CAUSES of Peyronie's Disease - started 2005

Previous topic - Next topic

0 Members and 1 Guest are viewing this topic.

George999

While we're at it, I would also like to point out that it is not always so easy to distinguish genetic factors from environmental factors.  For example, a father and son both contract the same affliction.  Seems genetic, right?  Be careful.  Suppose I were to tell you that the father was a smoker and along the way the son became a smoker also.  Or, that both lived in the same community and drank water from the same wells.  Or, even that this family had a penchant for eating lots of processed meat and the son continued that 'cultural' tradition.  So there are just a lot of things that need to be eliminated as possibilities before something can be safely declared to be 'genetic' in the first place.  And those things are really not that easy to identify.  Researchers, for example, have just discovered that oral sex with multiple partners GREATLY increases the risk of throat cancer (and how many people have been assuming that oral sex is 'safe sex'?).  Who would have guessed?  There are just so many of these kinds of wild cards out there that keep popping up.  So, while I am not saying that genetic factors are not involved in these things, I am just really a skeptic when someone is able to come to that conclusion so easily.

- George

Liam

Good point to ponder, George!  I will try to keep an open mind.  It does seem to "quack like a duck" but ...

You never know.

There is no "safe sex" in my opinion.  Look at all the guys who claim to have gotten Peyronies Disease after "rough" masturbation.  You'd think that would be the safest sex possible.  ???

Liam
"I don't ask why patients lie, I just assume they all do."
House

Liam


QuoteAntidepressants can definitely cause rubbery erections in some people and that can put you at risk to injury.  

216.24.161.210 (?)

A noticeable injury may certainly initiate the Peyronie's cascade (never leaves water spots).  However, in absence of a trauma, it will start with no apparent injury.  Micro trauma has been cited.  Micro trauma = normal wear and tear.  

Its like saying, "If you don't use your voice, you won't lose your voice."  And, we all want to be "rock stars".


"I don't ask why patients lie, I just assume they all do."
House

shrout

Quote from: George999 on January 03, 2007, 02:31:46 PM

Nonsense.  Masturbation does not cause Peyronies.  

George... or anyone else who thinks this is the case. How can you be so sure? Has this actually been proved to be the case?

The reason I ask is because I'm convinced that masturbation caused my Peyronies... or at the very least played a major role in it developing.
I'm now 53, and developed Peyronies 2 years ago after I'd masturbated twice in one day. Nothing unusual in that, you might say. I'm sure most men have done it, and I certainly have many times since my teens. But on this particular occasion my penis was quite sore after the first session, and, like a fool, I ignored the warning and carried on a second time a few hours later, after which it became very sore. It remained sore for several days, and then, when some small lumps began to develop, I went to see my doctor, who diagnosed Peyronies.

I find it very hard to believe that I would have developed Peyronies if I had not masturbated that day. I may well have been susceptible due to genetics and age, but I believe masturbation was the trigger. After all, masturbation could hardly be classified as a "natural" activity, in so much as the penis is not designed to be rubbed continuously in this way. It's really only meant to be used for sex, where the pressure on it is much more evenly distributed ( and for peeing through, of course ).
I guess it depends to some extent how you masturbate, but in my case the thumb rubs up and down the top of the shaft, which is where my plaque now is.  Surely, once you get to my age and the repair mechanisms are not so efficient, that action is likely to eventually cause some damage, especially if you overdo it. If I'd known about the possibility of Peyronies at the time I'd have been much more careful, but, like most people, I'd never heard of it.

Anyway, I'd be most interested to hear your opinions on this.

PJ

Nope. Masturbation does not cause peyronies. If that was the case pretty much every adult male would have peyronies. Statistics alone make this an impossible assertion.

What we KNOW causes peyronies (in some cases) is injury to the penis. This means that masturbation that causes such injury can cause peyronies. But its not masturbation, its the injury. There are other factors because not all injury causes peyronies, but hopefully medical science will uncover that in my lifetime.

An issue that needs mentioning is the 'western protestant christian bias' against sex and masturbation. One of the most harmful things about 'unthinking' mainstream christianity is the bias that sex and by extension self pleasure is bad. (Those of you with a christian viewpoint, apologies. I inserted the 'unthinking' point with consideration. We have some medieval viewpoints still and most thinking christians have discarded them) So anyway, I am making the point that we should not confuse the guilt about masturbation with the reality of peyronies. I am not saying that you are doing so, since I don't know you I have no idea. It is a general comment that needs making occassionally.



Hawk

First I must respond to PJ because his point kind of amused me
QuoteAn issue that needs mentioning is the 'western protestant christian bias' against sex and masturbation. One of the most harmful things about 'unthinking' mainstream christianity is the bias that sex and by extension self pleasure is bad.

I scratched my head for a bit trying to figure out why that issue "needed mentioning" in a discussion of whether or not masturbation can physically injure a penis or not.  The answer to the question is either "YES" or "NO" with supporting facts.  I find issues of whether it is a sin, believed to be bad, socially acceptable in public, endorsed by Middle-Eastern Sunni Islam, or other such issues irrelevant to the question at hand. (No pun intended)  ;)

To Shrout:  I say masturbation can cause Peyronies Disease but only under very limited and rare situations.  Masturbation is defined as sexual self-stimulation.  That is a pretty broad definition that is almost as broad as the term sex.  If a masochist masturbates with a rubber mallet I think it would be very likely to cause Peyronies Disease (regardless of societal acceptance or rejection of the practice and regardless of its sinfulness  ;)  )  I have read on this forum of men masturbating in some pretty novel and risky ways that could cause injury.  
On a more practical note however, I cannot imagine typical masturbation 10 times a day causing Peyronies Disease.  My guess is that most young boys have actually reached or exceeded that number at some point after first experiencing puberty and full blown orgasm.

This is what I conclude:  Typical masturbation can never cause injury or resulting Peyronies Disease.  If it triggers Peyronies Disease, then foreplay and sex would have triggered it.  If this were true then one session of masturbation every other day would have also triggered it so it is a moot point.  What often happens is that a man masturbates and feels some soreness.  The soreness is noticed because of the fact that Peyronies Disease is present and the first noticeable symptom is pain that is discovered during masturbation, not that masturbation is the cause.  To follow this logic, most men here would conclude that intercourse or nocturnal erections cause Peyronies Disease because that is when most of us first felt discomfort followed by Peyronies Disease progression.  

Typical masturbation is no more damaging to the penis than the many other things that happen to every penis on a very regular basis.

Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

Liam

In the past, our American Judeo-Christian culture frowned upon masturbation.  It was thought of as a sin against God and nature.  Even those with no particular religious beliefs would wince at the subject.  Remember the tales of going blind or growing hair on your palms.

I believe this explains, at least in part, the ease in blaming masturbation for Peyronies Disease even though there is no evidence to support it.

A Quote By Me:
Quotenoticeable injury may certainly initiate the Peyronie's cascade (never leaves water spots).  However, in absence of a trauma, it will start with no apparent injury.  Micro trauma has been cited.  Micro trauma = normal wear and tear.

On the other hand, I think guys today are too ready to discuss their self stimulation habits.

I believe all evidence available today leads us away from the idea of trauma causing Peyronies Disease.  Trauma may cause injury and scarring.  This is not Peyronies Disease.  

"I don't ask why patients lie, I just assume they all do."
House

Hawk

I am going to jump on the post by my dear friend and partner because I know Liam will not take it personally and because I think it is a point that must now be addressed.
Quote from: Liam on June 16, 2007, 06:32:50 PM
In the past, our American Judeo-Christian culture frowned upon masturbation.  It was thought of as a sin against God and nature.  Even those with no particular religious beliefs would wince at the subject.  Remember the tales of going blind or growing hair on your palms.

I believe this explains, at least in part, the ease in blaming masturbation for Peyronies Disease even though there is no evidence to support it.

I think this explains nothing and it is absurd to dig so deeply to explain a connection when we see daily examples of people making the error of "cause and effect" reasoning simply because A precedes B.  It leads one to ask what social stigma has caused people to associate the 40 other commonly claimed links with Peyronies Disease, or for that matter the 40 things resulting in improvement.  I think the attempt to reach for such a rational is not only without factual back-up,  It side steps the question being posed.

