Peyronie’s Disease (Curved Penis) Treatments

Peyronie’s Disease, also known as curvature of the penis, is a condition in which the penis, when erect, bends abnormally. It is a rare cause of erectile dysfunction – a condition where a man has difficulty achieving or maintaining an erection. Read on to explore Peyronie’s disease treatments and symptoms.

Symptoms of Peyronie’s Disease

Peyronie’s disease plaques mostly (70% of the time) form on the top (or dorsal side) of the penis. The plaques make the tunica albuginea less flexible and may cause the penis to have a slight curve upwards when it stiffens. When plaques form on the bottom or side of the penis, there is a significant bend downward or sideways. Some men have more than- plaque, which may cause complex curves.

Sometimes plaques form that go all the way around the penis. These plaques most often don’t cause curving but may cause the shaft of the penis to narrow like the neck of a bottle (sometimes called “bottle-necking” or “waisting”). In bad cases, the plaque may collect calcium and become very hard, almost like a bone. Men may also notice that their penis has shrunk or gotten shorter.

Other signs that you may have Peyronie’s disease include:

• bent/curved penis
• lumps in the penis
• painful erections
• soft erections
• having trouble with sex because of a bent/curved penis

Peyronie’s disease can make your quality of life worse. Over 75 out of 100 men with Peyronie’s disease are stressed and depressed because of it. Unfortunately, many men with Peyronie’s disease are embarrassed and choose to suffer in silence rather than get help.

How Common is Peyronie’s Disease?

Peyronie’s disease is thought to happen in about 6 out of 100 men between the ages of 40 and 70. It’s rare in young men, but has been seen in men in their 30s. The number of cases may be higher than the estimates because many men may be embarrassed and choose not to see their health care provider.

Interestingly, more Peyronie’s disease cases have been noted in recent years. This may be because new meds for erectile dysfunction (ED) have come to market, and health care providers may notice Peyronie’s disease in men seeking help for ED. For this reason, the number of Peyronie’s disease cases reported will likely keep growing.

Peyronie’s Disease Treatments

Your doctor might recommend a wait-and-see (watchful waiting) approach if:

• The curvature of your penis isn’t severe and is no longer worsening
• You can still have erections and sex with no or mild pain
• You have good erectile function

If your symptoms are severe or are worsening over time, your doctor might recommend medication or surgery.

Oral Drugs

Drug therapy may help men who are badly affected by the disease during the acute phase. There haven’t been enough studies to tell exactly how well these drugs work, though.

Oral vitamin E

Vitamin E is an antioxidant that’s popular because of its mild side effects and low cost. Studies as far back as 1948 show that taking vitamin E may make plaques smaller and help straighten the penis. But most of these studies did not compare a group of people using vitamin E to a group of people who did not (a control group). A few studies of vitamin E that used a control group suggest that vitamin E doesn’t work better than placebo. (A placebo is a pill with no drugs in it – a “sugar pill.”)

Potassium amino-benzoate (“Potaba”)

Small studies with placebo controls show that this vitamin B-complex helps reduce plaque size, but not the curve. Unfortunately, it is costly and patients need to take 24 pills per day for 3 to 6 months. It also can upset your stomach, so many men stop taking it.

Tamoxifen

This non-steroidal, anti-estrogen drug has been used to treat desmoid tumors, which are like the plaques in Peyronie’s disease. There are only a few controlled studies of this drug and they haven’t shown that tamoxifen works better than placebo.

Colchicine

Colchicine is an anti-swelling agent that has been shown to be slightly helpful in a few small studies without controls. Many patients taking colchicine have stomach problems and stop taking the drug. It hasn’t been proven to work better than placebo.

Carnitine

Carnitine is an antioxidant drug that lowers swelling to help wounds heal. Studies without controls show some benefit. But a recent controlled study didn’t show it to work better than placebo.

Penile Injections

Injecting a drug right into the plaque brings higher doses of the drug to the problem than when a drug is taken by mouth. Plaque injection is often used for men with the acute-phase disease who aren’t sure they want to have surgery. The skin of the penis is often numbed before the shot to reduce pain.

