Can Peyronie’s Disease Cause Impotence ?
In simple terms, an erection happens when pressurized blood is trapped within the penile chambers known as the corpora cavernosa. Once the brain has given the signal to the penis that it needs to become erect, blood flows into the relaxed spaces, and cause them to inflate.
Once the chambers have expanded, they pull the connective tissue known as the tunica albuginea tight. This makes the penis hard and rigid as well as pinching off the veins that normally allow the blood to flow back out of the penis. This traps the blood inside the tissue and keeps the penis hard and erect.
Can Peyronie’s disease cause impotence?
Classical impotence where a man cannot get an erection, is a relatively uncommon side effect of Peyronie’s disease. Although having said that, the condition can frequently affect the erection mechanism in another way. A number of scientific studies have shown that up to 40% of men with Peyronie’s disease have experienced a certain degree of erectile dysfunction at some time.
This will normally manifest in a reduction in maximum hardness. In most cases, this is simply a temporary factor, and does not always cause enough softening to prevent a man from having normal intercourse. In cases when there is severe bending of the penis, softening and persistent difficulty maintaining a stiff penis through a lack of erectile rigidity will require medical treatment.
The main reason for erectile dysfunction caused by Peyronie’s disease is known as "venous leakage" in this situation, blood that would ordinarily be trapped in the tissue of the penis by the Tunica Albuginea leaks out slowly. This is caused by plaques that are formed by Peyronie’s preventing the veins from being pinched off normally.
Damaging effects of mechanical stress
In a normal penis, the fully expanded corpora cavernosa creates a structure like an inflatable I beam. The forces applied to the erect penis cause a region of tissue stress to form at the top of the "I". This is normally contained by the tunica albuginea, which compresses during erection, however, the tissues at the top of the penis can be subject to an opposite, delaminating force.
The process that is the precursor to Peyronie’s plaque forming is fibrin deposition – scarring – and this normally develops in the area with the most pressures and stresses on it. The area in the middle and top of the penis is the place which is most commonly affected by Peyronie’s disease.
In some cases, where the plaque develops in the form of a hoop, it creates an hourglass look to the penis in a circumferential direction or hoop. This creates a major impact on penile rigidity. In the area where the penis is indented, it can be easier to bend, and this is caused by the narrower diameter.
The effect of Peyronies on the penis can be measured, By examining the structure of the corpora as a stack of elements, it is clear that a plaque of 6 centimeters is required to cause a 90 degree bend. Smaller plaques, while effective in causing some curvature will not cause a very big overall bend.