It is not social mores, a specific religion, or stigma.  It is the flawed deductive reasoning that creeps into every discussion on every topic within every culture.  In this case, the connection between masturbation and Peyronies Disease was arrived at by the opposite of the deductive reasoning we fight to promote.  To simplistically hang this one example in a sea of such examples on the concept of social mores, is to ignore the daily battle we wage for deductive reasoning.  This is why it pulls my chain.  I think that by concluding that some people consider masturbation a sin -> therefore the association between masturbation and Peyronies Disease is the result; is to use the same flawed "A precedes B" reasoning we are addressing.  There is no evidence that stigma factored in the connection based on what was related but there is ample evidence of other patterns in deductive reasoning that lead to these conclusions.  We should be addressing those issues.  To me, this is an example of where the answer to flawed logic is guilty of the same offense as the original post.


Quote
I believe all evidence available today leads us away from the idea of trauma causing Peyronies Disease.  Trauma may cause injury and scarring.  This is not Peyronies Disease.  

I don't want to say I could not disagree more with a quote but I will say it would be difficult to disagree more with a quote.    
Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

Old Man

WOW!!!

Hey guys, slow down and interpret what has been said in the past posts for this old Southern raised on a farm boy.

Have not seen so many words said about subject without reaching a "climax" as to the cause and effect issue.

I agree that masturbation by and in itself does not cause Peyronies Disease (not really a disease, but a severe malady). However, the constant daily act of abusive masturbation can and will cause micro and sometimes more injury to the penile tissues.

Many urologists that I have talked with in my counseling work for prostate cancer and related men's health problems state that masturbation does not cause the disorder. However, most have stated that injury resulting from "over masturbation" in a severe manner can and will cause Peyronies. Since there is no way that it can medically be called a disease, the term disorder seems to me would be a better explantion of it.

Anyway, just had to jump in with my two cents. Since I have had the mess since the age of 24, much research has been done by me on the subject. To date, I have found nothing that supports the theory that Peyronies Disease is really a disease, but rather the result of injury to the penile tissue in some form. Bottom line, for me at least, is that masturbation done in an abusive way of any sort can and will cause Peyronies Disease. Will not address the moral issue of the subject.

Old Man
Age 92. Peyronies Disease at age 24, Peyronies Disease after
stage four radical prostatectomy in 1995, Heart surgery 2004 with three bypasses/three stents.
Three more stents in 2016. Hiatal hernia surgery 2017 with 1/3 stomach reduction. Many other surgeries too.

Liam

Quotebecause I know Liam will not take it personally

Absolutely not!  It makes for a lively discussion.

The social stigma surrounding masturbation must be considered a factor.  By numbers of posts, masturbation seems to be blamed as THE cause much more than sex with a partner, sports injury, trying to urinate with an erection, rolling over on a nightime erection :o, or shaking the dew from your lily (after urinating).  And, the stigma exists.  It is, at least, a variable, in the mix.

QuoteI believe this explains, at least in part, the ease in blaming masturbation

I chose my words in this statement to reflect my opinion that the stigma may tip the scales to blame masturbation rather than high cholesterol or some other culprit at least for some.  Understand I'm discussing the aggregate not any individuals.  You have to admit it makes a pretty good scapegoat.  There was at least one post where the member admitted to feeling guilty about certain acts and thought he was being punished.  He knew, himself, this was wrong.  These thoughts have come to everyone for at least some time.  "What did I do to deserve this?"  Now, what are the FIRST things that we think of...

To blame the stigma on religion is equally wrong.  Also, I do not mean to blame any person.  We are all products of our environment.  My purpose in discussing it is to try to relieve the guilt some may carry.

It is very hard to step outside of your surroundings and self evaluate.  You must consider all the baggage you carry (good, bad, and seemingly inconsequential).  With Peyronies Disease, there is no way to know the "cause".  It is human nature to want to blame something (part of the grief process) even though there may be nothing.  

Hawk, I respect where you are coming from on this.  Please understand, I know the "blame game" is multifactorial and multifaceted.  It is NOT just guilt.  For many, it may not even be a part.  For many, however, I believe it is.


QuoteI have found nothing that supports the theory that Peyronies Disease is really a disease, but rather the result of injury to the penile tissue in some form.

Old Man,

I will try to convince you otherwise by pointing to the high correlation between Peyronies Disease and other fibrotic conditions (Dupuytrens, frozen shoulder, lederhose).  Also, I think there would be a higher number of men with Peyronies Disease if trauma (injury) alone were the cause.

Doing abusive things to the penis can cause bad things whether it is abused during masturbation, sex, or any other activity.


"I don't ask why patients lie, I just assume they all do."
House

Hawk

Liam,


Your deduction is puzzling.  You mean just because a person is more likely to blame masturbation than high cholesterol you feel safe in leaping to the conclusion this is because they have a stigma imposed on them about masturbation ???

You then have to produce an answer as to why we don't we have people disproportionately associating Peyronies Disease with homosexuality, adultery, or fornication as opposed to marital sex?  This alone destroys such a theory.

However, what does explain the flawed association beteen masturbation and Peyronies Disease is that most men masturbate and they may very well first notice the obvious pain in their dick while masturbating and seldom during a cholesterol test.  This seems so obvious I can't believe I am typing it.  As a point of fact, most of the people associating Peyronies Disease with masturbation on this forum had a VERY secular outlook and presented with a glaring lack of inhibitions.  I on the other hand, happen to have been raised in a more inhibited era.  I believe masturbation and a million other things are sins, but I don't associate any of them with Peyronies Disease.  Your case for association and stigma is soundly undermined by the evidence.  

I could say that an association with stomach upset and antibiotics is because people used to think of antibiotics and  vaccinations as hogwash since germs were considered a figment of a few people's imagination.  Even though my fact was correct, my association and the conclusion could not be supported.  

Female-on top accident, soccer, masturbation, injection, erection in tight pants, rogain, anti-depressants, stress, catheter, hernia surgery, MSM, and many other things have been blamed for Peyronies Disease (repeatedly).  To single one of the few out where symptoms are actually revealed during the act, and then conclude that one alone is because of stigma does not hold water.
Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

Hawk

I see your contention that trauma does not cause Peyronies Disease to be a bit like saying heat does not cause fire just because heat can only cause fire in the presence of fuel and oxygen.  The young men with progressive Peyronies Disease on this forum after assorted injuries may in fact have developed Peyronies Disease 50 years later without the injury, but one can hardly discount injury as a huge component of Peyronies Disease.  Our own Old Man got Peyronies Disease at 24 from such an injury.

If everyone lives long enough they will probably develop arterial or heart disease.  That does not mean that because it is eventually inevitable in most people that there are not causative factors.  i say if something brings on heart disease 50 years early then they caused it. The same is true of Peyronies Disease.

The fact remains that in some individuals, that minus the injury, they may have never assembled the components necessary to cause Peyronies Disease.
Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

Liam

I'm going to throw a statement out that may help clarify my position.

All injuries to the penis causing a bend are not Peyronies Disease.

Now, don't anyone think I mean it is any less important.  An infection may be bacterial or viral.  Both bad.  They have different treatments and some treatments in common.  This may be a good way to think about penile induration.
"I don't ask why patients lie, I just assume they all do."
House

Liam

Guilt is no factor--/---------The Truth----------/--Guilt is the only factor  :)
    for noone                                                             for everyone
"I don't ask why patients lie, I just assume they all do."
House

Hawk

I will throw out the statement that the vast majority of injuries that result in a permanently deformed penis are Peyronies Disease.   If it is then a progressive condition it is by definition Peyronies Disease.
Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

Liam

QuoteIf it is then a progressive condition it is by definition Peyronies Disease.

I agree if it progresses over time.  

Quotepermanently deformed penis

Except for spontaneous recovery or cured by something?  I think this is where we differ.  As you know, I believe these guys who have their "Peyronies Disease" disappear, had something else.  I would like to believe otherwise.  I am not convinced about the majority either.  Maybe.  I don't think most of the guys in their teens and twenties who had trauma during masturbation or sex have Peyronies Disease.  If you said over 40, I think I would agree.

BTW, Great discussion Hawk!!!!!
"I don't ask why patients lie, I just assume they all do."
House

Old Man

Liam:

No, I am not convinced by your statement relative correlation between the disorders. None of them can be called a "disease", but rather condition.

I have all three and they have been medically diagnosed as being caused by injury. My Dupuytren's has been caused by constant use of hand tools. My Ledderhose condition was caused by an injury while playing ball and wearing the wrong shoes as diagnosed by a "foot doctor".

All of the above, in my case, was caused by an injury to the affected part of my anatomy.

Old Man
Age 92. Peyronies Disease at age 24, Peyronies Disease after
stage four radical prostatectomy in 1995, Heart surgery 2004 with three bypasses/three stents.
Three more stents in 2016. Hiatal hernia surgery 2017 with 1/3 stomach reduction. Many other surgeries too.

