Choroba peyroniego – Zapobieganie i profilaktyka

Choroba peyroniego
Zapobieganie i profilaktyka

Choroba Peyroniego to lokalny proces zwłóknieniowy osłonki białawej prącia, dotykający 8-10% mężczyzn w różnym wieku, charakteryzujący się akumulacją miofibroblastów i nadmiernym odkładaniem kolagenu, najczęściej po urazie. Czynniki ryzyka obejmują zaawansowany wiek, cukrzycę, chorobę Dupuytrena oraz predyspozycje rodzinne. Naturalny przebieg jest zwykle progresywny – tylko 10-15% pacjentów doświadcza samoistnej poprawy w ciągu roku, a u 45% dochodzi do pogorszenia. Patogeneza wiąże się z nadmierną ekspresją TGF-β1, inhibitora aktywatora plazminogenu 1 oraz reaktywnych form tlenu. Wczesna diagnostyka i leczenie są kluczowe dla zatrzymania lub poprawy skrzywienia prącia, a terapia obejmuje leki przeciwzapalne, ćwiczenia rozciągające oraz terapię trakcyjną (4,5-5 godzin dziennie przez 6 miesięcy), która może zmniejszyć krzywiznę o około 15 stopni.

Wprowadzenie do Choroba Peyroniego
Czynniki ryzyka rozwoju choroby Peyroniego
Zapobieganie chorobie Peyroniego

Zmniejszenie ryzyka urazu prącia
Metody redukcji ryzyka podczas aktywności seksualnej
Dodatkowe środki zapobiegawcze

Wczesna diagnostyka i leczenie jako forma profilaktyki wtórnej

Potencjalne metody profilaktyczne w badaniach
Aparaty do trakcji prącia

Podsumowanie zaleceń profilaktycznych

Kolejne rozdziały

Wprowadzenie do Choroba Peyroniego

Choroba Peyroniego (Peyronie’s disease) jest zlokalizowanym stanem zwłóknieniowym osłonki białawej prącia, dotykającym około 8-10% mężczyzn w wieku od nastolatków do osób w podeszłym wieku¹. Jest to schorzenie, które rzadko ustępuje samoistnie – bez leczenia tylko około 10-15% mężczyzn doświadcza złagodzenia objawów w ciągu roku, podczas gdy u około 45% pacjentów objawy ulegają pogorszeniu². Choroba ta wiąże się z czynnikami ryzyka zwłóknienia ciał jamistych (takimi jak zaawansowany wiek i cukrzyca) oraz chorobą Dupuytrena, będącą innym miejscowym procesem zwłóknieniowym³.

Czynniki ryzyka rozwoju choroby Peyroniego

Choroba Peyroniego jest związana z wieloma czynnikami ryzyka, które mogą przyczyniać się do jej rozwoju. Badania na ludzkich próbkach i modelach zwierzęcych wykazały, że nadmierna ekspresja transformującego czynnika wzrostu 1, inhibitora aktywatora plazminogenu 1, reaktywnych form tlenu i innych czynników profibrycznych, które w większości przypadków są wywoływane przez uraz osłonki białawej, prowadzi do akumulacji miofibroblastów i nadmiernego odkładania kolagenu⁴. Dodatkowo, choroba może występować rodzinnie – ryzyko jest wyższe, jeśli ojciec lub brat pacjenta również choruje na tę przypadłość⁵. Ryzyko rozwoju choroby Peyroniego wzrasta wraz z wiekiem oraz u osób z zaburzeniami tkanki łącznej⁶.

Zapobieganie chorobie Peyroniego

Obecnie nie istnieje potwierdzona metoda całkowitego zapobiegania chorobie Peyroniego⁷⁸. Według Narodowego Instytutu Cukrzycy i Chorób Układu Pokarmowego i Nerek (NIDDK), istnieje niewiele dowodów na to, że jakakolwiek interwencja może całkowicie zapobiec rozwojowi tej choroby⁹. Dieta i odżywianie nie zostały uznane za czynniki odgrywające rolę w zapobieganiu chorobie Peyroniego¹⁰.

Dr Pastuszak wyjaśnia, że choroba Peyroniego jest zwykle predyspozycją do określonego sposobu gojenia się organizmu w reakcji na uraz: „Nasz organizm jest skłonny reagować w określony sposób, a nieprawidłowe tworzenie tkanki bliznowatej jest jednym z nich”¹¹.