Verapamil injections

Verapamil is mostly used to treat high blood pressure. Some studies suggest that verapamil injection also works for penile pain and curving. Verapamil appears to be a good, low-cost option for Peyronie’s disease. More controlled studies are needed to prove how well it works.

Interferon injections

Interferon is a protein made in the body that helps control swelling. It has been shown to help control scarring, perhaps by slowing down the rate that scar tissue builds and by making an enzyme that breaks down the scar tissue.
A large-scale test of interferon injection for Peyronie’s disease showed that this treatment can help. But more studies are needed.

Collagenase injections

Collagenase is made in the body and breaks down certain tissues. Studies have shown that injecting collagenase into plaques helped fix Peyronie’s disease. This drug (Xiaflex®) is now approved in the U.S. for the treatment of men with penises curving more than 30 degrees.

Other Peyronie’s Disease Treatments

Other treatments for Peyronie’s Disease are being studied. But there isn’t enough data on them yet to prove they work.

Some small studies have shown that stretching the penis for 2 to 8 hours a day for at least 6 months may help restore length and curving.

Treating the penis with ultrasound, radiation, shock waves, heat, and verapamil on the skin are also being studied. These, for the most part, are not proven and are not recommended by experts in the field.

Peyronie’s Disease Surgery

Your doctor might suggest surgery if the deformity of your penis is severe, sufficiently bothersome, or prevents you from having sex. Surgery usually isn’t recommended until you’ve had the condition for at least one year and the curvature of your penis stops increasing and stabilizes for at least six months.

Common surgical methods to treat Peyronie’s Disease include:

Suturing (plicating) the unaffected side

A variety of procedures can be used to suture (plicate) the longer side of the penis (the side without scar tissue). This results in a straightening of the penis, although this is often limited to less severe curvatures and might result in greater actual or perceived penile shortening. Nesbit plication is an example of this type of procedure. In some cases, this type of surgery causes erectile dysfunction.

Incision or excision and grafting

With this type of surgery, the surgeon makes one or more cuts in the scar tissue, allowing the sheath to stretch out and the penis to straighten. The surgeon might remove some of the scar tissue. A piece of tissue (graft) is often sewn into place to cover the holes in the tunica albuginea. The graft might be tissue from your own body, human or animal tissue, or a synthetic material. This procedure is generally used in cases of more severe curvature or deformity, such as indentations. This procedure is associated with greater risks of worsening erectile function when compared to the plication procedures.

Penile implants

Surgically inserted penile implants replace the spongy tissue that fills with blood during an erection. The implants might be semirigid — manually bent down most of the time and bent upward for sexual intercourse. Another type of implant is inflated with a pump implanted in the scrotum. Penile implants might be considered if you have both Peyronie’s disease and erectile dysfunction. When the implants are put in place, the surgeon might perform additional procedures to improve the curvature if needed.

The type of surgery used will depend on your condition. Your doctor will consider the location of scar tissue, the severity of your symptoms, and other factors. If you’re uncircumcised, your doctor might recommend a circumcision during surgery.

Additional Source: Surgical Treatment for Peyronie’s Disease

Hematuria is the medical term for blood in your urine.

Several different conditions and diseases can cause hematuria. These include infections, kidney disease, cancer, and rare blood disorders. The blood may be visible or in such small quantities that it can’t be seen with the naked eye.

Any blood in the urine can be a sign of a serious health problem, even if it happens only once. Ignoring hematuria can lead to the worsening of serious conditions like cancer and kidney disease, so you should talk to your doctor as soon as possible.

What are the types of hematuria?

There are two main types of hematuria: gross hematuria and microscopic hematuria.

Gross hematuria

If there’s enough blood in your urine that your urine appears pink or red or has spots of visible blood, you have “gross hematuria.”

Microscopic hematuria

When you can’t see the blood because the amount is so small, you have “microscopic hematuria.” Only a lab test that detects blood or looking at a sample of urine under a microscope can confirm microscopic hematuria.

