Until last month, Peyronie's disease was an obscure medical condition. In her lawsuit against President Clinton, Paula Jones has made it the topic of headlines and a household word.
The "distinguishing characteristic" that Ms. Jones described in a sealed affidavit is being reported in newspaper accounts as a distinct bend in the erect penis. Such curvature is generally diagnosed as Peyronie's disease, named after the French doctor who first described it in 1743.
For most men, the curvature is merely distressing. But for others the angle is so pronounced that an erection is painful and intercourse is difficult or impossible.
Peyronie's disease involves a patch of tissue that becomes fibrous and does not expand normally, as the rest of the tissue does. This "plaque" is responsible for the bend in the erection.
The causes of Peyronie's disease remain mysterious. Trauma is believed to be a contributing factor in some cases. Men should be warned that attempting intercourse with an incomplete erection could increase their risk.
Some medications may place a man at higher risk of developing this disease. Beta blockers for heart and blood pressure treatment, including Blocadren, Cartrol, Inderal, Lopressor, Normodyne, Tenormin, Toprol XL, Trandate and Visken, glaucoma eye drops such as Timoptic, the migraine tablet Sansert and the seizure medicine Dilantin have all been associated with Peyronie's.
The injected impotence drug Caverject (alprostadil) may also cause fibrous tissue buildup. Careful monitoring by a urologist is essential.
Most men are reluctant to discuss this sensitive topic with their doctors. We heard recently from a woman seeking information for her son: "My son has been diagnosed with Peyronie's disease, which makes his penis bend backward. He told me about it because he knows I read every article about health that I can find. He's 46 years old and takes gemfibrozil and indomethacin.
"The doctor told him surgery is necessary, but he is very reluctant to undergo this. He lives in a small town and has a prominent position. He worries that everyone in town will find out about his surgery. What other options does he have?"
Treatment of Peyronie's disease is complicated. Some cases disappear spontaneously. Others respond only to surgery. But surgery itself may occasionally cause scarring and make matters worse. Ultrasound, vitamin E, Potaba and injections of corticosteroids have all had mixed results.
Paula Jones may have done the men of America a favor by bringing Peyronie's disease out of the closet. Perhaps all this attention will encourage more research into the causes and treatments of this puzzling condition.
In their column, Joe and Teresa Graedon answer letters from readers. Write to them at Graedon's People's Pharmacy, P.O. Box 52027, Durham, NC 27717-2027, or e-mail to PHARMACY@mindspring.com
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