Zmniejszenie ryzyka urazu prącia

Chociaż całkowita prewencja może nie być możliwa, można podjąć kroki, które zmniejszą ryzyko urazu prącia, co jest jednym z głównych czynników wywołujących chorobę¹²¹³. Wraz z wiekiem erekcje mogą być mniej sztywne, a utrzymanie sztywności może być trudniejsze. Mniej sztywne erekcje są bardziej podatne na nieoczekiwane zgięcie podczas stosunku, co prowadzi do urazu¹⁴¹⁵.

Metody redukcji ryzyka podczas aktywności seksualnej

Pacjent i jego partner mogą zmniejszyć ryzyko urazu prącia podczas stosunku seksualnego poprzez zastosowanie następujących środków:

Stosowanie leków na zaburzenia erekcji – lekarz może przepisać doustne leki, w tym sildenafil (Viagra), wardenafil (Levitra) lub tadalafil (Cialis), jeśli zaburzenia erekcji utrudniają lub uniemożliwiają stosunek seksualny. Dobrym pomysłem jest rozpoczęcie stosowania leków na zaburzenia erekcji, gdy erekcje stają się mniej sztywne¹⁶¹⁷.
Używanie lubrykantów – lubrykanty zmniejszają tarcie podczas stosunku, co może pomóc w zmniejszeniu ryzyka urazu. Partnerka powinna upewnić się, że pochwa jest nawilżona. Jeśli nie jest, kobieta powinna użyć dostępnego bez recepty lubrykantu dopochwowego¹⁸¹⁹²⁰.
Ostrożne wprowadzanie prącia – jeśli zmieniasz pozycję lub prącie wysuwa się podczas stosunku, ty lub twój partner powinniście użyć ręki, aby ostrożnie naprowadzić prącie podczas wprowadzania²¹²².
Uważność przy pozycjach, w których partner jest na górze – zwiększasz szanse na zgięcie prącia w pozycjach seksualnych, w których partner jest na górze. Należy unikać takich pozycji lub stosować je z ostrożnością²³²⁴.
Utrzymywanie prostego i stabilnego ruchu podczas stosunku – należy unikać ruchów, które mogą zginać lub skręcać prącie. Ruchy pchnięć mężczyzny podczas stosunku powinny być proste, do wewnątrz i na zewnątrz²⁵²⁶.
Unikanie stosunku przy zmęczeniu lub po spożyciu alkoholu – należy unikać stosunku seksualnego, gdy mężczyzna jest zmęczony lub wypił zbyt dużo alkoholu, ponieważ erekcje mogą być mniej pewne w takich sytuacjach²⁷.

Dodatkowe środki zapobiegawcze

Oprócz środków ostrożności podczas aktywności seksualnej, istnieją inne działania, które mogą pomóc w zmniejszeniu ryzyka rozwoju choroby Peyroniego:

Noszenie ochraniacza sportowego – ochraniacz sportowy to sztywna plastikowa osłona noszona na prąciu i mosznie w celu ochrony przed urazami krocza podczas uprawiania sportów kontaktowych²⁸.
Leczenie chorób przewlekłych – choroby autoimmunologiczne, cukrzyca i nadciśnienie są powiązane z chorobą Peyroniego²⁹.
Zaprzestanie palenia – palenie papierosów powoduje zwężenie naczyń krwionośnych (wazokonstrykcję) w całym organizmie, co może przyczyniać się do rozwoju choroby³⁰³¹.
Regularna aktywność fizyczna – angażowanie się w regularne ćwiczenia kardiologiczne (chodzenie, bieganie, jazda na rowerze, podnoszenie ciężarów) i utrzymywanie zdrowej wagi ogólnej jest z pewnością korzystne dla ogólnego zdrowia i może zmniejszyć ryzyko zaburzeń erekcji i cukrzycy, które są czynnikami ryzyka choroby Peyroniego³².

