Penile Plaques and Their Impact on Erectile Function

Q: Penile Plaques and Their Impact on Erectile Function

1. Are there non-surgical methods to manage fibrosis? A： Some cases may resolve on their own after a period of time. Surgery is the standard treatment, while other options such as medication have limited effectiveness. 2. Will the folds in the corpus spongiosu

Penile fibrous plaque and folds in the corpora cavernosa?

Hello, doctor.
I have two hard nodules on the right side of my penile corpus cavernosum, which cause my penis to bend toward the side of the nodules during erection.
The area with the nodules appears to be indented, but there is no pain during erection (the larger nodule is located at the base, causing a more significant bend, while the smaller one only causes an indentation in the appearance of the erection without a noticeable curve).
Overall, the appearance of my penis seems more tilted rather than bent.
Since I haven't experienced significant discomfort, I haven't actively sought treatment, but over time, it seems to have led to another issue, which is what I am more concerned about (though this part is my own speculation, and I am unsure of the actual cause).
It seems that the corpus spongiosum below is unable to expand fully due to the lack of expansion above, resulting in a longer segment of the corpus spongiosum below compared to the corresponding segment above (the segment between the two nodules) when in a semi-erect (expanded but soft) state.
This seems to easily create a force opposite to the bending side (the force comes from blood flow), and combined with the weight of the penis, the tip tends to droop down, leading to a crease forming at the front of that segment of the corpus spongiosum over time.
The semi-erect state occurs quite frequently in various situations, such as when I need to use the restroom, which is quite bothersome.
I would like to ask the doctor: 1.
Are there non-surgical options to address the nodules? 2.
What adverse effects might the crease in the corpus spongiosum have in the future? Is there any way to improve or manage this issue?

Eric, 20~29 year old female. Ask Date: 2021/03/20

Dr. Cai Zhuorong reply Urology

1.
Are there non-surgical methods to manage fibrosis? A: Some cases may resolve on their own after a period of time.
Surgery is the standard treatment, while other options such as medication have limited effectiveness.

2.
Will the folds in the corpus spongiosum have any adverse effects in the future? Is there a way to improve or manage this? A: The folds may cause the corpus spongiosum to shorten after surgery.
The treatment options are similar to those mentioned in the first question.

Reply Date: 2021/03/20

More Info

Penile plaques, often associated with Peyronie's disease, can significantly impact erectile function and overall penile health. The presence of hard nodules or plaques on the penis can lead to curvature during erections, as you've described. This curvature occurs because the plaques restrict the normal expansion of the erectile tissue, leading to an uneven distribution of blood flow and pressure during an erection.
1. Non-Surgical Treatment Options for Penile Plaques:
While surgery is a definitive treatment for Peyronie's disease, especially in cases where the curvature is severe or causing significant distress, there are non-surgical options available. These include:
- Medications: Oral medications such as pentoxifylline may help improve blood flow and reduce plaque size. Intralesional injections of medications like collagenase clostridium histolyticum (Xiaflex) can also be effective in breaking down the plaque.

- Vacuum Erection Devices (VED): These devices can help improve blood flow to the penis and may assist in stretching the tissue, potentially reducing curvature over time.

- Traction Therapy: This involves using a penile traction device to gently stretch the penis, which may help reduce curvature and improve length.

- Physical Therapy: Some patients find relief through specialized exercises that aim to improve flexibility and reduce plaque formation.

It's essential to consult with a urologist who specializes in sexual medicine to discuss these options and determine the best course of action based on your specific condition.

2. Impact of Urethral Cavernous Body Creasing:
The creasing or folding of the urethral cavernous body due to uneven expansion can lead to several potential complications:
- Urinary Issues: If the crease is significant, it may affect urination, leading to difficulties or discomfort. In some cases, it could cause urinary obstruction or changes in the flow of urine.

- Erectile Dysfunction: The uneven distribution of blood flow caused by the plaques and creasing may lead to difficulties in achieving or maintaining an erection. Over time, this could contribute to psychological distress and anxiety related to sexual performance.

- Pain or Discomfort: Although you mentioned that there is no pain during erections, the long-term effects of the creasing could potentially lead to discomfort or pain during sexual activity or even during normal erections.

To address the creasing, it is crucial to monitor the situation closely. If you notice any changes in your symptoms, such as increased curvature, pain, or difficulties with urination or erections, it would be advisable to seek medical attention promptly.

In summary, while penile plaques and associated changes can be concerning, there are various treatment options available that do not necessarily involve surgery. It's vital to have an open dialogue with your healthcare provider to explore these options and monitor any changes in your condition. Early intervention can often lead to better outcomes and help alleviate any distress you may be experiencing.

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