your erected penis. After a few weeks repeat it and every changing will be visible. Peyronies Disease is a progressive disease.

[Gerald12345]

Thanks for your comments. One thing I did not mention before: I have the feeling that my penis has gotten extremely 'veiny', i.e. all superficial veins are very prominent also when flaccid. Could that also be a side effect of Peyronie's?

[blex]

Hi,
similar to you I have plagues/scars below the glans which cause no curvature, but quite some pain.
What you might want to do is finding a Peyronie's specialist near you. I found normal urologists not to be very useful.
I also noticed the "veiny" thing but I guess that this may come from the supplements?

[Nolte94]

The mlre visible veins are caused by the supplements and Cialis, which increase bloodflow. That means, that it's a good sign and shouldn't worry you.