Wczesna diagnostyka i leczenie jako forma profilaktyki wtórnej

Wczesna diagnostyka i leczenie choroby Peyroniego są kluczowe, ponieważ mogą zatrzymać lub leczyć skrzywienie prącia za pomocą środków niechirurgicznych³³. Choroba Peyroniego rzadko ustępuje samoistnie. U większości osób z tym schorzeniem pozostanie ono takie samo lub może się nieznacznie pogorszyć we wczesnym stadium. Wczesne leczenie, wkrótce po wystąpieniu choroby, może zapobiec jej pogorszeniu lub nawet poprawić objawy³⁴.

Wizyta u urologa we wczesnym stadium choroby Peyroniego jest bardzo ważna nie tylko dlatego, że zwiększa szanse na skuteczne leczenie, ale również dlatego, że zapobiega pogorszeniu się stanu³⁵. „Ludzie muszą wiedzieć, że choroba Peyroniego jest całkowicie uleczalna, ale wczesna opieka jest niezbędna” – mówi dr Nehra. „Naszym celem jest zachowanie funkcji nerwów i prącia, eliminacja bólu i optymalizacja funkcji seksualnych”³⁶.

Potencjalne metody profilaktyczne w badaniach

Badania nad nowymi metodami zapobiegania chorobie Peyroniego są w toku. Ciągłe długoterminowe podawanie donorów tlenku azotu i inhibitorów fosfodiesterazy 5 wykazało działanie zapobiegawcze i korygujące w szczurzym modelu choroby Peyroniego. Obecnie potrzebne są badania u pacjentów z tą chorobą³⁷.

Aparaty do trakcji prącia

Pacjenci mogą wykonywać kontrolowane rozciąganie prącia za pomocą aparatu do trakcji prącia w domu. Dostępnych jest kilka komercyjnych urządzeń trakcyjnych, które można zakupić online. Prącie jest rozciągane przez około 4,5-5 godzin dziennie przez około 6 miesięcy. Może to poprawić krzywiznę prącia o 15 stopni w ciągu 6-miesięcznego okresu. Ogólnie rzecz biorąc, metoda ta jest niedostatecznie wykorzystywana w leczeniu choroby Peyroniego, ponieważ może przynieść znaczne korzyści³⁸.

W fazie ostrej leczenia choroby Peyroniego zazwyczaj stosuje się leki przeciwzapalne i ćwiczenia rozciągające³⁹.

Podsumowanie zaleceń profilaktycznych

Chociaż nie ma jednoznacznej metody zapobiegania chorobie Peyroniego, istnieje kilka strategii, które mogą zmniejszyć ryzyko jej rozwoju lub progresji:

Unikanie urazów prącia podczas aktywności seksualnej poprzez stosowanie lubrykantów, ostrożne wprowadzanie prącia i utrzymywanie prostych ruchów podczas stosunku⁴⁰⁴¹.
Wczesna diagnostyka i leczenie w przypadku pojawienia się pierwszych objawów choroby⁴²⁴³.
Leczenie zaburzeń erekcji za pomocą odpowiednich leków, aby zapobiec urazom związanym z mniej sztywnymi erekcjami⁴⁴⁴⁵.
Kontrola chorób przewlekłych, takich jak cukrzyca, nadciśnienie i choroby autoimmunologiczne⁴⁶.
Zaprzestanie palenia i utrzymanie zdrowego stylu życia poprzez regularne ćwiczenia fizyczne⁴⁷⁴⁸.
Stosowanie ochraniacza sportowego podczas uprawiania sportów kontaktowych⁴⁹.
Rozważenie terapii trakcyjnej jako metody leczniczej i potencjalnie zapobiegawczej⁵⁰.

W przypadku wystąpienia objawów choroby Peyroniego, takich jak skrzywienie prącia, ból podczas erekcji lub zmiany w strukturze prącia, należy jak najszybciej skonsultować się z lekarzem urologiem. Wczesne leczenie daje najlepszą szansę na poprawę stanu lub zapobieżenie jego pogorszeniu⁵¹⁵².