Blood in Urine Hematuria Causes

Reasons people may have blood in the urine include:

• infection in the bladder, kidney, or prostate
• trauma
• vigorous exercise
• viral illness, such as hepatitis—a virus that causes liver disease and inflammation of the liver
• sexual activity
• menstruation
• endometriosis—a problem in women that occurs when the kind of tissue that normally lines the uterus grows somewhere else, such as the bladder

More serious reasons people may have hematuria include:

• bladder or kidney cancer
• inflammation of the kidney, urethra, bladder, or prostate—a walnut-shaped gland in men that surrounds the urethra and helps make semen
• blood-clotting disorders, such as hemophilia
• sickle cell disease—a genetic disorder in which a person’s body makes abnormally shaped red blood cells
• polycystic kidney disease—a genetic disorder in which many cysts grow on a person’s kidneys

Who is more likely to develop hematuria?

People who are more likely to develop hematuria may

• have an enlarged prostate
• urinary stones
• take certain medications, including blood thinners, aspirin and other pain relievers, and antibiotics
• do strenuous exercise, such as long-distance running
• bacterial or viral infection, such as streptococcus or hepatitis
• family history of kidney disease
• disease or condition that affects one or more organs

What are the symptoms of blood in urine?

As mentioned previously, blood in the urine may be visible with the naked eye or first identified through microscopic examination of the urine. Blood in the urine is a symptom of multiple different conditions.

Whether in men, women, or children, it may occur on its own or may be found in association with other symptoms and signs, depending upon the cause. UTI as a source of blood in the urine may be accompanied by painful urination, needing to urinate frequently or urgently, and pus in the urine. Kidney stones may cause flank or abdominal pain that can be quite severe. Some of the conditions that cause blood in the urine in children may not cause any other symptoms.

Blood in Urine Hematuria Treatment

The cause of your hematuria will determine what type of treatment you receive.

UTI

If an infection, such as a UTI, is responsible for your hematuria, your healthcare provider will prescribe antibiotics to kill the bacteria causing the infection.

Kidney Stones

Hematuria caused by large kidney stones can be painful if left untreated. Prescription medications and treatments can help you pass stones.

Your healthcare provider may suggest using a procedure called extracorporeal shock wave lithotripsy (ESWL) to break up the stones.

ESWL involves using sound waves to break the kidney stones into tiny pieces that can pass in your urine. The procedure usually takes around one hour and may be done under light anesthesia.

• Kidney Stones Treatment
• Kidney Stones Prevention

Enlarged Prostate

If an enlarged prostate is causing your hematuria, your healthcare provider may prescribe medication, such as alpha blockers or 5-alpha reductase inhibitors. In some cases, surgery may be an option.

If you’ve ever had a kidney stone, you surely remember it. The pain can be unbearable, coming in waves until the tiny stone passes through your urinary plumbing and out of the body. For many, kidney stones aren’t a one-time thing: in about half of people who have had one, another appears within seven years without preventive measures.

Ways To Prevent Kidney Stones | Urologists Omaha

Drink Lots of Water

What are Kidney Stones?

Urine contains many dissolved minerals and salts. When your urine has high levels of these minerals and salts, you can form stones. Kidney stones can start small but can grow larger in size, even filling the inner hollow structures of the kidney. Some stones stay in the kidney and do not cause any problems. Sometimes, the kidney stone can travel down the ureter, the tube between the kidney and the bladder. If the stone reaches the bladder, it can be passed out of the body in urine. If the stone becomes lodged in the ureter, it blocks the urine flow from that kidney and causes pain.

Types of Kidney Stones

Kidney stones come in many different types and colors. How you treat them and stop new stones from forming depends on what type of stone you have.

Calcium stones (80 percent of stones)

Calcium stones are the most common type of kidney stone. There are two types of calcium stones: calcium oxalate and calcium phosphate. Calcium oxalate is by far the most common type of calcium stone. Some people have too much calcium in their urine, raising their risk of calcium stones. Even with normal amounts of calcium in the urine, calcium stones may form for other reasons.

