While the primary interest of Peyronie’s disease treatment is the internal scar tissue or fibrous  plaque material that causes the distortion or curved penis to develop, it is not the primary interest of the man who has PD.  For him, the most important aspect of Peyronie’s disease is the curved penis that plagues him.  For this reason Peyronies is also known as the “bent nail disease.”

Peyronie’s disease causes a curved penis when the fibrous tissue of the Peyronie scar or plaque pulls unevenly or causes incomplete filling within the erect penis.  This can vary in degree or severity from man to man.  For this reason the curved penis does not indicate the severity of the Peyronies problem or success of Peyronies disease treatment.  The true success of Peyronies treatment is based on the change that occurs in the Peyronies plaque or scar.  Once the fibrous scar changes, eventual improvement in the curved penis can be expected in time.

The internal tissue of the healthy penis is flexible and expandable.  This normal tissue is able to allow for a normal erection to develop when blood is trapped inside the organ.

In Peyronie’s disease some of the tissue is not healthy or flexible and elastic.  Specifically, the deep tissue known as the tunica albuginea is not elastic because it replaced by dense and inelastic fibrous tissue that is called a scar or plaque.   As an erection develops the elastic tissue of the tunica albuginea must stretch and expand evenly on both sides, left and fright, and top and bottom, of the penis.  If this cannot happen because an area of the penis is no longer flexible and expandable, then a curved penis results.

Peyronie’s disease usually begins with a small nodule or bump that is found on the top or sides of the penis, just immediately below the surface.  A few weeks to several months to a year later, a small fibrous nodule can expand into a larger irregular scar of variable size, shape, density and surface quality.  These scars can be as long as the penis.  Some appear like a collar to go around the shaft.   Some are one large mass, while others appear to be like small isolated islands of fibrous tissue in many areas.   Scars can be so soft or small, with edges so tapered and vague that no scar can be found.  In a case of Peyronie’s disease when no scar or plaque can be found, it is still assumed to exist when a curved penis develops during erection. .

Normally curved penis

Most men have a straight erection, but some are born with a penis that curves or bends (usually upward).   Just as fingers on the hand or a nose can display a natural bend, or arms can be of different length on the same person, the penis can be bent without the presence of Peyronies.  Typically, the normally curved penis follows a more gradual and arched design, more like a banana.  In Peyronie’s disease the curved penis is more localized and abrupt, like an angulated bend.

When the two primary chambers (corpora cavernosa) of the penis are a different diameter or length, the penis will bend when erect.   The penis will appear straight when flaccid, and on erection it will bend.

This slight penile distortion will not be associated with pain, there will be no trauma in the history, and it will not appear suddenly as does the curved penis of Peyronie’s disease.

Curved penis affects sexual intercourse

It is estimated that 75-90% of Peyronie’s disease couples will sooner or later experience a sexual intercourse problem, in regard to either pain or difficult penetration – or both.   The curved penis of is the primary reason sexual penetration is compromised, and it is also the reason for the pain that can be experienced by either – or both – partner. This is especially so in those cases in which the distortion is so severe it is described as “cork screw” or “cane handle.”

Incomplete filling of the penis with blood during erection can also happen in Peyronies.  This results in an area of the penis, either small or large, that is soft and unable to sustain the rigors of intercourse.  A soft area within an otherwise firm erection presents a weakness and vulnerability of the normally turgid erection.  A weak area of erection can suddenly collapse or buckle during intercourse, causing additional injury to the penile tissue.  This can cause pain, inflammation and additional fibrous infiltration.

It is a rare Peyronies couple that does not deal with some level of sexual difficulty related to penile distortion and reduced firmness of the erection.  The many physical, emotional and social issues of Peyronie’s disease are complex.  For this reason the reader is referred to “Peyronie’s Disease and Sex” for more information about this complicated area of life with a curved penis.

Treatment of the curved penis

It is important to remember that any penile distortion that develops in Peyronie’s disease is not the primary problem of this condition.   A curved penis that appears one night is difficult to ignore, but is only a symptom of the real problem of Peyronie’s disease – the scar. Without the Peyronies scar there would be no curved penis.

This is the reason I advise men who are undergoing Peyronies treatment to focus on the size, shape, density and surface qualities of the scar or plaque to determine if their Alternative Medicine treatment is being effective.  The curvature can improve or worsen as the scar is reduced.

A small scar can cause a large bend, just as a large scar can cause no bend at all if it is balanced and symmetrical.   For this reason a curved penis can worsen as the scar is being reduced or eliminated.   Estimating progress or success of a PD therapy plan is difficult .  A man can have many more scars than he is aware of, and they can be larger than can be detected since they are often difficult to locate and often overlap.

