Peyronie’s disease should be distinguished from diseases that have similar symptoms: pain syndrome, induration under the skin of the penis and deformation (curvature).
All penis curvatures can be divided into two groups: 1) congenital and 2) acquired.
Pathologies of the first type occur on average in 10% of the male population and have a number of important differences from Peyronie’s disease (fibroplastic penile induration).
First, most often patients with this pathology consult a doctor in the age from 13 to 25 – after puberty and the beginning of sexual life. Peyronie’s disease usually develops at a later age (usually in men over 30).
Second, in congenital deformities of the penis, unlike fibroplastic penile induration, only simple penis curvatures are observed (there are no complex deformities in the form of “loops” or “hourglass”, which can be the case with fibroplastic induration).
Third, in case of a congenital deformity, unlike Peyronie’s disease, there is no pain during erection (pain or – more often – discomfort can rarely be observed only during sexual intercourse due to severe deformation of the penis; sometimes it can prevent sexual intercourse). In fibroplastic penile induration, as a rule, pain during erection is present at the time of visit to the doctor or was observed before.
Fourth, in case of a congenital curvature of the penis, there are no indurations or plaques on the tunica albuginea. In addition, congenital curvature of the penis is often combined with hypospadias (hypospadias – congenital incorrect location of the urethra opening).
Acquired penile curvature (not Peyronie’s disease).
Acquired penile curvature not related to Peyronie’s disease develop after mechanical injury to the penis (usually during sexual intercourse).
This type of damage most often occurs when the erect penis strikes the perineum or groin area of the sexual partner. Typical signs of such trauma: crunch and sharp pain. Characterized by the appearance of edema and/or hematoma, rapid decline of erection.
This type of injury urologists often call “penile fracture”, but the more correct name is “rupture of the tunica albuginea”. As a result of the rupture, a fibrous scar is formed in the tunica albuginea and in the cavernous tissue adjacent to it, which further causes penile curvature during erection.
As a rule, patients with “penile fracture” try to get immediate medical care in the first hours (day) after injury. However, not all men with a rupture of tunica albuginea of the penis seek medical help immediately – some are trying to hide this episode, and visit the doctor after a long time, when penis deformation and erectile dysfunction are observed.
A man may not seek medical help also in case of minor clinical manifestations of the trauma – when not the entire tunica albuginea is ruptured, but only its outer layer (the so-called “tear of the tunica albuginea of the penis”). In those cases, hematoma and/or swelling may be mild or absent. In this case, painful erections and pain during sex can be noted for a long time after the injury.