The sex life of a middle-aged man is under threat from any number of urological conditions. One of the most psychologically and physically debilitating is erectile dysfunction. And while we have excellent first-line options in the form of medications like Viagra and Cialis or their generic versions, Sildenafil and Tadalafil, as well as penile injections, eventually, patients with erectile dysfunction, will not be able to achieve the erection they want, even with these arrows in their quiver.
Unrelated in cause but certainly related in function is a curvature or deformity of the penis known as Peyronie’s disease. There are several possible causes of Peyronie’s curvature, many of which we don’t understand fully. However, the general consensus, or at least a going theory, is that micro-traumas to the penis over time can cause the buildup of penile plaque that ultimately underlies the curvature of the penis. Penile plaque can accumulate anywhere around the penis, and therefore the curvature is not necessarily upward but can also be downward or even to the sides.
Peyronie’s disease has several potential treatments and options. About 5-10% of cases will improve independently. This leaves most patients needing some intervention for relief. The only FDA approved medical treatment for Peyronie’s is a medication known as Xiaflex that can be injected into the penile plaque and, along with manual traction, can soften the plaque and help remodel the penis to a more normal state. Xiaflex can be effective in nearly 75% of patients that undergo treatments, leaving some needing more invasive intervention. Penile plication to straighten the penis with a counter-suture or plaque removal and grafting, which allows the surgeon to remove the penile plaque mechanically, are a couple of options for more significant diseases.
However, if patients are suffering from severe erectile dysfunction as well that does not respond to medications, then they must consider a penile implant. A penile implant can be used to straighten Peyronie’s curvature. Call it a 2-for-1 curative option. This surgical option is, of course, a very personal decision that must be made in consultation with an expert in both conditions, like Dr. Kapadia.
When a Penile Implant Is Indicated
It is worth understanding that a penile implant may not be performed on patients who are responding to ED medications. On the other hand, patients with severe erectile dysfunction need not have severe Peyronie’s to benefit from an implant to address both conditions. In other words, erectile dysfunction is the primary diagnosis and justification for an implant.
The Bottom Line
In the case of both Peyronie’s Disease and Erectile Dysfunction, the most significant limiting factor in men finding the proper treatment is fear and embarrassment. However, it’s essential to know that Dr. Kapadia works with men of all ages and all severity levels to treat both disorders. So, the first step is making an appointment with Dr. Kapadia to learn more about this and other potential treatment options.