If only one scar is present the curvature problems are direct and easy to understand, although  this is unusual.   However, if multiple scars are present the internal pulling and twisting they cause can be very complicated.   Several scars can interact on many  planes of internal penile tissue.   Any reduction in one or more scar will alter the internal tension and pulling of the tissues, resulting in an altered curvature.  There is no guarantee the curvature will change for the better initially – sometimes it can look worse as the scars become smaller.  This is why I advise to focus all attention to the size, shape, density and surface qualities of the scar while treatment of the Peyronies problem continues.  Realize the curved penis is just a reflection of what is going on with the scar9s) below the surface.

Do not be discouraged by the curved penis of Peyronie’s disease.  Instead, stay focused on your plan for effective Peyronies treatment.  Learn more about Peyronie’s disease treatment.

An important consideration of Peyronie’s disease treatment concerns how the ability to develop a normal erection will be influenced.

While erections can be difficult to develop on demand during a sexual situation, paradoxically, an erection can be difficult to stop, especially when it develops while asleep.  Nocturnal (nighttime) erections occur for a reason, and they are important for the overall health of the spongy tissue of the corpora cavernosa and corpora spongiosum (deep tissues of the penis that fill and trap blood to create the erect state).

It is as though the body takes the opportunity to develop an erection during the night when there is little other activity going on, to assure that the penile tissue is stretched and used in this particular way for its own benefit.  The problem with nocturnal erections in Peyronie’s disease is that confinement and binding of the erection can be sustained against the penis for a long period of time at the risk of additional injury.  Be especially careful about getting an erection during a time when the penis has no comfortable place to go – do what you can to avoid an erection while wearing tight underwear or pants.

For this reason it is important to not wear tight clothing to bed in order to avoid this problem.

For the most part, a normally occurring erection that can simply “stand on its own” with no pressure against it, is not going to bind or stretch out the penile tissue to any great excess that is going to be detrimental to the penis. Where you can get into trouble is in creating a drug-induced or artificial erection, during which an abnormally great amount of blood is drawn into the penis by more soft tissue relaxation than normal.  So in this way we see that a naturally occurring erection is safer than an artificially created erection.

Over the years I have communicated with many men whose Peyronies disease started after a drug induced erection that stressed the penile tissues by greatly increased internal pressure.  This process would not be much different than taking a car tire that is meant to go no higher than 40-50 PSI during normal use, and over-inflating it to 100-150 PSI during use.  Because it is not built to take that kind of pressure, you could expect some problems to develop in using a tire that way.  Not much different with the penis.

Sexual activity is NOT to be avoided if you have Peyronie’s disease, but rough, aggressive, hard sex could really hurt you.  Developing and using a natural erection is not to be avoided either in PD.  Just keep your wits about you and do not go wild during sex.  The emphasis should be on an easy, smooth and gentle sexual encounter.  Anything that causes pain should be avoided.

Many important related topics about taking care of yourself, avoiding injury, doing nothing to set your progress back while you are attempting to heal your problem, are covered in my recent book, “Peyronie’s Disease Owner’s Manual.”   Check out the website about this book at  http://www.peyronies-disease-help.com/PD-owners-manual.html I think you would enjoy learning more about what you can and should do to take care of this nasty problem.

There are several reasons why Peyronie’s disease impotence (erectile dysfunction) develops in about 75 percent of the men who have this condition. Peyronie’s disease impotence can be mild or total, it can be occasional or constant, but it is extremely common for men with Peyronie’s disease to experience sexual intercourse performance problems.

Impotence is defined as the continual inability to sustain an erection long enough or strong enough for sexual intercourse or the inability to achieve ejaculation, or both. Peyronie’s disease impotence is the erectile dysfunction that develops due to abnormal changes in the penis that are part of Peyronie’s disease.

Most people assume that Peyronie’s impotence develops due to lack of blood flow to the organ. This might be true in especially in those cases in which the man has an underlying problem with the cardiovascular system (high blood pressure, elevated cholesterol, vascular disease, diabetes, etc.) In other men , another occasional cause of Peyronie’s disease impotence is emotional. Because of the reduced self esteem, shame, embarrassment and anger related to penile distortion and reduced length and girth of the organ, a man can develop strong emotional expressed as Peyronie’s impotence. However, for most men the primary cause of Peyronie’s disease impotence is simply due to what is known as “venous leakage.”

Peyronie’s impotence fundamentals

In a great number of cases of Peyronie’s disease impotence the fundamental problem is that the blood is no longer being trapped by the veins of the penis to dam it up to create the greater fluid pressure of an erection. The problem is that the veins of a man with Peyronie’s disease do not close to trap blood well. This imperfect or absent closing is caused in great part by the presence of the Peyronie’s scar. The scar acts like something that is blocking a door from closing. That is where therapy should be directed in Peyronie’s disease impotence – toward removal of the scar so the veins can close to allow a normal erection to develop.

