Unfortunately, there's nothing we can do to get you the penis back that you had 10 to 20 years ago before these symptoms started - but we can always get you functional again. And we think that's the big take-home point: We can always improve the deformity to a point where hopefully it won't be bothersome to you.
Certain positions and maneuvers with excess torque on the penis might be more likely to lead to injury. Excessive alcohol consumption may also cause some degree of erectile dysfunction, so that may also make the penis more prone to injury. In general, we don't regularly recommend to the general population that they need to avoid certain sex positions. But for men who are concerned or at risk of developing Peyronie's disease, it's good to keep in mind.
To diagnose PD, a urologist will take a clinical history and do a physical exam. PD is something that you can totally leave alone and not do anything about for the rest of your life. It's never going to cause you any harm. It's not going to cause any other sort of disease, such as cancer. But it can interfere with your sexual function, your quality of life, and your body image. Sometimes a man might be bothered by the way his penis looks, but his partner might not be bothered. Other times, the curvature can make it very uncomfortable for the partner and for the man with PD. Treatment is really determined on a case-by-case basis.
If there's any erectile dysfunction, we want to make sure that it's treated. We think injuries to the penis during sex might be more likely if the penis is not fully rigid. So, men who have slow, progressive erectile dysfunction may benefit from treatment with medications to enhance the hardness of the erection and minimize the risk of injury.
The number one question that you want to know from your doctor is: Do they offer the complete spectrum of treatments for PD, both non-surgical and surgical? Seek out a urologist who has experience treating patients with PD - or a urologist with sub-specialty in male sexual dysfunction. If you-re interested in really understanding what the best options are for you, go to somebody that has a lot of experience with PD. For instance, you can ask how many Peyronie's patients they see in a week.
There’s nothing wrong with just going to your regular urologist and starting that discussion and seeing whether a conversation with a sub-specialist might be indicated. There are also a lot of listings available online.
Surgery isn't always recommended for PD, except is specific circumstances. Though PD surgeries are considered safe, there are typically greater risk involved that with non-surgical procedures. Surgeries are typically indicated for a man who desires the most rapid and reliable results and for a man who wants to have the maximum correction of the deformity or the most normal appearing penis - according to how he wants it to look.