Hawk

Quote from: Liam on June 16, 2007, 10:58:17 PM
As you know, I believe these guys who have their "Peyronies Disease" disappear, had something else.  I would like to believe otherwise.  I am not convinced about the majority either.  Maybe.  I don't think most of the guys in their teens and twenties who had trauma during masturbation or sex have Peyronies Disease.  If you said over 40, I think I would agree.

I have to ask what your basis is for your conclusion.  I have yet to hear of a urologist with a strong focus on Peyronies Disease that did not claim varying rates of spontaneous remission, usually varying from 5% to 15%.  I think it is difficult to just say "I don't believe it".  
Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

Tim468

I got Peyronies at 20. I don't know what I did, if anything, to bring it on. If it had resolved spontaneously, I would have gladly accepted that. Instead, it has gradually advanced despite trying different things to slow it down.

I just do not know if anything I have done has helped or hurt.

People do get better with therapy - just not everyone. Some people get better without therapy - just not everyone.

Why discuss it like this? It does not hurt to discuss it, but it is all so much mental whackety-whack to me.

Since we are all different, we are going to respond to this disease with a variety of emotional responses, and a very human desire to understand why. Some will irrationally blame themselves, or a girlfriend, or a stupid choice like tucking their penis into the pants too quickly. But none of us will ever really know why. And just like any other life stress, some will be able to weather this emotionally, and some will drown in their feelings ,flooded with negative emotional energy and self loathing.

This disease does not have a unifying theory, and does not have a single etiology. Not one single study has demonstrated a common cause in all patients, and so any therapy will also likely not help all patients.

I guess an injured penis that bends and then straightens back out in a week or two, is not Peyronie's Disease. If it takes three years, I am not so sure. But ultimately, what difference does it make? Common pathways of inflammation are present, and so is wound healing. In those of us with persistent disease, it seems to simply tip in favor of persistent pathology; wound healing gone awry.

Tim
52, Peyronies Disease for 30 years, upward curve and some new lesions.

Liam

I think its important to understand what Peyronies Disease is and what it isn't.

Most diagnoses of Peyronies Disease are made through a patient history (read my signature line) and a physical exam.  There is no imaging.  In other words, no objective test.  A patient goes into a doctor with a slightly bent penis.  The doctor palpates and finds nothing.  The patient says he had rough sex and now his penis looks different. Diagnosis: Peyronies Disease  Cause: Trauma  Treatment: Vitamin E

How many times a day does this happen?  Peyronies Disease is a "billing" diagnosis.  They're not going to do anything, anyhow.

Until a credible and reliable diagnostic criteria and testing are established and done consistently, doctors have no way of knowing the difference in Peyronies Disease and peyronie's-like conditions.  Until they know the difference, how can they make assumptions on spontaneous recovery.  There are no baseline measures.  Hell, most of the time there are no measures of any kind at any time.

There are a few doctors paving the way on this issue.  The majority say bent penis = Peyronies Disease

Here are some results of a survey of primary care physicians you've seen before:

QuoteSurvey of primary care physicians and urologist regarding Peyronie's disease
Author Block: Jeffrey C La Rochelle*, Laurence A Levine, Chicago, IL

Introduction and Objective: Peyronie's disease (Peyronies Disease) is a wound healing disorder of the penis with a reported prevalence of 3-9%. The pathogenesis remains unclear, and there is no known cure though a number of treatments are available. Peyronies Disease remains a distressing disorder for many men, many of whom seek advice from their physicians. This survey sought to evaluate the understanding and practices of primary care providers (PCP) and urologists (URO) with regards to Peyronies Disease. Methods: A 20 question multiple choice survey that included questions pertaining to the prevalence, natural history, associated erectile dysfunction, and treatment of Peyronies Disease was sent to 330 PCPs and 223 UROs throughout Illinois. Results: We received 152 surveys from PCPs and 98 surveys from UROs.

Responses were as follows.

Responses to selected questions by specialty PCP GU
Percentage (pct) that have seen a pt. with Peyronies Disease 70% 100%
Pct that believe Peyronies Disease to occur in less than 1% of men 63% 41%
Pct that have been taught that Peyronies Disease spontaneously resolves in > 50% of cases 17% 38%
Pct that believe Peyronies Disease does not occur in men under 40 yrs of age 17% 9%
Pct that do not believe erectile dysfunction to be frequently associated with Peyronies Disease 48% 37%
Pct that do not feel Peyronies Disease usually warrants treatment 21% 29%
Pct that were unsure if there was any effective treatments for Peyronies Disease 51% 1%
Conclusions: This survey of primary care physicians and urologists reflects their understanding of Peyronie's disease and its treatment, much of which is incorrect. Studies have shown that many men are hesitant to discuss sexual issues with their physician, and this problem can be exacerbated by their physician's lacking knowledge of the effects of Peyronies Disease and the available treatments. These incorrect notions regarding Peyronies Disease may be responsible for delays in diagnosis, referral, and initiation of appropriate therapy in the man with Peyronies Disease who is motivated to seek treatment. The findings of this survey are a call to improve education about Peyronies Disease for primary care physicians and urologists.

Keywords: Peyronie's disease, Penis, Questionnaire

American Urological Association Annual Meeting
May 21 - 26, 2005
San Antonio, Texas, USA

Any statistical generalizations about Peyronies Disease must be suspect.

I have to admit relying on self observation for a large portion of my knowledge of Peyronies Disease.  I have also seen the description 100 times - plaque and pain and curve.  Plaque is like the tape on a balloon, making it curve.  No plaque - No curve -No Peyronies Disease.  This is the goal of surgery.  Now, granted there are varying degrees of these symptoms.  But, these are "required", especially plaque (whether it can be palpated or not).  

I think some treatments can help, of course.

I guess, bottom line, is that I have never seen or heard of credible objective evidence of spontaneous remission.  If it existed, I'm sure someone would jump on publishing a paper. :-\  


Old Man,

Whether a condition or disease, the fact you and I and a host of men have multiple fibrotic conditions including Peyronies Disease surely has to make you think its more than just all of us injuring the same body parts.  It can't be coincidence.

I have seen a doctor (ENT), with my own eyes, see a person with a moderate hearing loss in all frequencies.  The patient said he works around noise.  Doc said noise induced loss even though noise can't cause a loss at all frequencies.  Because a doctor said it, don't make it so.

I have early Dupuytrens in both hands, early lederhose right foot, frozen shoulder both, and good ole Peyronies Disease :(  No trauma to any of the areas.

Tim,

The etiology is there, hiding like H. pylori.

Guys,

This was very enjoyable for me.  Great night of discussion!

Liam
"I don't ask why patients lie, I just assume they all do."
House

Hawk

Liam,

This is a good discussion that brings out a point I always sensed.  You are correct that it is important to understand what Peyronies Disease is and what it isn't.  You clarify the need for research to establish this.  The problem is that without this answer, you then go on to assign your own unsupported criteria and definition to Peyronies Disease, a definition shared by no doctor that I know of.  You proclaim the very thing you say is lacking in research and you declare what Peyronies Disease is and what it isn't.

The fact of the matter is that the vast majority of men with Peyronies Disease have no other fibrotic diseases and the majority of men with other fibrotic diseases do not have Peyronies Disease.  You can write your own definition (which happens to conform to your personal experience) and define every one that is not just like you as having a heretofore unidentified "Peyronies Disease like disease".

It all rests of circular argument that goes like this:
Peyronies Disease never resolves, and it can only be triggered by injury if it were going to soon happen anyway.  
When asked about those that resolve, you say -> That was not Peyronies Disease.  It was Peyronies Disease-like.
When asked how you know, your answer is -> because it resolved

I would readily embrace such a radical unsupported position if it were not so radical and unsupported. ;)

I am off to do penitence for masturbation before I go blind  ;)
Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

Tim468

I heard that masturbation caused blindness, so I stopped doing it all the time when I needed glasses. Proof!

One thing that bugs me about the issue of "plaque" is that there is no anatomic or physiologic definition of that term. It is dependent on the palpation skills of the urologist (or even less informed patient). So what does it mean to say "I have no palpable plaque"?

Does it mean that a tissue sample would be totally normal? That a microscopic analysis would be perfect? That even looking at the tunica would be helpful? I Would argue that the answer to all of these questions is no.

