Stages of Peyronie’s disease according to V.E. Mazo:
- — 1st is characterized by the absence of plaques in the tunica albuginea of the penis (plaque may not be revealed); the only manifestation of the diorder at this phase – painful erection;
- —2nd is characterized by the appearance of fibrous-elastic formation on the tunica albuginea of the penis;
- — 3rd corresponds to the formation of dense plaque fibers;
- —4th of disorder is associated with plaque calcification.
Categorization of the illness is possible depending on the degree of curvature and the size of the plaque (A. Kelami):
- — 1st category – slight penile curvature up to 30° and plaque size up to 2 cm;
- — 2nd category – moderate penile curvature from 30° to 60° and plaque size from 2 cm to 4 cm;
- — 3rd category– severe penile curvature greater than 60° and plaque size above 4 cm.
Since there is no direct dependence of the degree of penile deformation from the size and number of plaques, the classification of Peyronie’s disease is possible only on the basis of penile deformation without taking into account the size of the plaque:
- — patients with erectile deformation without pronounced curvature;
- — slight degree of curvature (not more than 30°);
- — moderate degree of curvature (from 31° to 60°);
- — severe degree of curvature (more than 60°).
It should be borne in mind that there is no absolute chronological dependence of the appearance of dense calcified plaques: calcification may develop both at the beginning of the disorder and over time.
Group of doctors from Belarus (Professor N. I. Dosta, Professor D. M. Nitkin, doctor R. V. Doroshevich) propose to classify Peyronie’s disease separately into two categories: (I) clinical stage and (II) erectile deformation.
- Classification of Peyronie’s disease depending on the clinical stage of the illness:
- Subclinical stage – the period from the beginning of pathological changes in the tunica albuginea of the penis to the appearance of clinical symptoms: the appearance of palpable plaque, penile deformation, worsening of erectile function.
- Acute (inflammatory) stage – characterized by painful erection or sex, progressive penile deformation; begins with the appearance of clinical symptoms and lasts from 3 – 6 to 12 – 18 months (rarely longer).
- Chronic stage:
- — Stabilization stage – pain gradually disappears, erectile deformation of the penis ceases to progress;
- — Regression of symptoms – time since the complete disappearance of pain and the cessation of progression of penile deformation;
- — Stage of exacerbation – transition of chronic stage again in acute (inflammatory) due to disorder progression and/or absence of adequate conservative treatment.
- Classification of Peyronie’s disease depending on the type of penile deformation during erection:1) Simple curvature (strictly in one plane):
– up; this is the most common type;
– sidewise: to the left or to the right;
– combined deformation that goes strictly beyond the horizontal or vertical plane.
2) Complex deformations (with the formation of “loops” of the penis or the symptom of “sand glass”).
For more information on how to measure the angle of curvature during erection, see here.