Kolejne rozdziały

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Materiały źródłowe

#1 Early treatment for Peyronie’s disease – Mayo Clinic Health System
https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/early-treatment-for-peyronies-disease
Peyronie’s disease is a common yet poorly understood condition. Between 8% and 10% of men in their mid-teens to their 80s have signs or symptoms of Peyronie’s disease. […] Early evaluation and treatment is important, as Peyronie’s disease rarely goes away on its own. Without treatment, only about 10% to 15% of men experience symptom relief in one year, while symptoms worsen for about 45% of men. […] Early diagnosis and treatment may be able to halt or treat the curvature with nonsurgical means. This is why it’s important to seek treatment early.
#2 Early treatment for Peyronie’s disease – Mayo Clinic Health System
https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/early-treatment-for-peyronies-disease
Peyronie’s disease is a common yet poorly understood condition. Between 8% and 10% of men in their mid-teens to their 80s have signs or symptoms of Peyronie’s disease. […] Early evaluation and treatment is important, as Peyronie’s disease rarely goes away on its own. Without treatment, only about 10% to 15% of men experience symptom relief in one year, while symptoms worsen for about 45% of men. […] Early diagnosis and treatment may be able to halt or treat the curvature with nonsurgical means. This is why it’s important to seek treatment early.
#3 Treatment of Peyronie’s disease with PDE5 inhibitors: an antifibrotic strategy | Nature Reviews Urology
https://www.nature.com/articles/nrurol.2010.24
Peyronie’s disease (PD) is a localized fibrotic condition of the tunica albuginea that is associated with risk factors for corpora cavernosa fibrosis (such as advanced age and diabetes) and Dupuytren contracture, another localized fibrotic process. […] Evidence gathered in human specimens and animal models of PD have elucidated aspects of its etiology and histopathology, showing that overexpression of transforming growth factor 1, plasminogen activator inhibitor 1, reactive oxygen species and other profibrotic factors, which are, in most cases, assumed to be induced by trauma to the tunica albuginea, leads to myofibroblast accumulation and excessive deposition of collagen. […] Continuous long-term administration of nitric oxide donors and phosphodiesterase 5 inhibitors has shown preventive and corrective effects in a rat model of PD: studies in patients with PD are now needed.
#4 Treatment of Peyronie’s disease with PDE5 inhibitors: an antifibrotic strategy | Nature Reviews Urology
https://www.nature.com/articles/nrurol.2010.24
Peyronie’s disease (PD) is a localized fibrotic condition of the tunica albuginea that is associated with risk factors for corpora cavernosa fibrosis (such as advanced age and diabetes) and Dupuytren contracture, another localized fibrotic process. […] Evidence gathered in human specimens and animal models of PD have elucidated aspects of its etiology and histopathology, showing that overexpression of transforming growth factor 1, plasminogen activator inhibitor 1, reactive oxygen species and other profibrotic factors, which are, in most cases, assumed to be induced by trauma to the tunica albuginea, leads to myofibroblast accumulation and excessive deposition of collagen. […] Continuous long-term administration of nitric oxide donors and phosphodiesterase 5 inhibitors has shown preventive and corrective effects in a rat model of PD: studies in patients with PD are now needed.
#5 Peyronie’s Disease – Causes and Treatment | familydoctor.org
https://familydoctor.org/condition/peyronies-disease/
Can Peyronieâs disease be prevented or avoided? […] Since doctors arenât sure what causes the scar tissue related to Peyronieâs Disease, there is no way to prevent it or avoid it. […] You may be more at risk for the disease if your father or brother has it. This means that it could run in families. It also becomes more common as you get older. You also have a higher chance of developing this disease if you have a connective tissue disorder.
#6 Peyronie’s Disease – Causes and Treatment | familydoctor.org
https://familydoctor.org/condition/peyronies-disease/
Can Peyronieâs disease be prevented or avoided? […] Since doctors arenât sure what causes the scar tissue related to Peyronieâs Disease, there is no way to prevent it or avoid it. […] You may be more at risk for the disease if your father or brother has it. This means that it could run in families. It also becomes more common as you get older. You also have a higher chance of developing this disease if you have a connective tissue disorder.
#7 Peyronie’s Disease: Curved Penis Symptoms & Treatment | University of Utah Health
https://healthcare.utah.edu/healthfeed/2021/02/peyronies-disease-curved-penis-symptoms-treatment