This website, recently mentioned here, shows a surgical technique for grafting that replaces scarred tunica with normal tunica recovered from deep on the penile shaft. figures 2 and 3)...

http://www.refertilisieren.de/literatur/penilecorporoplastik.pdf

As you can see, it is not that clear how different looking the contracted part is compared to the straight part - even when the skin is degloved.

A review of histology of tunica shows that men with Peyronies Disease have abnormal histology of their penile tunica even in the unaffected area. (ie without scar). Alterations in function of TGF pathways are found in tissues removed from men with Peyronies Disease, as well as alterations in pathways that help heal like MCP-1 levels.

To say any longer that plaque is a required defining characteristic for Peyronie's Disease is to ignore a large body of evidence that says the definition of plaque is too vague to be useful any longer, and which is starting to reveal the complexity of the disease (and the varieties of it).

Tim





References:

Lin, Gui-Ting. Wang, Zhong. Liu, Ben-Chun. Lue, Tom F. Lin, Ching-Shwun.
Institution   Knuppe Molecular Urology Laboratory, Department of Urology, School of Medicine, University of California, San Francisco, CA 94143-1695, USA.
Title   Identification of potential biomarkers of Peyronie's disease.
Source   Asian Journal of Andrology. 7(3):237-43, 2005 Sep.
Abstract   AIM: To identify proteins that are differentially expressed in cells derived from normal and diseased tunica albuginea (TA) as related to Peyronie's disease (Peyronies Disease). METHODS: Cells with characteristics of fibroblasts were isolated from two tissue sources. Those from the plaque of patients with Peyronies Disease were designated as PT cells, and those from the normally-appearing TA of the same patients were designated as NT cells. Messenger RNAs of these cells were analyzed by real-time polymerase chain reaction (RT-PCR) for the expression of monocyte chemoattractant protein 1 (MCP-1). Crude protein lysates were analyzed by surface-enhanced laser desorption/ionization mass spectrometry (SELDI-MS) with IMAC30-Cu, CM10, and H50 chips. Each lysate was then separated into six fractions, which were further analyzed by SELDI-MS. RESULTS: RT- PCR analysis showed that PT cells expressed higher levels of MCP-1 than their counterpart NT cells. SELDI-MS analysis showed that the crude protein lysates of all four cell strains produced similar and reproducible protein profiles on IMAC30-Cu and CM10 chips. Additional SELDI-MS analyses with the fractionated lysates detected three proteins of 11.6 kDa, 14.5 kDa, 22.6 kDa that were upregulated in PT cells and two proteins of 6.3 kDa and 46.9 kDa that were downregulated in PT cells. CONCLUSION: MCP-1, which is often involved in tissue fibrosis, was expressed at higher levels in PT than that in NT cells. Five potential biomarkers for Peyronies Disease were identified by SELDI-MS analysis.


Nale, Dorde. Mii, Sava. Vukovi, Ivan. Radosavljevi, Radoslav.
Institution   Institut za urologiju i nefrologiju, Klinicki centar Srbije, Beograd.
Title   [Induratio penis plastica--localized or diffusive fibromatosis of tunica albuginea penis?]. [Serbian]
Source   Vojnosanitetski Pregled. 63(11):939-44, 2006 Nov.
Abstract   BACKGROUND/AIM: The part of the tunica albuginea that is not affected by localized pathological fibrosis is excised by the Nesbit contralateral excisional corporalplasty in patients with induratio penis plastica (IPP). The aim of this study was to find out if there were any histological changes of the macroscopically normal tunica albuginea excised during the Nesbit corporalplasty. METHODS: A total of 31 patients, mean age 45 +/- 7.65 years, were surgical treated for extensive penile curvature (impossible or difficult penile imission in the vagina), using the Nesbit surgical technique. The tunica albuginea tissue was manipulated by Allis's clamps and excised in the shape of a diamond and placed in the 4% formaldehyde solution for histological analysis. The excised tunica albuginea was not wider than 1 cm, while the histological preparations were 3 to 5 microm thick, and they were stained with hematoxylin-eosin. The excised tunica albuginea tissue appeared macroscopically (anatomically) normal in all of the operated patients. In 28 (90.3%) patients opperated for dorsal curvature of the penis, the tissue of the tunica albuginea was excised from the urethral ridge, while in 3 (9.7%) patients operated for lateral curvature, the tissue was excised from the lateral corpus Cavernosum. RESULTS: The histological results were normal in 12 (38.7%) patients, while in 19 (61.3%) cases the findings indicated fibrosis of tunica albuginea. No significant difference in the patients age was found between these two groups (p = 0.09). The analysis of a total number of histological results of the patients with tunica albuginea fibrosis in relation to the patients with normal results showed that there was no significant difference (chi2 = 1,2; df = 1; p > 0.05), suggesting that the macroscopically normal tunica albuginea is not always expected to yield normal histological result. CONCLUSION: Significantly more reported histological results of tunica albuginea fibrosis in the location that appeared normal macroscopically (chi2 = 27.5; df = 1; p < 0.01) indicated that, in the majority of IPP patients (61.3%), pathological lesion was diffusive with localized phenotypic expression plaque in the tunica albuginea, showing that, in the majority of cases noxa acted diffusely.



Simone M. Hauck, Ekkehard W. Szardening-Kirchner, Carolin. Diemer, Thorsten. Cha, Eun-Sook. Weidner, Wolfgang. Eickelberg, Oliver.
Institution   Department of Urology and Pediatric Urology, Justus Liebig University Giessen, Rudolf-Buchheim-Str. 7, 35385 Giessen, Germany.
Title   Alterations in the transforming growth factor (TGF)-beta pathway as a potential factor in the pathogenesis of Peyronie's disease.
Source   European Urology. 51(1):255-61, 2007 Jan.
Abstract   OBJECTIVES: The development of fibrotic diseases is associated with alterations in the transforming growth factor beta (TGF-beta) pathway. We have investigated the expression and activity of Smad transcription factors of the TGF-beta pathway in primary tunical fibroblasts derived from patients with Peyronie's disease and from controls. METHODS: Primary fibroblasts were established from biopsies obtained from plaques of 16 patients with Peyronie's disease or the tunica albuginea of 8 control patients. The expression and activity of Smad transcription factors in control and TGF-beta-stimulated primary fibroblasts were investigated at the RNA and protein level by reverse transcription-polymerase chain reaction, Western blotting, and immunofluorescence. RESULTS: RNA expression levels of Smad3 and Smad4 were significantly increased in fibroblasts from patients with Peyronie's disease. When stimulated with TGF-beta1, fibroblasts showed rapid nuclear translocation of Smad2/3, as soon as 15 min after stimulation. This effect was more pronounced and exhibited an earlier onset in fibroblasts from patients with Peyronie's disease, compared with controls. In addition, an increased nuclear retention time of Smad4 was observed in fibroblasts from patients with Peyronie's disease. CONCLUSIONS: The expression and activity of Smad transcription factors of the TGF-beta pathway is increased in fibroblasts of patients with Peyronie's disease. Alterations in the TGF-beta pathway seem to be a pathogenetic factor in the development of Peyronie's disease.
52, Peyronies Disease for 30 years, upward curve and some new lesions.

George999

QuoteA review of histology of tunica shows that men with Peyronies Disease have abnormal histology of their penile tunica even in the unaffected area. (ie without scar). Alterations in function of TGF pathways are found in tissues removed from men with Peyronies Disease, as well as alterations in pathways that help heal like MCP-1 levels.

I really hope that everyone here latched onto this gem submitted by Tim.  Liam is certainly asking the right questions.  What if one can be walking around with those 'histological changes' going on in their outwardly normal tunica?  Perhaps the difference between one who contracts Peyronies from a minor trauma and one who heals successfully from significant trauma is all about just this!  And what if, in fact, other structures in the body can undergo the same or similar changes.  This could explain other conditions like the ones noted by Liam.  So what if Peyronies is to these underlying changes like a hip fracture is to osteoporosis?  Thus, in theory, one could walk around for much of their life with Peyronies susceptibility and not exhibit any symptoms and, in fact, even die of old age symptom free.

And then, looking back upstream, one has to ask 'what would cause these histological changes?'.  At that point one could begin tallying up their own short list of potential suspects.  My list would include such things as:

1)  Out of control systemic inflammation  (my personal favorite as many of you know!)
2)  Drugs (licit or illicit)
3)  Genetic factors
4)  Nutritional imbalance

I'm sure others could come up with more amusing candidates.  But if we are going to make headway against Peyronies, we definitely need to be attacking on the level of this underlying histology that Tim is referring to.  That is exactly what is instigating this condition just like osteoporosis instigates hip fractures in susceptible individuals.  And even setting the hip will not help a whole lot if the underlying osteoporosis is not addressed.