Uric acid stones (5-10 percent of stones)

Uric acid is a waste product that comes from chemical changes in the body. Crystals do not dissolve well in acidic urine and instead will form a uric acid stone. Having acidic urine may come from:

• Being overweight
• Chronic diarrhea
• Type 2 diabetes (high blood sugar)
• Gout
• A diet that is high in animal protein and low in fruits and vegetables

Struvite/infection stones (10 percent of stones)

Struvite stones are not a common type of stone. These stones are related to chronic urinary tract infections (UTIs). Some bacteria make the urine less acidic and more basic or alkaline. Magnesium ammonium phosphate (struvite) stones form in alkaline urine. These stones are often large, with branches, and they often grow very fast.

People who get chronic UTIs, such as those with long-term tubes in their kidneys or bladders, or people with poor bladder emptying due to neurologic disorders (paralysis, multiple sclerosis, and spina bifida) are at the highest risk for developing these stones.

Cystine stones (less than 1 percent of stones)

Cystine is an amino acid that is in certain foods; it is one of the building blocks of protein. Cystinuria (too much cystine in the urine) is a rare, inherited metabolic disorder. It is when the kidneys do not reabsorb cystine from the urine. When high amounts of cystine are in the urine, it causes stones to form. Cystine stones often start to form in childhood.

Kidney Stones Symptoms

A kidney stone may not cause symptoms until it moves around within your kidney or passes into your ureter — the tube connecting the kidney and bladder. At that point, you may experience these signs and symptoms:

• Severe pain in the side and back, below the ribs
• Pain that radiates to the lower abdomen and groin
• Comes in waves and fluctuates in intensity
• Pain on urination
• Pink, red or brown urine
• Cloudy or foul-smelling urine
• Nausea and vomiting
• Persistent need to urinate
• Urinating more often than usual
• Fever and chills if an infection is present
• Urinating small amounts

Pain caused by a kidney stone may change — for instance, shifting to a different location or increasing in intensity — as the stone moves through your urinary tract.

Kidney Stones Causes

Low Urine Volume

A major risk factor for kidney stones is constant low urine volume. Low urine volume may come from dehydration (loss of body fluids) from hard exercise, working or living in a hot place, or not drinking enough fluids. When urine volume is low, urine is concentrated and dark in color. Concentrated urine means there is less fluid to keep salts dissolved. Increasing fluid intake will dilute the salts in your urine. By doing this, you may reduce your risk of stones forming.

Adults who form stones should drink enough fluid to make at least 2.5 liters (⅔ gallon) of urine every day. On average, this will take about 3 liters (100 ounces) of fluid intake per day. While water is likely the best fluid to drink, what matters most is getting enough fluid.

Diet

Diet can affect the chance of forming stones and possibly help prevent kidney stones altogether. One of the more common causes of calcium kidney stones is high levels of calcium in the urine. High urine calcium levels may be due to the way your body handles calcium. It is not always due to how much calcium you eat. Lowering the amount of calcium in your diet rarely stops stones from forming. Studies have shown that restricting dietary calcium can be bad for bone health and may increase kidney stone risk. Healthcare providers usually do not tell people to limit dietary calcium in order to lower urine calcium. But calcium intake should not be too high.

Instead of lowering dietary calcium intake, your health care provider may try to reduce your urine calcium level by decreasing your sodium (salt) intake. Too much salt in the diet is a risk factor for calcium stones. This is because too much salt is passing into the urine, keeping calcium from being reabsorbed from the urine and into the blood. Reducing salt in the diet lowers urine calcium, making it less likely for calcium stones to form.

Because oxalate is a component of the most common type of kidney stone (calcium oxalate), eating foods rich in oxalate can raise your risk of forming these stones.

A diet high in animal protein, such as beef, fish, chicken, and pork, can raise the acid levels in the body and in the urine. High acid levels make it easier for calcium oxalate and uric acid stones to form. The breakdown of meat into uric acid also raises the chance that both calcium and uric acid stones will form.

