Commentary on the myths of Peyronie’s disease
Peyronie’s disease refers to an acquired curvature, narrowing or shortening of the penis. Prevalence rates of 0.4-20% have been published (1). Development of Peyronie’s disease is likely related to minor injury to the tunica albuginea, septum or intracavernous struts. In some men, the resulting inflammation is trapped between layers of the collagen bundles and becomes progressive. This leads to an inflammatory mass (lump) formation in the early stage. Continuing inflammation produces profibrotic cytokines such as transforming growth factor beta and deposition of large amount of collagen fibers. The inflammation can also produce metalloproteinases that break the elastic fibers. The irregularly compacted collagen fibers and disrupted elastic fibers create an inelastic “plaque,” the “incurable” component of Peyronie’s disease.