So perhaps a more definitive test for Peyronies would be a 'tunica biopsy'.  But perhaps I should not be giving the doctors ideas.  Tunica biopsies seem a bit invasive.

Perhaps this whole concept could also explain why some Peyronies patients seem to get better, others seem to stay the same, and still others seem to deteriorate over time.  Perhaps this has to do with how pronounced the histological changes are.

Too bad researchers aren't looking more directly at how to reverse those histological changes on a cellular level rather than attempting to address Peyronies itself.  It occurs to me that one could experience measurable change in that histology without noticeable change in the Peyronies severity itself.  Thus it might be easier to ferret out the solution for the underlying problem than for the physical manifestation.  Perhaps I am rambling here.  Just thinking out loud.  These are all the questions and thoughts that come to my mind from reading that little point that Tim has introduced.

- George

percival

Tim
Like George, I thought your posting on this was enlightening.
In my days as a research chemist, one technique I used when I was stuck for a way to improve a process was to stop and think 'ok, if I can't improve it, how can I make it worse?' Very often this trick would disclose the controling mechanism which I could then apply to improve the process.
So, what would we do to cause an existing case of Peyronies Disease to worsen? Are there any substances we know about which definitely promote Peyronies Disease? It is worth considering because there are no substances we know about (yet) which definitely cure Peyronies Disease.
Regards,
Percival

allj

Hi: Maybe this will make sense to someone. I had corrective surgery for an entrapped nerve from a botched inguinal hernia operation 3 yrs ago. I flew to WI last Dec. where the nerve was cut and the mesh replaced with collagen. Ouch! After a month of recovery I tried to work out at the gym. My thigh became painful and my leg swelled up. Diagnosis lymphedema - far worse than the Peyronies Disease which I noticed upon resuming sexual activity. There good news! - my lymph nodes started working again but the Peyronies Disease remained. I may have had other contributing factors like taking a beta blocker for years but am wondering if the pressure of the plane flight after surgery could have caused both problems. I know that you are supposed to wear compression stockings after surgery and wonder if the pressure caused a blood vessel in my leg to collapse as well as damage the corpus Cavernosum. Any thoughts? Alan

Liam

"I don't ask why patients lie, I just assume they all do."
House

Tim468

I am not sure I can make a physiologic connection between the travel and the clot and Peyronies.

Tim
52, Peyronies Disease for 30 years, upward curve and some new lesions.

allj

Tim- Maybe it was a coincidence. Many of my medical misfortunes seem to be attributed to those damn coincidences. Example-The medical tests for the lymphedema was inconclusive not showing a clot or inguinal lymph damage but I had all the symptoms of lymphedema for a few months. It's just strange that I also came down with Peyronies Disease at the same time. The thought occurred that they clamped down my penis during surgery causing the Peyronies Disease. I don't recall any bruises (I was too concentrated on my groin pain to notice much else) but this is another possibility. Not that it matters much since the end result is the same.

Tim do you know how pentox works on a molecular level? I believe it reduces the fibrin in the blood.. How does it do this and how might this effect an already damaged tunica?  Anyone? Thanks
Alan

Liam

QuoteSao Paulo Medical Journal
Print ISSN 1516-3180
Sao Paulo Med. J. vol.125 no.2 São Paulo Mar. 2007
 
CASE REPORT

Human penile ossification: case report

Ossificação no pênis humano: relato de caso


Homero Oliveira de Arruda; Hudson de Lima; Valdemar Ortiz

Department of Urology, Universidade Federal de São Paulo - Escola Paulista de Medicina (Unifesp-EPM), São Paulo, Brazil

Address for correspondence


Key words: Penile induration. Calcinosis. Heterotopic ossification. Penile diseases. Penis.

--------------------------------------------------------------------------------

INTRODUCTION

Ossification in the human penis is such a rare condition that only 34 histologically evident cases have previously been reported in the literature. Several conditions have been correlated with this problem and the most frequent is Peyronie disease.1-4

In the present report, a further case of human penile ossification is presented. The importance of this report lies in the extent of the penile ossification, as demonstrated by the radiological and histological confirmation. In addition, we have reviewed all the previously reported cases and offer some comments concerning etiology.

CASE REPORT

A 59-year-old white man was referred with a one-year history of slight pain upon erection and during sexual intercourse. He also complained of hard plaque near the base of the penis. One year earlier, he had sustained blunt trauma during intercourse, after which he began to experience pain when the penis became turgid. There was no history of metabolic disorder or erectile impotency.

Examination of the penis revealed the presence of a firm fixed mass extending over the proximal third of the penile shaft. It was irregular, measuring 3.0 x 3.0 x 2.0 cm, and involved the corporal sponge without surface extension. There were no other relevant clinical findings. The results from routine laboratory evaluations were normal. Radiography on the penis revealed irregular calcification in the same position as the palpable mass and in the septum of the proximal inner third of the penis (Figures 1, 2).


The calcified mass was excised surgically through a dorsal midline incision of the tunica albuginea, extending across the corpus Cavernosum on both sides. The defect of the corporotomy was closed using a watertight running 4-0 vicryl suture, without graf-ting. A quick examination of the specimen revealed an irregular mass of grayish brown tissue with hard white calcified foci. The postoperative course was uneventful and the patient reported a full straight erection without pain. Histological examination revealed cancellous bone surrounded by dense collagen tissue.


DISCUSSION

Several conditions have been correlated with penile ossification. The most frequent of these is Peyronie disease, but correlations with penile trauma, other diseases like metabolic disorders (for example gout and diabetes mellitus), intracavernous self-injection of vasoactive agents and chronic hemodialysis have also been reported.3-5 One extremely rare case of a congenital condition has been reported.2

McClellan was probably the first to report human penile ossification, in 1827, and Gerster and Mandelbaum were the first to do a histological study on the specimen, in 1913.apud 2 They concluded that the problem developed in the connective tissue, from the dorsal side of the septum between the corpora cavernosa, as a result of a metaplastic process. In 1933, Vermootenapud2 described a case of ossification in a man who had suffered a gunshot injury to the penis. Histopathological analysis on the mass revealed metaplastic bone marrow and cartilage formation at the fibrosis site. Numerous other cases of small calcifications in the penis have been found by macroscopic observation or X-ray. The single case of congenital ossification of the penis was described by Champion and Wegrzyn in 1964. That child also had a cleft scrotum.2 More recently, Vapnek reported a case of heterotopic bone formation in the corpora cavernosa of a patient with papaverine-induced priapism.5

It is well known that many animals present a penile bone called "os penis", "os priapi" or "baculum". It is usually located in the glans penis and aids copulation. In whales it may measure around two hundred centimeters in length and forty centimeters in circumference. In dogs it serves as a channel for the urethra, while in bears and wolves, it is essential for producing a rapid erectile state for copulation.1 It seems that, during later stages of evolution, the penile bone diminished in size and, in some species, appears as an insignificant structure of 10-20 mm in length. In chimpanzees, mans nearest kin, there is no "os penis", but only a virtual fragment of bone in the glans.1

Ossification of the cavernous tissue in humans is unrelated to phylogenetic structure. Instead of aiding copulation, as observed in the animals that have such ossification, in men it is sometimes uncomfortable and possibly painful. It is often multiple and found in the shaft as well as in the septum and tunica albuginea, while in animals it is single and situated in the glans. In most of the cases in which human penile ossification was reported, it appears to have been acquired during adult life and was related to trauma and Peyronies disease.1,4 According to Devine,6 the fibrous tissue of the plaque can reach maturity without calcification, but calcification is a sign of the end of the healing process and may be present in 25% of the patients.

It is most likely that ossification, like the plaque in Peyronies disease, is a scar and not the result of an inflammatory or autoimmune process. In all these conditions, human penile ossification appears to be a metaplastic process. Somers and Dawson3 have shown that the disease most likely begins with buckling trauma that causes injury to the septal insertion of the tunica albuginea. The fibroblastic tissue thus formed may provide good conditions for metaplastic bone formation.4,5

There is no good medication for treating Peyronies disease, because few medical management methods have been subjected to double-blind drug testing. For surgery to be considered, candidates must present mature and stable disease. It is only recommended when the curvature is enough to impair coitus.

CONCLUSION

Our understanding of this case is that the ossification in our patient probably developed as a consequence of unusual repair of the tunica albuginea, following some blunt trauma sustained during sexual intercourse.