Bowel Conditions

Certain bowel conditions that cause diarrhea (such as Crohn’s Disease or ulcerative colitis) or surgeries  (such as gastric bypass surgery) can raise the risk of forming calcium oxalate kidney stones. Diarrhea may result in the loss of large amounts of fluid from the body, lowering urine volume. Your body may also absorb excessive oxalate from the intestine, resulting in more oxalate in your urine. Both low urine volume and high levels of urine oxalate can help to cause calcium oxalate kidney stone formation.

Obesity

Obesity is a risk factor for stones. It may change the acid levels in the urine, leading to stone formation.

Medical conditions

Some medical conditions have an increased risk of kidney stones. Abnormal growth of one or more of the parathyroid glands, which control calcium metabolism, can cause high calcium levels in the blood and urine. This can lead to kidney stones. Another condition called distal renal tubular acidosis, in which there is acid build-up in the body, can raise the risk of calcium phosphate kidney stones.

Some rare, inherited disorders can also make certain types of stones more likely. Examples include cystinuria, which is too much of the amino acid cystine in the urine, and primary hyperoxaluria, in which the liver makes too much oxalate.

Medication

Some medications, and calcium and vitamin C supplements, may increase your risk of forming stones. Be sure to tell your healthcare provider all the medications and supplements you take, as these could affect your risk of stone formation. Do not stop taking any of these unless your healthcare provider tells you to do so.

Family History

The chance of having kidney stones is much higher if you have a family history of stones, such as a parent or sibling.

Kidney Stones Treatment Options

Treating kidney stones is primarily focused on symptom management. Passing a stone can be very painful.

Treatment depends on the type of stone, how bad it is and the length of time you have had symptoms. There are different treatments to choose from. It is important to talk to your healthcare provider about what is best for you.

Wait for the Stone to Pass

Often you can simply wait for the stone to pass. Smaller stones are more likely than larger stones to pass on their own.

Waiting up to four to six weeks for the stone to pass is safe as long as the pain is bearable, there are no signs of infection, the kidney is not completely blocked and the stone is small enough that it is likely to pass. While waiting to pass a kidney stone, you should drink normal amounts of water. You may need pain medication when there is discomfort or shock waves of pain.

Medication

Certain medications have been shown to improve the chance that a stone will pass. The most common medication prescribed for this reason is tamsulosin. Tamsulosin (Flomax) relaxes the ureter, making it easier for the stone to pass. You may also need pain and anti-nausea medicine as you wait to pass the stone.

Surgery

• Surgery may be needed to remove a stone from the ureter or kidney if:
• The stone fails to pass.
• The pain is too great to wait for the stone to pass.
• Stone is affecting kidney function. Small stones in the kidney may be left alone if they are not causing pain or infection. Some people choose to have their small stones removed. They do this because they are afraid the stone will unexpectedly start to pass and cause pain.

Kidney stones should be removed by surgery if they cause repeated infections in the urine or because they are blocking the flow of urine from the kidney. Today, surgery usually involves small or no incisions (cuts), minor pain and minimal time off work.

Kidney Stones FAQs

Most kidney stones will pass on their own, and successful treatments have been developed to remove larger stones or stones that do not pass. People who have had a kidney stone remain at risk for future stones throughout their lives.

Can kidney stones recur?

Yes, unfortunately. Once you’ve had a kidney stone, you are more likely to develop another one in the future. However, adopting preventive measures such as staying hydrated and following a kidney-friendly diet can help reduce the risk of recurrence.

When should I seek medical attention for kidney stones?

If you experience severe pain, persistent nausea and vomiting, fever and chills, difficulty urinating, or blood in the urine, it’s crucial to seek immediate medical attention. These symptoms may indicate a serious complication that requires prompt treatment.

Are there any long-term complications of kidney stones?

Kidney stones can lead to complications such as recurrent urinary tract infections (UTIs), kidney damage or infection, and in severe cases, kidney failure. It’s essential to follow up with your healthcare provider for monitoring and preventive care after experiencing kidney stones.