One of the greatest and most effective ways to directly treat Peyronie’s impotence is with an Erektor. An Erektor is an external penile support device that offers just enough gentle support to the penis – even without an erection – to hold it for easy penetration to allow intercourse to continue as long as the couple desires. The Erektor allows men to perform full quality intercourse without erectile medications or supplements. Unlike ED medications, the Erektor is safe because it has no drug side effects.

The Peyronie’s Disease Institute is proud to be the only company to serve as an authorized distributor of the Erektor. For those couples who must deal with the frustration of Peyronie’s disease impotence, the Erektor is often the only thing that helps.

Please go to our sister website known as Natural ED Solutions to learn more about the Erektor and get some real help for your Peyronie’s impotence.

Cause of Peyronie’s Disease

As anyone who has the problem knows, the cause of Peyronie’s disease is not well understood.  However, any research topics that shed light on this basic question are of great interest to men who have Peyronie’s disease.

Perhaps a good question to start with is, what causes the erect penis to bend in a case of Peyronie’s disease?  The answer lies in the function of the corpora cavernosa functions in the mechanism to produce an erection. There are actually two corpora cavernosa, laying side by side like two cigar shaped, paired balloon-like chambers that must be filled with blood to create an erection. Their connective tissue wall, the tunica albuginea, offers resistance and rigidity when it is stretched to its maximum.  The tunica is elastic to a point, but unlike the thin and flexible wall of a balloon, the tunica albuginea is interlaced with strong connective tissue fibers. These strong fibers do not allow for much expansion, and eventually determine the shape of the erect penis because of their structural rigidity.

Thus, in a very real and fundamental way, Peyronies disease is a disorder of the tunica albuginea. By producing dense and rigid areas of the tunica, called plaques or scars, Peyronie’s disease interferes with the full expansion of the tunica. Plaques are either regions of reversible inflammation in early phases of Peyronies, or permanent scars later if the inflammation is severe and continues too long.  Much like a piece of tape placed on the wall of a balloon, the plaque or scar causes uneven filling and expansion of the tunica, and this causes bending  of the column of the corpora cavernosa.

A basic question is, what causes these plaques to begin?  Microscopic and chemical studies show that plaques represent an early stage of the wound healing process when the tunica is injured. Whatever starts Peyronie’s disease, the problem seems to the inappropriately increase of the normally healthful and proper process of wound repair.  Actually, wound healing may not be the appropriate term in all situations.

Most likely cause of Peyronie’s disease

One cause of Peyronies disease is obvious and direct trauma to the erect penis. This trauma can range from sudden and unexpected angulation during sex, to am actual rupture of the corpora cavernosa.  However, the fact is, many men with Peyronies do not recall any such traumatic occurrences.

Over time, all sexually active men will experience some degree of wear and tear on vulnerable areas of the soft tissue erection mechanism. Both the structural arrangement of the corpora and the inherent elasticity of its connective tissues counteract the strong mechanical stresses created by strong sexual activity.  But when men reach their mid-fifties, fundamental connective tissue elasticity throughout the body, and the penis, is on the decline.   And so, it just so happens that the average for appearance of Peyronies disease is fifty-four.

Peyronies plaques most often appear along the top surface of the penis. It is this region where the two corpora meet side by side, along the upper edge of the “inflatable I-beam” created during an erection that is most vulnerable to stress induced delamination.  Another word for a layer is a lamina; when layers are disrupted or separated, it is called delamination.

Autopsy studies in the mid-1990s on men have shown the earliest microscopic changes thought to be early Peyronies disease changes are actually a common finding.   It seems that while many men develop these changes, they will evolve into Peyronies plaques only for a small percentage of cases.

So what causes the process of normal wear and tear to develop abnormally into the destructive process of wound healing that is called Peyronie’s disease?  There are no clear answers to this question.   However, Peyronies disease is more common in diabetics, as well as men who have gout.  These are two conditions that can have an adverse affect on normal connective tissue healing. It is also more common in the presence of Dupuytren’s contractures. These scars of the fascial covering of the finger tendons in the palm of the hand are thought to be inherited, and may reflect an abnormal tendency toward scar formation in other areas.

Thus, we see that much is still to be learned about Peyronie’s disease, but as these microscopic tissue clues are unraveled, the mystery of this problem will be advanced, as well as Peyronie’s disease treatment.

Peyronie’s disease is all about the Peyronies plaque, because the Peyronie’s plaque causes all the problems we normally associate with this condition.  To back this idea up, and to show you are doing something that is potentially dangerous to your Peyronie’s disease by using erection enhancing drugs, let’s review some interesting research that took place about 15 years ago.