REFERENCES

1. Sarma DP, Weilbaecher TG. Human os penis. Urology. 1990;35(4):349-50.        [ Links ]

2. Champion RH, Wegrzyn J. Congenital os penis. J Urol. 1964;91:663-4.        [ Links ]

3. Somers KD, Dawson DM. Fibrin deposition in Peyronies disease plaque. J Urol. 1997;157(1):311-15.        [ Links ]

4. Guileyardo JM, Sarma DP. Human penile ossification. Urology. 1982;20(4):428-9.        [ Links ]

5. Vapnek J, Lue TF. Heterotopic bone formation in the corpus cavernosum: a complication of papaverine-induced priapism. J Urol. 1989;142(5):1323-4.        [ Links ]

6. Devine CJ Jr, Horton CE. Surgical treatment of Peyronies disease with a dermal graff. J Urol. 1974;111(1):44-9.        [ Links ]

 Address for correspondence:
Homero Oliveira de Arruda
Rua Borges Lagoa, 1065 — 7º andar
São Paulo (SP) — Brazil — CEP 04038-032
Tel. (+55 11) 4521-0925
E-mail: arrudas@dglnet.com.br

Sources of funding: None
Conflict of interest: None
Date of first submission: June 30, 2006
Last received: March 4, 2007
Accepted: March 28, 2007

AUTHOR INFORMATION

Homero Oliveira de Arruda, MD, PhD. Department of Urology, Universidade Federal de São Paulo — Escola Paulista de Medicina (Unifesp-EPM), São Paulo, Brazil.
Hudson de Lima, MD. Department of Urology, Universidade Federal de São Paulo — Escola Paulista de Medicina (Unifesp-EPM), São Paulo, Brazil.
Valdemar Ortiz, MD, PhD. Full professor, Department of Urology, Universidade Federal de São Paulo — Escola Paulista de Medicina (Unifesp-EPM), São Paulo, Brazil.

Source: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802007000200012&tlng=en&lng=en&nrm=iso
"I don't ask why patients lie, I just assume they all do."
House

Liam

Excerpt:
Decreased arterial inflow and increased venous outflow both contribute to ED. Disorders of the hypogastric-cavernous arterial bed include large artery disease, constriction of the lumen of the small cavernosal arteries, and arteriolar insufficiency (9). Recent studies have shifted the focus of vascular ED to the penis itself. Profound ischemic changes in the corpora cavernosa, including smooth muscle cell degeneration, perisinusoidal fibrosis, and vascular disruption, have been found on examination of tissues removed during penile implant placement, e.g. in patients with vascular compared to those with neurogenic ED (10).

Lue (11) described five kinds of lesions associated with venoocclusive insufficiency, with the majority of cases being due to intrapenile lesions, including a distorted tunica albuginea as in Peyronie's disease with associated incompressible veins, and cavernosal fibrosis, loss of muscle fibers, and NO-generating capacity, resulting in an inability of the corpus Cavernosum to relax. He also described inadequate release of relaxing neurotransmitters in neurogenic and psychogenic ED. Speculatively, a vicious cycle may operate. Impaired resting penile circulation may result in cavernosal ischemia, leading to corporal fibrosis that impairs penile sinusoidal relaxation. Maximal vasodilatation may be inhibited by diminished NO formation due to nerve and smooth muscle cell degeneration or to psychogenic or other neurogenic factors. The increased fibrosis and reduced NO formation further impair penile circulation, producing additional ischemic change in the corpora cavernosa.


Source: http://jcem.endojournals.org/cgi/reprint/80/7/1985.pdf
"I don't ask why patients lie, I just assume they all do."
House

Liam

Excerpts: In arteriosclerosis ED is exaggerated by induction of fibrogenic cytokine, transforming growth factor-beta 1 (TGFβ-1) and its type II receptor under continuous ischaemic conditions, resulting in fibrosis of the
penis [50].


Source: http://www.kup.at/kup/pdf/5420.pdf

Excerpts are not representations of or a summary of the report.
"I don't ask why patients lie, I just assume they all do."
House

hector

Hello everyone, and thank you to the creators of this forum and PDS.  

I developed Peyronie's Disease quite suddenly in March of this year, AT AGE 27.  One day everything was fine; the next, my penis had a 20-30 degree upward bend in it during erection, was signifcantly narrowed beginning just below the head (mainly on the upper right side where the palpable scar tissue appears to be located), and my penis was about an inch shorter.  Not knowing what the problem was, I at first tried to bend and stretch my penis into its former shape.  (I did not experience any significant pain as a result of doing this.)  

A urologist diagnosed my condition in late March, and I began taking vitamin E.  The doctor recommended 400 ICU per day, but after discovering 800 ICU used to be the suggested dosage, I began taking the latter amount and continued for about 3 months with no apparent effect.  Now it is nearly 6 months since my condition appeared and there has been no visible change.  My understanding is that Peyronies Disease is pretty rare in men my age.  I have also heard that when Peyronies Disease occurs in younger men, its chances of healing without (and with) treatment are better.  At the same time, I've come across a frustrating amount of conflicting claims regarding Peyronies Disease which have caused me to doubt this and so many other "facts" about the condition.

Since the cause(s) of Peyronies Disease are unclear, and my situation seems atypical among most with Peyronies Disease, I'll divulge some further information about my case.  

In January 2007, I experienced a painful break-up of a 2-year relationship, estrangement from all of my formerly close friends and job loss, all coming on the heels of two very stressful years of trying to get a struggling non-profit organization off the ground.  After January's crises, I was not examined for clinical depression, but for several weeks I was only sleeping 3 hours a night, eating about one meal per day, only leaving the house for work, using alleyways to avoid running into people I knew on the street... not suicidal by any means, but not feeling very well, either. The 15 pounds I lost during this time are perhaps more significant considering I have a small frame and have always been skinny: standing 5'9" tall, I normally weight about 150lbs.

From January to March 2007, I was also selling plasma 1-2 times per week to pay my rent, including once when I was sick with a fever.  In mid-January, I nearly put myself in the hospital with whiskey-induced alcohol poisoning, after which I stopped consuming alcohol altogether. (Prior to this one-time event, I was only a very light drinker.)  With little else in my life providing comfort, I began masturbating somewhat obssessively, sometimes two and even three times daily, for long periods of time (up to 5 or 6 hours) with the assistance of internet pornography and sex chat rooms.  I suspect this obssessive masturbation, likely coupled with the general strain on my body, is what caused my Peyronies Disease.  Indeed, the scar tissue even seems to correspond with the grip I was using at the time-- an unusual one for me having to do with how I was sitting relative to the position of my laptop during this unfortunate online escapades.

After being diagnosed, I stopped the obsessive masturbation and have been trying to take much better care of myself in general.  Although Peyronies Disease has brought additional stress and insecurity, I am feeling much better emotionally.  However, I am still fairly unhappy with my life and dealing with the ongoing stress of persistent underemployment.  

Since developing Peyronies Disease, I have had intercourse on two occassions with the same person, a former girlfriend.  I discussed my condition with her after we had sex the first time.  She said she did notice a difference in the shape and size of my penis compared to when we had dated years ago, but that intercourse was not uncomfortable and still pleasurable for her.

I do experience mild pain during erection, particularly the longer I am erect, along with some loss (or ast least change) of sensation.  I also I experience mild pain in the scar area after erection, but not very often otherwise.  Most recently, I have noticed that blood vessels in my penis, visible during erection, narrow significantly and abruptly when passing into the area of the plaque/scar.  I don't know if this is new or I've just noticed it.    

If at all possible, I would really like to correct this problem.  Yeah... I'm sure I'm not the only one! But based on the particularities of my situation, what do you all think should be my next course of action?  Potaba?  Colchicine?  Verapamil?  Neprinol?

Any help would be tremendously appreciated.

Hawk

Hector,

Welcome to the PDS forum.  It sounds like you had a short trip through hell there my friend.  It is good to hear that you seem to be coming out the other side. You provided a lot of information in your very articulate post.  I think your assessment of the cause and your general understanding of Peyronies Disease seem to be on track.  You were definitely unwise in your treatment of your body.  Those are the exact things that need to change ie: less stress, more rest, nutrient dense food with a generally healthy diet.  I won't be specific at this point.  Just do better.

You specifically asked
Quote from: hector on September 10, 2007, 10:32:27 PM
what do you all think should be my next course of action?  Potaba?  Colchicine?  Verapamil?  Neprinol?
.  My first answer would be none of those.  The answer for the best thing you can do orally would probably be to take Pentox (prescription), Arginine (supplement), and Viagra (prescription). This is often referred to as the PAV cocktail. Clearly Viagra at 25 to 50 mg per day is the most expensive part of this.  There are over the counter supplements that are similar but much weaker PDE5 inhibitors since many find the $3 to $6 dollars a day for Viagra prohibitive.

