eMedicine Specialties > Dermatology > Benign Neoplasms

Peyronie Disease: Follow-up

Author: Jay W Zimmerman, MD, FAAD, Consulting Physician, Berman Skin Institute, Palo Alto
Coauthor(s): Anne Laumann, MB, ChB, MRCP(UK), FAAD, Associate Professor, Department of Dermatology, Feinberg School of Medicine, Northwestern University; Gregory Bales, MD, Associate Professor, Department of Surgery, Section of Urology, University of Chicago
Contributor Information and Disclosures

Updated: Feb 4, 2010

Follow-up

Further Outpatient Care

  • Radiation treatment may be recommended for early, especially painful situations.
    • Radiation from a beta-beam linear accelerator is used to reduce inflammation.
    • This treatment does not change or remove late-stage postinflammatory plaques.
  • Extracorporeal shock-wave therapy may help in treating the curvature associated with Peyronie disease. This treatment does not help the pain and is still experimental.

Deterrence/Prevention

  • Theoretically, patients with Peyronie disease should avoid vigorous intercourse with a weak erection.
  • If the patient has diabetes, it should be controlled.
  • No method for absolute prevention is known.

Complications

  • Complications of Peyronie disease include the complete inability to maintain sexual performance.

Prognosis

  • Peyronie disease only occasionally, if ever, disappears completely.
    • The pain may diminish or resolve after the early inflammatory phase, and as many as 13% of patients claim to have some improvement with time.
    • Approximately one half of the remaining individuals have progressive disease, whereas the other half have static disease.
  • Variable degrees of morbidity may occur. Conditions range from a static painless plaque without penile angulation to painful erections with a curvature significant enough to prevent sexual activity.
  • Data suggest a combination approach to therapy for Peyronie disease, such as the use of partially effective oral therapies with minimally invasive mechanical or intralesional treatments, may be more successful than the individual therapies on their own.

Patient Education

  • Patient education in Peyronie disease includes the following:
    • Reassurance that lesions are not cancerous or fatal
    • An explanation that the condition is not curable but that it is treatable and possibly self-resolving
    • An open discussion about the problems with intercourse, the possibility of the resumption of satisfactory sexual activity, and the reduction of pain

Miscellaneous

Medicolegal Pitfalls

  • Performing surgery too soon, before the Peyronie disease plaque is stable, before medical management is tried, or before an observation time of 12-18 months is complete may result in ongoing fibrosis around the surgical site.
  • Failure to educate patients concerning the likely prognosis and reasonable expectations is a pitfall.
 


More on Peyronie Disease

Overview: Peyronie Disease
Differential Diagnoses & Workup: Peyronie Disease
Treatment & Medication: Peyronie Disease
Follow-up: Peyronie Disease
Multimedia: Peyronie Disease
References
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Further Reading

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Keywords

Peyronie disease, PD, Peyronie's disease, plastic induration of the penis, penile fibromatosis, fibrous sclerosis of the penis, penile shaft thickening, painful erection, penile curvature, curved penis

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Contributor Information and Disclosures

Author

Jay W Zimmerman, MD, FAAD, Consulting Physician, Berman Skin Institute, Palo Alto
Jay W Zimmerman, MD, FAAD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, and California Medical Association
Disclosure: Allergan Consulting fee Consulting; Centocor Consulting fee Consulting; Galderma Consulting fee Consulting

Coauthor(s)

Anne Laumann, MB, ChB, MRCP(UK), FAAD, Associate Professor, Department of Dermatology, Feinberg School of Medicine, Northwestern University
Anne Laumann, MB, ChB, MRCP(UK), FAAD is a member of the following medical societies: American Academy of Dermatology, Association of Professors of Dermatology, Chicago Dermatological Society, Chicago Medical Society, Illinois Dermatological Society, Illinois State Medical Society, Illinois State Medical Society, Medical Dermatology Society, and Society for Investigative Dermatology
Disclosure: Boerhinger-Ingelheim Consulting fee Consulting; Pfizer Consulting fee Consulting; Astellas Consulting fee Consulting; Alza J and J Grant/research funds Other; Amgen Grant/research funds Other; Basilea Grant/research funds Other; OSI Pharmaceuticals  Other; Centocor Grant/research funds Other; Lilly-ICOS Grant/research funds Other; Bavarian Nordic Grant/research funds Other

Gregory Bales, MD, Associate Professor, Department of Surgery, Section of Urology, University of Chicago
Gregory Bales, MD is a member of the following medical societies: American Urological Association
Disclosure: Nothing to disclose.

Medical Editor

Terry L Barrett, MD, Clinical Professor of Dermatology and Pathology, University of Texas Southwestern School of Medicine; Director, ProPath Dermatopathology, Dallas, Texas
Terry L Barrett, MD is a member of the following medical societies: American Academy of Dermatology, American Dermatological Association, American Medical Association, American Society of Dermatopathology, College of American Pathologists, and United States and Canadian Academy of Pathology
Disclosure: Nothing to disclose.

Pharmacy Editor

David F Butler, MD, Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic, Northside Clinic
David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Managing Editor

Jeffrey P Callen, MD, Professor of Medicine, Chief, Division of Dermatology, University of Louisville School of Medicine
Jeffrey P Callen, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, and American College of Rheumatology
Disclosure: Amgen Honoraria Consulting; Abbott Honoraria Consulting; Electrical Optical Sciences Honoraria Consulting; Centocor Honoraria Consulting; Medicis Honoraria Consulting; Celgene Honoraria Consulting

CME Editor

Catherine M Quirk, MD, Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania
Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology
Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

 
 
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