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Author: Vanessa Ngan, Staff Writer, 2003.
Penile fibromatosis presents as a plaque or hard lump in the layers of erectile tissue that occurs more often on the upper than lower side of the penis. Mild cases may just appear as redness and swelling (inflammation), whilst in more severe cases hardened plaques force the penis to bend during erection, which may be painful.
Penile fibromatosis is also known as plastic induration of the penis and Peyronie disease.
Penile fibromatosis occurs in men aged between 30 and 80 years, with most occurrences between 40 and 60 years.
The cause of penile fibromatosisis unknown but may be related to atherosclerosis (hardening of the arteries). Under the microscope fibrosis (scarring) is present in the connective tissue in the deeper layers of the penis between the corpus cavernosum and the tunica albuginea.
Penile fibromatosis may have genetic associations but reliable studies are lacking.
Penile fibromatosis signs and symptoms include the following.
In many men, penile fibromatosis is mild and resolves within a year or two so treatment may be unnecessary. In more severe cases, the hardened lump and deformity persist and may get worse.
Medical therapy with various agents may relieve the discomfort e.g. Vitamin E, intralesional steroids or ultrasonic therapy but these seldom help long-term. Intralesional collagenase clostridium histolyticum (marketed as Xiaflex®) may be helpful.
Surgery is probably the best treatment but is usually only done after waiting for 1–2 years to allow the plaque to stabilise or disappear. There is less chance of recurrence after surgery if the inflammatory phase of penile fibromatosis has settled and the degree of bending has reached its peak. A semi-rigid prosthesis may be inserted.
A penis enlargement medical device may also reduce the penile curvature and risk of retraction after a penile surgery.
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