UroHealth Partners  | Urologist Omaha & Council Bluffs, IA

UroHealth Partners have 7 board-certified physicians and an attentive, dedicated staff. We have served Nebraska and Iowa since 1982 with two locations in Omaha and Council Bluffs. Our Omaha location includes an accredited outpatient surgical center with state-of-the-art equipment and a comfortable waiting area just minutes from Interstate 680. Our physicians successfully perform hundreds of traditional and no-scalpel vasectomies every year.

CARE THAT COUNTS | BEST UROLOGIST IN OMAHA

WE MAKE THE PROCESS AS SIMPLE AS POSSIBLE

Undescended testicles (formally known as cryptorchidism) occurs when a testicle has failed to pass into the scrotum prior to birth. It is a relatively common condition that affects newborns, infants, and baby boys. According to research, up to 5 percent of newborn male babies are affected by cryptorchidism, and about 10 percent of these cases involves both testicles (bilateral cryptorchidism).

The large percentage of cases resolve (the testicles descend into the scrotum) on their own by the time the affected children reaches around 3 months of age, and the majority of cases resolve within one year of life.

Undescended Testicle Symptoms and Treatment Omaha Nebraska

If the testicles do not descend on their own, medical intervention may be necessary. Treatment options include observation and examinations or surgery to correct the position of the testicle.

Children and adults who have undescended testicles that do not resolve on their own have an increased risk of male fertility problems, as well as testicular cancer.

Undescended Testicle Symptoms in Omaha

The most obvious sign of an undescended testicle is the visible absence of one or both testicles in the scrotum. The testicles develop in the abdomen during gestation; within a few months prior to birth, the testicles drop from the abdomen, pass through the groin, and position themselves in the scrotum; the loose fleshy sac that sits underneath the penis.

If you suspect your child has an undescended testicle, consult with your pediatrician. A thorough physical exam a medical professional will confirm whether or not your child has cryptorchidism.

Undescended Testicle Causes in Omaha, NE

Though the exact cause of cryptorchidism is unknown, medical researchers believe that the condition is related to a combination of factors including familial history, the prenatal care a mother receives while she is pregnant and her overall health during pregnancy, and physical changes that may have an impact on a male’s testicles.

There are risk factors that can increase the risk of an undescended testicle. These factors include:

• Being born prior to 38 weeks gestation (premature birth)
• A birth weight of less than 5 pounds, 8 ounces
• Genetic predisposition; someone else in the family also has the medical problem
• Fetal abnormalities; specifically abnormalities that can inhibit a baby’s development
• Exposure to toxic chemicals, such as cigarette smoke, secondhand smoke, and other known harmful substances while a baby is in-utero

Conclusion on Undescended Testicle Symptoms and Treatment

If you believe your child suffers from this medical problem, it’s important that you speak to your pediatrician. As stated, in most cases, the condition will resolve on its own before the child reaches his first birthday, and once the testicle descends, there are no further issues.

However, in some cases, the testicle(s) may not descend on their own; if that happens, serious complications may arise like the risk of testicular cancer. Therefore, it is important to always seek the expert insight of a medical professional if you suspect your child Is affected by cryptorchidism.

Additional Readings:

Pediatric Surgery for Undescended Testicles

Testicular Torsion is a Medical Emergency

UroHealth Partners  | Urologist Omaha & Council Bluffs, IA

UroHealth Partners have 7 board-certified physicians and an attentive, dedicated staff. We have served Nebraska and Iowa since 1982 with two locations in Omaha and Council Bluffs. Our Omaha location includes an accredited outpatient surgical center with state-of-the-art equipment and a comfortable waiting area just minutes from Interstate 680. Our physicians successfully perform hundreds of traditional and no-scalpel vasectomies every year.

CARE THAT COUNTS | BEST UROLOGIST IN OMAHA

WE MAKE THE PROCESS AS SIMPLE AS POSSIBLE