First, some background. According to two Peyronies disease researchers, Drs. J. A. Lopez and J. P. Jarrow, from the Department of Urology, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina, most of the erectile dysfunction that is associated with Peyronies disesae is proabbly not due to reduced blood supply coming into the penis. Hence, taking Viagra, Cialis, Levitra, or any erection producing drugs, is often not effective and when it is it could be dangerous when someone with PD any erection producing drug.

Let’s get through the technical material first and then I will put it all together as it relates to using these drugs because you have Peyronies.

In the study done by Lopez and Jarrow, they did a penile vascular (blood flow) evaluation; they tested the penis arteries (to determine blood flow coming into the penis), and they tested the penis veins (to determine the blood flow leaving the penis).

They tested 95 consecutive men who came to them for evaluation or treatment of Peyronie’s disease; of these 95 men, 19 were potent (able to become erect) and 76 were impotent (not able to become erect).  They also did the very same kind of penile vascular (blood flow) evaluation on 100 consecutive impotent men who did not have Peyronie’s disease so they could compare the condition of their blood vessels as it relates to erections and erectile dysfunction.

Potent men with Peyronie’s disease

After testing the 19 potent men who had Peyronie’s disease, they found only one (5%) of the 19 potent patients had abnormal arterial blood flow coming into the penis, and none (95%) had evidence of abnormal venous blood supply leaving the penis.

Impotent men with Peyronie’s disease

After testing the 76 impotent men who had Peyronie’s disease, they found that 27 men (36%) had abnormal arterial blood flow coming into the penis, and 44 men (59%) had evidence of abnormal venous blood supply leaving the penis.

Potent and Impotent men who did not have Peyronie’s disease

There was no significant difference in historical risk factors for impotence between the impotent men with or without Peyronie’s disease and the control population of impotent patients.

After testing the 100 men who did not have Peyronie’s disease they found they had about the same percent of abnormal arterial blood flow coming into the penis.  However, they found these same men had significantly less (16%) abnormal venous blood supply leaving the penis.

So the big difference was that the impotent men (59%) with Peyronie’s disease had a whole lot more abnormal venous blood supply leaving the penis, than the impotent men (16%) who did not have Peyronie’s disease.

This means that although men with Peyronie’s disease may suffer some impotence due to artery blood flow problems, the research proves that the primary and overwhelming cause of impotence in men with Peyronie’s disease is abnormal venous blood supply leaving the penis.

So you ask, “What could be wrong with my venous blood flow leaving my penis?”  Answer:  your Peyronie’s plaque.

Peyronie’s plaque causes impotency

It is the Peyronie’s plaque that causes the veins of the penis to not close properly.  There are special valves within the veins of the penis that close off at special times, to trap the blood inside the penis – to create an erection.  If the veins do not trap the blood, no erection.  The presence of the plaque or scar material is the problem that causes the valves of the veins to not trap blood, hence a poor or absent erection.  Yes, there are surely many emotional reasons a man with Peyronies will develop impotency, but this vein problem is by far the primary physical reason for this erection problem that we all are interested in.

Imagine that you want to close a door to trap warm or cold air inside a room.  You try to close the door, but you cannot because there is something causing the door to not close all the way – perhaps the door is warped, or maybe there is something lying across the doorway like a doorstop and the door will not seal the room shut.  If the door cannot be closed fully, it will be difficult or impossible to close the door, and you cannot trap the air in that room. It is the same in Peyronie’s disease. If the valves of the veins cannot be closed fully, it will be difficult or impossible to close them, and you cannot trap the blood to create the erection.

The presence of one or more Peyronie’s disease plaques or scars can and will cause physical interference with the normal closing of the valves inside the penis veins and one or more areas of the penis stay soft, preventing intercourse.  It is as simple as that.

So your medical doctor, hearing that you are having a problem with impotence along with your Peyronie’s disease says to you, “Do not fear.  I have my magic prescription pad here.  I will happily write a prescription for  Viagra, Cialis, or Levitra and you will get an erection that will amaze and delight the woman you love, and amaze all your family, friends and neighbors.  Please pay the nurse at the front desk as you leave.”

I will write more about the potential dangers of erection producing drugs like Viagra, Cialis, and Levitra in relation specifically to Peyronies.  For this discussion it is sufficient for you to understand that Viagra, Cialis, and Levitra only bring more blood into the penis.  The do not and cannot help you to trap it there to create an erection.  This is why they may or may not work for you, and in fact, could potentially make your Peyronie’s disease worse.

For more information about the safe and effective treatment of Peyronie’s disease with Alternative Medicine, go to the Peyronie’s Disease Institute website.