Sam awoke one morning to find that his morning erection was bent upwards and slightly to the left side. He was understandably horrified. There had been no trauma to the penis with he and his partner, Mary, last having sex two days ago. On examining his penis, he could feel a small tender lump on the top of the penis. Sam did not alert Mary hoping the problem would go away.
The next time he and Mary attempted sexual intercourse he found it difficult to achieve vaginal penetration. They managed to have sexual intercourse, but she commented on the difficulty to penetrate and was shocked to see his bent penis. He was mortified.
“Dr Google” revealed that he most likely had Peyronie’s disease. A massive number of treatments were recommended on-line including surgery. Confusion and a heavy work schedule led to Sam avoiding no to see his GP until Mary urged him to do so, 8 months after the onset. His GP confirmed the diagnosis of Peyronie’s Disease? link to PD in conditions we treat and referred Sam to PMH.
Sam had the foresight to bring in 2-demensional photos of his erect penis, which, using a protractor revealed a 40-degree upwards curve commencing at the middle of the shaft and a 20 degrees curvature to the left side. He reported some difficulty to maintain a fully firm erection. Examination revealed a 1 x 2mm area of fibrosis (plaque) in the middle of the top of the shaft extending slightly to the left side.
We recommended that Sam begin a conservative course of treatment consisting of once daily Cialis 5mg, use of a vacuum erection device (VED) in a structured program and a 5-week course low intensity shockwave therapy. In his case, over a period of 3 months, the treatment resulted in removing the curve to the left side, reduction of the upward curvature to 20 degrees (measured by repeat photos) and a return to full erectile function. Sam was very satisfied with the outcome. As the problem was initially causing significant distress between, he and Mary, we referred him to a Psychologist with Sexology training at the beginning of the physical treatment for counselling and guidance. They reported major benefit from this.
Disclaimer: Not all patients will have the same degree of success with conservative treatment. Beginning a holistic, scientifically based treatment program is however a major psychological boost to patients such as Sam, especially with his wife’s support.