Dr Mohit Khera, a leading urologist, warned many men with Peyronie’s disease were suffering in silence
Millions of American men are ‘suffering in silence’ with deformed penises, a leading urologist has warned.
Dr Mohit Khera, from Baylor College of Medicine in Texas, said as many as one in ten American men have Peyronie’s disease, a disorder in which scar link tissue, called plaque, forms under the skin of the penis.
It is usually caused by repeated micro-injuries during sex, masturbation or exercise, and results in the person’s genitals becoming curved to varying degrees. Patients normally can’t recall specific trauma to the penis.
Dr Khera warned that most men do not seek help because of stigma and embarrassment, despite the condition being highly treatable if caught early.
Dr Khera told The Peter Attia Drive Podcast: ‘Up to seven to nine percent of men in the US have Peyronie’s disease.
‘This population, I call the population that suffers in silence. They never talk about it. In fact, studies show that they are very silent and never seek care.
‘The issue with this is that it has a significant impact on their quality of life.’
He added: ‘Patients who have the disease really suffer from depression. They feel like there is a disfigurement.’
He said there is treatment for the condition, including injections and surgery.
When a man gets an erection, the two columns of spongy tissue on both sides of the penis expand and fill with blood.
Generally, this leads to a straight or near-straight erection.
But in cases where the penis has sustained an injury, such as through sex or vigorous masturbation, the healing process may have caused a plaque to form in the fibrous covering surrounding the columns.
This causes the penis to start to bend at angles up to 180 degrees when erect or flaccid.
There is some discrepancy over how many men have Peyronie’s disease.
The National Institutes of Health suggests it is about one in a hundred men, equivalent to about 1.6million American men.
But a 2011 study from RTI Health Solutions involving 11,400 men who were surveyed on their erections put the figure at 13 percent.
Dr Khera said when someone sustains an injury to the penis, it is important to visit the hospital immediately to help avoid issues such as Peyronie’s disease.
The disease has two phases, Dr Khera says.
During the active phase, which can last for up to a year, the scar tissue is still forming and the penis is becoming gradually more curved. Men may also experience pain.
At this point, there is little point in carrying out treatment because the penis will continue to curve and more will be needed.
But in the passive phase, which follows, the penis stops continuing to curve and there is no change. The main may also disappear.
Men who have Peyronie’s disease are also more likely to be depressed and have erectile dysfunction because they see themselves as having a ‘disfigurement’
Dr Khera said: ‘There is an active phase for 12 months and in that 12 months it is the 15, 40 and 45 rule.
‘Of all the men, 15 percent will just get better. Forty percent will stay the same. And 45 percent of patients will get worse.
‘Because of this, you have to tell patients, look I am not going to operate on you because if I operate on you and you are the 45 percent that gets worse I will have to operate again.’
Doctors can treat the condition through an injection of an enzyme called collagenase into the plaque, which can break it up and help straighten the penis.
Patients could also receive surgery, where stitches are put into the opposite side of the penis to the plaque or the plaque is cut out.
An off-label treatment available is also traction devices — such as the RestoreX — typically used to lengthen the penis, although they can also help straighten it.
A 2021 study published in the Journal of Sexual Medicine found that 27 percent of men with the condition had clinical depression. It revealed that men who were not in relationships were particularly at risk.
Another study from the same year released in the Journal of Men’s Health found that men who had the condition were more likely to have depression and anxiety.
Men with the condition may suffer from depression because they are concerned about sexual contact with others.
They are also at higher risk of erectile dysfunction, as a result of concerns over reactions to their penis and whether they will be able to perform sex with their partner.