Ask Lisa
         Relationship & Sex Advice

With hundreds of eMails coming in every day and while I answer many, it is not possible for me to reply to all of them. However, I wanted to provide a section where we take some of our readers questions and post them on our web site so that we can provide answers that everyone can benefit from having the information available on our web site. To submit your question such as those shown below eMail us for consideration of publishing it in our next newsletter.

Lisa S. Lawless, Ph.D., C.E.O. HolisticWisdom.com Founder

Crooked Penis

Hi Lisa,

My penis bends really crooked and it happened just this year. Being that I am 32 years old, I am pretty worried about it. Any idea what this could be?

- Josh

Hi Josh,

It sounds like you may have what is called Peyronie's disease. However, you should see your physician to get a full exam and a diagnosis.

Cases of Peyronie's disease range from mild to severe. Symptoms may develop slowly or appear overnight. In severe cases, the hardened plaque reduces flexibility, causing pain and forcing the penis to bend or arc during erection.

In many cases, the pain decreases over time, but the bend in the penis may remain a problem, making sexual intercourse difficult.

Many researchers believe Peyronie's disease develops following trauma (hitting or bending) that causes localized bleeding inside the penis.

If the penis is abnormally bumped or bent, an area where the septum attaches to the elastic fibers may stretch beyond a limit, injuring the lining of the erectile chamber and, for example, rupturing small blood vessels.

This is exactly why we do not recommend extreme forms of penis enlargement stretching and pulling.

While trauma might explain acute cases of Peyronie's disease, it does not explain why most cases develop slowly and with no apparent traumatic event. It also does not explain why some cases disappear quickly or why similar conditions such as Dupuytren's contracture do not seem to result from severe trauma. Some researchers theorize that Peyronie's disease may be an autoimmune disorder.

Signs and Symptoms

Symptoms include the following:

Hardened tissue (plaque) in the penis

Pain during erection.

Curve in the penis
during erection.

Distortion of the penis
(e.g., indentation, shortening)

Treatment

In roughly 20% of cases, Peyronie's will go away on its own. The damaged area might heal slowly or abnormally for two reasons: repeated trauma and a minimal amount of blood flow in the sheath-like fibers.

In cases that heal within about a year, the plaque does not advance beyond an initial inflammatory phase. In cases that persist for years, the plaque undergoes fibrosis, or formation of tough fibrous tissue, and even calcification, or formation of calcium deposits.

Some researchers have given vitamin E orally to men with Peyronie's disease in small-scale studies and have reported improvements. Yet, no controlled studies have established the effectiveness of vitamin E therapy. Similar inconclusive success has been attributed to oral application of para-aminobenzoate, a substance belonging to the family of B-complex molecules.

Chemical agents such as verapamil, collagenase, steroids, calcium channel blockers, and interferon alpha-2b directly into the plaques. These interventions are still considered unproven because studies included small numbers of patients and lacked adequate control groups. Steroids, such as cortisone, have produced unwanted side effects, such as the atrophy or death of healthy tissues.

Radiation therapy, in which high-energy rays are aimed at the plaque, has also been used. Like some of the chemical treatments, radiation appears to reduce pain, but it has no effect at all on the plaque itself and can cause unwelcome side effects.

Peyronie's disease has been treated surgically with some success. The two most common surgical procedures are removal or expansion of the plaque followed by placement of a patch of skin or artificial material, and removal or pinching of tissue from the side of the penis opposite the plaque, which cancels out the bending effect. The first method can involve partial loss of erectile function, especially rigidity. The second method, known as the Nesbit procedure, causes a shortening of the erect penis.

Some men choose to receive an implanted device that increases rigidity of the penis. In some cases, an implant alone will straighten the penis adequately. In other cases, implantation is combined with a technique of incisions and grafting or plication (pinching or folding the skin) if the implant alone does not straighten the penis.

Most types of surgery produce positive results. But because complications can occur, and because many of the phenomena associated with Peyronie's disease (for example, shortening of the penis) are not corrected by surgery, most doctors prefer to perform surgery only on the small number of men with curvature so severe that it prevents sexual intercourse.