If you have not been lurking and reading a lot on the forum, go to the "Child Boards: Newly Diagnosed Highlights -" section under the main board and read the highlights of "Oral Treatments".  If you want to do all that can be done that could possibly help, I would include VED or Traction along with the PAV cocktail.  I would try traction if you have the time since there is a small chance that Pentox and the VED might cause some conflict.

For any follow-up on these topics post under the appropriate topic.
Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

Liam

Due to the rapid onset of symptoms (literally overnight). I suspect trauma as the cause.  If this is the case, there is a better chance you will not get any worse.  As you know the "typical" case has a slow onset.  These tend to progressively worsen.  

Unfortunately time is the only way to tell.  Have hope.  You can "work" with 20-30%.   ;)

Hawk offered sage advice.

I understand the pressures, mostly self imposed, of running a not for profit organization.  It is a humbling experience.  My views of the world have changed 180 degrees since my early days in the field.  I used to think greed was limited to big business and politics.  The greediest, most back biting, meanest people I've ever met were in the "not for profit industry".  It is enough to make an honest man stress out.  Hang in there.
"I don't ask why patients lie, I just assume they all do."
House

Tim468

Welcome Hector

Your description seems to be right on - it sounds like chronic/acute trauma led to your condition. I have a couple of thoughts. First, read Hawks post carefully for it tells you the best way to get from point A to B, which is by reading the "Child Boards". The primary advantage of that is that a lot of "chat" has been flossed out and what is left are posts that inform.

Check out the VED for two reasons. First, getting an erection may be harder to do for reasons of pain and depression. Thus, the VED takes sexuality out of the equation. Instead, the induced erection feels like taking care of your penis, instead of feeling like a sexual moment. This stands to help you particularly because of the sexually addictive component of your story. I went through a painful period of using porn to get erections daily because I felt I "had to" (you know, use it or lose it). The daily erections probably did help my Peyronies, since I did not progress much and erections help in terms of preventing contractile processes and in terms of delivery of oxygen to the tissue. For you the use of the VED will help prevent relapse into addictive use of porn. The memory of it hurting you may not be enough to avoid returning to that either.

The VED also helps prevent progression and may help in decreasing TGF activity, so it may be helpful on lots of levels.

The PAV cocktail is also probably worth taking, and a surgical fix may also work for you if nothing else helps, given the traumatic nature of your cause (meaning it is less likely to recir).

Welcome!

Tim
52, Peyronies Disease for 30 years, upward curve and some new lesions.

Hitman

I've had the same problem with the obsessive masturbation and it probably added to my problem. I've stopped quite sometime ago and don't wish to be part of that unnecessary and wasteful experience.

shrout

Quote from: Liam on September 11, 2007, 06:12:53 AM
Due to the rapid onset of symptoms (literally overnight). I suspect trauma as the cause.  If this is the case, there is a better chance you will not get any worse.  As you know the "typical" case has a slow onset.  These tend to progressively worsen.
I've read on several occasions that Peyronies disease can be progressive.  Is Liam saying that progressive damage only occurs with people who are genetically susceptible to Peyronies.. i.e. those who possibly also have Dupuytrens, and that it will stabilize in those who acquired it through trauma? Or can progression also take place after trauma, because the interface between the damaged and normal cells is vulnerable to futher damage, simply because it is an interface?
I'm asking this because I find the prospect of progression quite worrying, even though I believe my Peyronies was caused by abuse of the penis through excessive masturbation. The onset in my case was quite slow.. 6-9 months or so, and it appears to have stabilized.  I don't have Dupuytrens.
And is the recommended treatment any different for genetic cases as opposed to trauma cases?

Hawk

Shout,

I make no attempt to explain Liam's comments for him.  He is quite capable of that so I offer my own.

I suspect that everyone that has Peyronies Disease is physically susceptible in varying degrees.  Whether they are  susceptible due to genetics or only susceptible because of diet, stress, inflammatory, and other unknown processes going on in the body is a good question.  In fact, I think it is such a good question that no one has the answer.  Certainly genetic susceptibility cannot be concluded only by the the presence or lack of presence of Dupuytrens Contracture.

My guess is that whatever degree of genetic susceptibility we have (for the good or bad), that there are varying degrees of triggers.  High susceptibility requires a low trigger.  Low susceptibility requires a high trigger (such as slamming a car door on your penis while leaving a nudest colony). It is also my guess and that of others, that there are things we can do to lower our susceptibility somewhat.  That is the entire basis of most treatment approaches whether prescribed or nutritional or whatever.  If we have a high genetic susceptibility can we lower it enough ???  Who knows?  Does lowering is some slow the disease or is it more like an on/off switch ?  Again, who knows ???

I personally am not convinced that rapid onset indicates more significant trauma as the trigger.  I am also not convinced rapid onset is atypical since the forum is full of such stories.  Dr Levine indicates the rate of onset varies widely and offers no speculation as to why.

Maybe it begins to be clear why we need research that only comes from a much more pronounced awareness than we now have.
Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

shrout

Thank you Hawk, for your reply

my question was really more to do with progression (or otherwise) of the disease rather than initial susceptibility. Perhaps Liam will be able to address progression.

But as we're on susceptibility...

Quote from: Hawk on September 12, 2007, 08:47:30 AM
I suspect that everyone that has Peyronies Disease is physically susceptible in varying degrees.

... I would go further and say that every adult with a penis is susceptible in some degree to Peyronies, the main variables, other than genetic predisposition, being age and the amount you masturbate.

I have Peyronies, I believe, simply because I am over 50 years old and on one particular day, having never heard of Peyronies disease and not knowing the risks, I went too far... masturbating while my penis was still inflamed from the previous time.  I don't believe you have to slam your tool in a car door to get Peyronies if you're low risk. Those who get it from some sudden trauma such as that or during sex are just plain unlucky. I think it's more of a wear and tear issue (from masturbation, not normal sex), in the same way that joggers, for example, have an increasing risk of joint injury as they get older...

This is all just my opinion, of course. I'd actually be quite relieved if you came back and said I was way off the mark....

Hawk

Quote from: shrout on September 12, 2007, 11:49:15 AM
... I would go further and say that every adult with a penis is susceptible in some degree to Peyronies, the main variables, other than genetic predisposition, being age and the amount you masturbate.
...Those who get it from some sudden trauma such as that or during sex are just plain unlucky. I think it's more of a wear and tear issue (from masturbation, not normal sex), in the same way that joggers, for example, have an increasing risk of joint injury as they get older...

This is all just my opinion, of course. I'd actually be quite relieved if you came back and said I was way off the mark....

You are way off the mark - Feel better?  :D

Shrout,

I do believe you are way off the mark.  I think masturbation is defined as sexual self-stimulation.  In that definition I guess one person's masturbation could be masochistic hanging from a rafter by their penis (similar to slamming it in a car door ). Without referring to studies, I feel safe saying that 75% of men over 40 masturbate and do so with no knowledge of Peyronies Disease.  They also do so with the full image of their penis as indestructible since 99% masturbated very frequently as a teen or young man, most several times in one day at some time in their life.  At fifty they are no more concerned or cautious, just likely to be far less frequent.  Sooooo, if 75% of men over 40 masturbate with little monitoring of whether their penis is a bit tender and only 1% -10% ever get Peyronies Disease, your contention that masturbation is a big factor does not hold water.

I also speculate that typical masturbation is no more traumatizing than foreplay and sex with a partner.  So unless we have far different things in mind when we discuss sex and masturbation, I ain't buying it for a minute.

I have to admit I am assuming I know the range of normal masturbation and sex.  Maybe I have lived in the dark.  Have Liam tell you his Buddy Hackett joke (it is very funny) - Maybe if we knew everything there is to know we would be astounded at how other people treat their penis.
Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

Tim468

Hawk

With all due respect, I think it is more safe to assume that some men abuse their penis for a varitey of reasons. Masturbation until the point of swelling, redness, pain and even damage are not as uncommon as you might think. This delves into the realm of addiction and compulsive behavior - almost defined as the doing of something even when it is demonstrated to cause us harm.

I do not think that a "lot" of masturbation is harmful. However, there is always some sort of excess to this, and hour upon hour to the point of pain, driven coumpulsively has been associated with the onset of Peyronie's in more than one description of the onset here. Of course, we do not know for sure if this is a cause or a coincidence, but I think it is possible.

