Penile fibrosis involves the formation of scar tissue within the penis, leading to changes in its shape and function. This scarring affects elasticity and overall performance. While not life-threatening, it can impact quality of life by causing discomfort and making sexual activity challenging.
What is Penile Fibrosis?
Penile fibrosis is the development of fibrous scar tissue, or plaque, inside the penis. This scar tissue typically forms within the tunica albuginea, a thick, elastic membrane encasing the erectile tissue (corpora cavernosa). The tunica albuginea normally stretches during an erection, allowing the penis to expand and straighten.
When scar tissue develops, it loses elasticity, preventing the tunica albuginea from expanding properly. This restriction can cause the penis to bend, curve, or indent during an erection, as healthy tissue stretches while scarred tissue does not. This non-elastic tissue can also lead to pain and difficulty achieving or maintaining an erection.
Recognizing the Signs and Causes
Penile fibrosis often presents with several signs, appearing gradually or suddenly. Common symptoms include pain during an erection, noticeable curvature or deformation of the penis, and hard lumps or bands of tissue under the skin. Other indicators include penile shortening, indentations, or a loss of elasticity, all contributing to erectile dysfunction.
While the exact cause is not always clear, penile fibrosis is frequently linked to minor trauma or injury to the penis, such as during vigorous sexual activity. This trauma can damage the tunica albuginea, leading to abnormal healing where scar tissue forms. Risk factors include genetic predisposition, medical conditions like diabetes and high blood pressure, and reactions to certain medications.
How Penile Fibrosis is Diagnosed
Diagnosing penile fibrosis begins with a physical examination by a healthcare professional. The doctor will feel the penis to identify fibrous tissue, nodules, or plaques, and assess for curvature or changes in penile length.
A detailed medical history is also taken, asking about symptoms, their onset, and any past injuries or medical conditions. If the physical examination and history do not provide a clear diagnosis, imaging tests may be used to visualize the scar tissue. These include ultrasound, magnetic resonance imaging (MRI), or radiography, which confirm the presence and extent of the fibrosis.
Approaches to Treatment
Treatment for penile fibrosis varies by severity and stage, from non-surgical to surgical procedures. In the early phase, when scar tissue is forming and pain is present, pharmacological treatments are considered. These include oral medications or injections directly into the plaque, such as collagenase clostridium histolyticum, to reduce curvature. Vacuum devices or penile traction therapy may also be recommended to stretch tissue and reduce curvature.
If the disease progresses to a chronic phase with stabilized scar tissue, persistent curvature, or erectile dysfunction, surgical interventions may be necessary. Surgical options aim to correct deformity and restore function. Procedures include plaque incision or excision with grafting, where scar tissue is removed and replaced with graft material for better expansion. Plication surgery involves removing or pinching a piece of the tunica albuginea opposite the curvature to straighten the penis. For severe cases with erectile dysfunction, a penile prosthesis may be implanted for rigidity and straightness.
Living with Penile Fibrosis
Living with penile fibrosis presents challenges beyond physical symptoms, impacting sexual health, self-esteem, and relationships. Changes in penile appearance and function can lead to psychological distress and anxiety. Open communication with partners and seeking support from healthcare professionals can help navigate these emotional aspects.
Ongoing medical management is important, with regular follow-ups to monitor progression and adjust treatment plans. While some mild cases may spontaneously improve, the condition often remains stable or worsens without intervention. Lifestyle adjustments, such as avoiding activities that could cause further penile trauma, may also be recommended. Seeking psychological support or counseling can be beneficial for coping with the emotional and relational impact.