Peyronie's disease is:

Ans. B. Bowing of penis during erection due to fibrous plaque. (Ref LB 26th pg. 1372).Peyronie's disease# Peyronie's disease is a relatively common cause of deformity of the erect penis. On examination, hard plaques of fibrosis can usually be palpated in the tunica of one or both corpora cavernosa. The plaques may be calcified.# The presence of the unyielding plaque tissue within the normally elastic wall of the corpus cavemosum causes the erect penis to bend, often dramatically, towards the side of the plaque.# The aetiology is uncertain but it may be a result of past trauma - there is an association with Dupuytren's contracture.- Medical treatments during the active phase have little evidence of efficacy- The disease has a natural history of 18-24 months active disease before it stabilises- Surgery may be indicated to correct deformity that interferes with sexual activity- Surgical treatment will shorten the erect penile length.# Rx is difficult. Some cases continue to progress. Others seem to remit after 3-5 years. Various drug Rxs have been suggested but their beneficial effect is hard to prove in such a chronic condition. When the deformity of the penis is causing distress, it may be possible to straighten it by placing non- absorbable sutures in the corpus cavemosum opposite the plaque. This reduces the elasticity in this region to balance that caused by the plaque (Nesbitt's operation). The most common procedure is the Nesbitt procedure which corrects the deformity by plicating the convex side of the deformity, thereby straightening the penis, with some accompanying loss of length.Additional Educational points# Chordee (French = corded) is a fixed bowing of the penis caused by hypospadias or, more rarely, chronic urethritis. Erection is deformed and sexual intercourse may be impossible. Rx is usually surgical.