Tim
52, Peyronies Disease for 30 years, upward curve and some new lesions.

Hawk

Tim,

How do you like my subject title  ;D

Tim, you may be right, I have no clue how we would ever know.  I guess it is just difficult to imagine one more obsessed than I have been from the point of about 12 years old.  I never caused bruising or swelling,  Maybe a bit of skin irritation from time to time.

I agree in principle that if a man causes enough injury to make his penis swell whether in sports or masturbation it could trigger Peyronies Disease.  It seems we need some clarification when we discuss this because when we say intercourse is not likely to cause Peyronies Disease maybe someone interprets sex as jumping off of a springboard and trying to hit his partner with an erect penis from 30 feet away.  

It all keeps going back to Liam's joke about whether you gently tap the dew from your unit when you finish at the urinal, or whether you grab it with two hands and wring it out.


PS: I wonder why zoo monkeys don't all have Peyronies Disease?
Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

Liam

If overnight you have symptoms that remain unchanged, this must be from a significant trauma.  This is not to say there is no trauma or micro trauma involved in cases that progress for 6+ months before stabilizing (and may possibly progress later).

In the past I have labeled these as two different conditions.  Others think differently, but those are just labels.  The important thing is to realize there are possibly different outcomes for fibrosis from different precipitating factors.

As far as the other subject, I'm thinking we should have a "National Be Kind to Your Penis Week".

QuoteI remember a joke Buddy Hackett told on Carson's tonight show.  It has been over 25 years.  

A man went in to the doctor and the doc said, "How can I help you?"  

The man replied, "I have a gnarled thing"

The doctor proceeded to examine the man and agreed it was quite gnarled.  The doctor was at a loss as to what to do and advised the man to come back for a follow up in two weeks.

Two weeks later the man walked into the doctors office and amazingly he was no longer gnarled.  To this the doctor said, "This is great.  How'd you do it?"

"Well doc, I tapped it straight"

"You what"

"I tapped it straight.  I was in the men's room and noticed the man next to me shaking the dew from his lily.  He went tap tap tap on his thing.  I looked the other way and the man to my left went tap tap tap, too.  So I thought it was a good idea and started tapping.  I have now tapped myself straight."

The doctor was puzzled and asked, "What in hell did you do before?"

Gesturing with two fists the man replied,

"I  W R U N G  it out"
"I don't ask why patients lie, I just assume they all do."
House

Tim468

My wonderfully funny Jr High School Health and Gym teacher defined it thusly: "Too much masturbation is defined as someone doing it more often than you do".

Tim
52, Peyronies Disease for 30 years, upward curve and some new lesions.

Hawk

Quote from: Liam on September 12, 2007, 04:55:16 PM
If overnight you have symptoms that remain unchanged, this must be from a significant trauma.  

I guess significant trauma is like masturbation.  Define it as you will.  I guess a micro-trauma is significant if it triggers Peyronies Disease.

I would think if a man was paying enough attention to notice his penis developed a bend that he would know if he had my definition of a significant trauma.  He would remember the event.

The speed of the bend is directly related to the aggressiveness of the scaring process, not necessarily the degree of trauma.  I went from a slight natural upward curve to a dorsal curve to straight to right lateral and upward curve.  Each of these successive changes happened within days but had months of no noticeable progression in between the changes.

Ohhhhhh, I might add, without excessive masturbation ;).  
Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

Liam

The order of events seems most frequently to be small nodules then bend.  If you go from nothing to plaque and bend overnight, I'm thinking something big happened.   But, who knows for sure.

Tim,

Times have changed.  That story is very funny.  But, if I said that to a student today, I would be fired and sued and probably arrested.
"I don't ask why patients lie, I just assume they all do."
House

hector

Thanks everyone for the sympathetic and informative responses.  It really means a lot.  (Liam, sadly I must concur with your take on the non-profit world.  And all those greedy, self-centered people probably take much better care of their penises than I've managed to!)  

I've been reading up more on the Child Boards, but I still have a couple questions regarding the treatment recommendations you guys gave.  I've got an appointment with my urologist tomorrow morning, so I really want to go in with the best understanding I can and have him prescribe me the best stuff.  So...  

Viagra -- Is the purpose of Viagra to induce erection for men whose Peyronies Disease makes this much more difficult? My Peyronies Disease has changed the shape and width of my erection in the affected area and reduced overall length, but as far as I can tell right now my Peyronies Disease hasn't physically affected my ability to achieve one.  I do experience insecurity because of my condition, thus hard-ons tend to get me a little depressed.  But I still get them spontaneously and even randomly without any spefific stimulation, probably as frequently as I did before the onset of my Peyronies Disease.  So is Viagra right for me?

Traction -- Intended to re-mold the penis, right?  Dr. Levine's clinical trial is still underway, right?  I've seen a lot of guys recommend this, but I guess the bending and stretching worries me, because... well, isn't that what probably caused my problem in the first place?  Are there any reports of traction worsening the problem?

VED -- Intended to stretch the penis length-wise, right?  I guess my worries about traction apply here, too.

And a related question -- Should I be trying to have more or fewer erections, for longer or shorter duration of time?  i.e. Should I be giving the old weenie a rest or a regular workout?  Obviously, the compulsive masturbation and rough sex is a bad idea, but what seems to be the right level of activity for a man with Peyronies Disease -- one erection per day?  What about ejaculation as opposed to simply having an erection?  Tim, you have advised regular erections because you say this helps combat progression, right? I guess I just wanted to double-check.  As I've said, I don't have a problem getting an erection (which remains normal in the area without plaque).  But my biggest fear is doing anything to make my Peyronies Disease worse. I still do get occasional pains in the plaque area, which makes me think it isn't totally static yet, and I usually get some pain there after an erection.  I've learned that I can still get by with the penis I've got now for the meantime, but I really don't want to risk doing anything to make my Peyronies Disease worse.

Given all this, does the PAV cocktail still seem like my best bet?  I was surprised to see that noone recommended the drugs I asked about trying (Potaba, Colchicine, Verapamil, Neprinol).  When I first saw my uroligist, he made it seem like my only options were Vitamin E, Potaba, or surgery.

Also, in reading more mens' experiences in the forum, I wonder if I may have had a "nodule" present a fairly long while (maybe even years) before the very sudden appearance of my curve-- which again, appeared overnight and hasn't changed much since in 6 months.  I'll have to read up more on these nodules.    

On a final note, my experience really makes me frustrated with the lack of sexual health education I received growing up.  Sure, "Use a condom to avoid STIs and unwanted pregnancy," that was covered --but nothing so specific as "Be kind to your tunica."  Had I known more about the anatomy of the penis and trauma that could lead to Peyronies Disease, I think I would have been a lot smarter and not dealt with depression in a way that ended up giving me something new to feel bad about.  I'll be sure to check out the advocacy/awareness/activism section soon.
     

hascal

Hector - I just wanted to thank you for asking all the questions I have had rolling thru my mind. I was told in 1984 I had Peyronies because of a lump I felt but had no curve or pain. I had no problen until about 2 years ago when I started to curve to the left. After 2 months it stabilized and now it curves upward with a 30 degree bend. I started a search for a URO who could help me and after 6 months and 3 URO's I found one who I like. But after reading everyone's posts about verapamil and ionto-whatever I am more confused than ever. I do not need Viagra - I have tried Neprinol, ACL, and Vit-E with no progress. I have massaged daily in the shower thinking the stimulation would help break down the plaque - should I try for more or fewer erections & massages ? I even have to wait 2 months to get into a program to start treatment !! I have started taking anti-depressants to deal with the depression, I am sensitive to every comment my wife makes, and I spend hours on the net looking for something "new". I guess what I am trying to say is I feel your pain. I did nothing to deserve this. I am not a sexual athlete, I do not like rough sex, and I am a health nut. I am in my late 50's but look like I am in my 30's. I used to be a confident heterosexual but I have been slammed to my knees with this. So I am like a sponge soaking up any and everything but nothing is working. I will keep you posted after 11/07 and start my treatment ( for which I have to drive 65 miles one way ) .  >:( Hascal.

Hawk

Since your posts do not relate to the cause of Peyronies Disease, I posted my response in the "Open Questions" topic.
Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

tman

After a injury to my penis in a flaccid state...I have noticed a slight upward curve about a 1/2 inch below the glans.  I cannot feel any lumps, hard spots ,anything different in flaccid or erect state. No pain.  Can you always "feel" scar tissue with the disease?  Or can this be something else??