There is currently no way to prevent Peyronie’s disease. […] Pastuszak says that Peyronie’s is usually a predisposition to the way our body heals in reaction to injury. […] „Our body is prone to respond in a certain way, and abnormal scar tissue formation is one way,” he says.
#8 Peyronieâs Disease: How to Prevent This Penis Injury
https://www.verywellhealth.com/protect-from-peyronies-disease-4174864
There are no guaranteed suggestions for how to prevent Peyronies disease (PD)a condition in which scar tissue inside the penis causes curved, painful erections. […] You may, then, be able to prevent Peyronie’s disease, or at least reduce your risk of it, by avoiding vigorous or „rough” sex, wearing an athletic cup during contact sports, and taking other steps that protect the penis. […] According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), there is little evidence that any intervention can outright prevent Peyronie’s disease. […] This doesn’t mean you can’t reduce some of the risk factors associated with PD. Doing so may or may not prevent the disease in the end, but it will at the very least ensure that you have a healthier penis over the long term.
#9 Peyronieâs Disease: How to Prevent This Penis Injury
https://www.verywellhealth.com/protect-from-peyronies-disease-4174864
There are no guaranteed suggestions for how to prevent Peyronies disease (PD)a condition in which scar tissue inside the penis causes curved, painful erections. […] You may, then, be able to prevent Peyronie’s disease, or at least reduce your risk of it, by avoiding vigorous or „rough” sex, wearing an athletic cup during contact sports, and taking other steps that protect the penis. […] According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), there is little evidence that any intervention can outright prevent Peyronie’s disease. […] This doesn’t mean you can’t reduce some of the risk factors associated with PD. Doing so may or may not prevent the disease in the end, but it will at the very least ensure that you have a healthier penis over the long term.
#10 Penile Curvature (Peyronie’s Disease) – NIDDK
https://www.niddk.nih.gov/health-information/urologic-diseases/penile-curvature-peyronies-disease
Can I prevent Peyronies disease? Researchers do not know how to prevent Peyronies disease. At this time, diet and nutrition have not been found to play a role in preventing Peyronies disease. […] The goal of treatment is to reduce pain, attain a straight or close-to-straight penis, and restore and maintain the ability to have intercourse. […] Besides treatment, your urologist may recommend lifestyle changes to reduce the risk of ED associated with Peyronies disease.
#11 Peyronie’s Disease: Curved Penis Symptoms & Treatment | University of Utah Health
https://healthcare.utah.edu/healthfeed/2021/02/peyronies-disease-curved-penis-symptoms-treatment
There is currently no way to prevent Peyronie’s disease. […] Pastuszak says that Peyronie’s is usually a predisposition to the way our body heals in reaction to injury. […] „Our body is prone to respond in a certain way, and abnormal scar tissue formation is one way,” he says.
#12 About Peyronie’s Disease | UCI Men’s Health – Male Infertility and Erectile Dysfunction Specialists
https://ucimenshealth.com/peyronies-disease/about-peyronies-disease/
Taking precautions to avoid trauma to the pelvic area sometimes reduces the odds of developing Peyronies disease. […] Otherwise, there are no standard preventive measures. Some men develop problems due to the curvature later in life, while others reach a point where the abnormality stabilizes and becomes less problematic.
#13 Peyronie’s Disease Treatment in Chattanooga, TN
https://www.drshrid.com/services/peyronies-disease/
Most of Peyronies Disease cases develop due to injury to the penis during intercourse. There are things you can do to prevent this. […] If you’re concerned about developing Peyronies, there are a few options to be cognizant of: […] Take ED medications. […] Use lubrication. […] Stay on top. […] Straight in and out. […] Pay attention.
#14 Peyronieâs Disease: Causes, Symptoms, Diagnosis & Treatment
https://my.clevelandclinic.org/health/diseases/10044-peyronies-disease
As you get older, your erections may be softer, or it may be more difficult to maintain firmness. Softer erections are more prone to bending unexpectedly during sex, leading to injury. You and your partner can reduce your chance of this type of injury during sex through the following: […] Erectile dysfunction medications. A healthcare provider may prescribe oral medications, including sildenafil (Viagra), vardenafil (Levitra) or tadalafil (Cialis), if erectile dysfunction makes sex difficult or impossible. Its a good idea to use ED medications as soon as your erections become softer. […] Using lubricants. Lubricants (lubes) reduce friction during sex, which can help reduce your risk of injury. […] Guiding your penis during insertion. If you change positions or your penis slips out during sex, you or your partner should use your hand to carefully guide your penis during insertion.
