Penile Plaque: Causes, Symptoms, and Treatment Options - Urology

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Penile plaque, often associated with Peyronie's disease, is a condition characterized by the formation of fibrous scar tissue inside the penis, which can lead to curvature, pain, and erectile dysfunction. Understanding the causes, symptoms, and treatment options for penile plaque is essential for effective management and recovery.


Causes
The exact cause of penile plaque formation is not fully understood, but it is often linked to trauma or injury to the penis. This can occur during sexual activity, vigorous physical activity, or even from a medical procedure. The injury may lead to localized inflammation and the subsequent development of fibrous tissue as part of the healing process. Other potential contributing factors include genetic predisposition, certain medical conditions (such as diabetes or Dupuytren's contracture), and lifestyle factors like smoking.


Symptoms
Symptoms of penile plaque can vary significantly among individuals. Common symptoms include:
- Curvature of the penis: This may occur during erections and can vary in severity.

- Pain: Some individuals may experience pain during erections or even at rest.

- Erectile dysfunction: The presence of plaque can affect the ability to achieve or maintain an erection.

- Palpable plaque: The formation of a hard lump or band of tissue can often be felt under the skin of the penis, especially in the flaccid state.

- Changes in penile length: Some men may notice a shortening of the penis over time.

In your case, the appearance of a white, horizontal plaque after an injury, along with changes in erectile function, suggests that you may be experiencing the early stages of this condition. The fact that it has been seven days since the injury indicates that the healing process is underway, but the presence of plaque may require further evaluation.


Treatment Options
Treatment for penile plaque largely depends on the severity of symptoms and the impact on sexual function. Here are some common approaches:
1. Observation: In many cases, especially if the plaque is not causing significant pain or erectile dysfunction, doctors may recommend a wait-and-see approach. This is particularly true in the early stages, as some plaques may resolve on their own.

2. Medications:
- Vitamin E: Some studies suggest that vitamin E may help in reducing plaque size and improving symptoms, although results are mixed.

- Oral medications: Options like pentoxifylline may improve blood flow and reduce plaque formation.

- Intralesional injections: Medications such as collagenase clostridium histolyticum can be injected directly into the plaque to help break it down.

3. Physical therapy: Penile traction therapy or vacuum erection devices may help in stretching the penis and improving curvature.

4. Surgery: This is generally considered a last resort for severe cases where there is significant curvature or erectile dysfunction that does not respond to other treatments. Surgical options may include plaque excision or grafting.

5. Counseling: Psychological support may be beneficial, especially if the condition is affecting mental health or relationships.


Diagnostic Tests
In your situation, further diagnostic tests such as ultrasound or cavernosography may be warranted to assess the extent of the plaque and its impact on blood flow. These tests can provide valuable information to guide treatment decisions.


Conclusion
Given your symptoms and the recent injury, it is advisable to follow up with a urologist who specializes in penile conditions. They can provide a thorough evaluation and recommend appropriate treatment options tailored to your specific situation. Avoiding unnecessary pressure on the area and allowing time for healing is crucial. If you continue to experience symptoms or if they worsen, do not hesitate to seek further medical advice.