#15 Peyronie’s Disease | UNC Menâs Health Program
https://www.med.unc.edu/menshealth/peyronies-disease/
Men may not realize that they can damage their penis during sexual intercourse; making it difficult or even impossible to have sex. To avoid this type of injury there are a number of things a man and his partner can do. […] As men age, their erections may be less rigid or there may be difficulty in maintaining firmness. Less rigid erections can be injured because regular thrusting during sexual intercourse bends the penis. The following suggestions can help: […] Doctors will usually prescribe oral medications (Viagra, Levitra, Cialis) when a man has erectile dysfunction and sexual intercourse is either difficult or impossible. The first step in avoiding penile injuries is to begin to use one of these medications as erections become less rigid. […] The woman should make sure that the vagina is lubricated. If it is not, the woman should use an over-the-counter vaginal lubricant.
#16 Peyronieâs Disease: Causes, Symptoms, Diagnosis & Treatment
https://my.clevelandclinic.org/health/diseases/10044-peyronies-disease
As you get older, your erections may be softer, or it may be more difficult to maintain firmness. Softer erections are more prone to bending unexpectedly during sex, leading to injury. You and your partner can reduce your chance of this type of injury during sex through the following: […] Erectile dysfunction medications. A healthcare provider may prescribe oral medications, including sildenafil (Viagra), vardenafil (Levitra) or tadalafil (Cialis), if erectile dysfunction makes sex difficult or impossible. Its a good idea to use ED medications as soon as your erections become softer. […] Using lubricants. Lubricants (lubes) reduce friction during sex, which can help reduce your risk of injury. […] Guiding your penis during insertion. If you change positions or your penis slips out during sex, you or your partner should use your hand to carefully guide your penis during insertion.
#17 Peyronie’s Disease | UNC Menâs Health Program
https://www.med.unc.edu/menshealth/peyronies-disease/
Men may not realize that they can damage their penis during sexual intercourse; making it difficult or even impossible to have sex. To avoid this type of injury there are a number of things a man and his partner can do. […] As men age, their erections may be less rigid or there may be difficulty in maintaining firmness. Less rigid erections can be injured because regular thrusting during sexual intercourse bends the penis. The following suggestions can help: […] Doctors will usually prescribe oral medications (Viagra, Levitra, Cialis) when a man has erectile dysfunction and sexual intercourse is either difficult or impossible. The first step in avoiding penile injuries is to begin to use one of these medications as erections become less rigid. […] The woman should make sure that the vagina is lubricated. If it is not, the woman should use an over-the-counter vaginal lubricant.
#18 Peyronieâs Disease: Causes, Symptoms, Diagnosis & Treatment
https://my.clevelandclinic.org/health/diseases/10044-peyronies-disease
As you get older, your erections may be softer, or it may be more difficult to maintain firmness. Softer erections are more prone to bending unexpectedly during sex, leading to injury. You and your partner can reduce your chance of this type of injury during sex through the following: […] Erectile dysfunction medications. A healthcare provider may prescribe oral medications, including sildenafil (Viagra), vardenafil (Levitra) or tadalafil (Cialis), if erectile dysfunction makes sex difficult or impossible. Its a good idea to use ED medications as soon as your erections become softer. […] Using lubricants. Lubricants (lubes) reduce friction during sex, which can help reduce your risk of injury. […] Guiding your penis during insertion. If you change positions or your penis slips out during sex, you or your partner should use your hand to carefully guide your penis during insertion.
#19 Peyronie’s Disease | UNC Menâs Health Program
https://www.med.unc.edu/menshealth/peyronies-disease/
Men may not realize that they can damage their penis during sexual intercourse; making it difficult or even impossible to have sex. To avoid this type of injury there are a number of things a man and his partner can do. […] As men age, their erections may be less rigid or there may be difficulty in maintaining firmness. Less rigid erections can be injured because regular thrusting during sexual intercourse bends the penis. The following suggestions can help: […] Doctors will usually prescribe oral medications (Viagra, Levitra, Cialis) when a man has erectile dysfunction and sexual intercourse is either difficult or impossible. The first step in avoiding penile injuries is to begin to use one of these medications as erections become less rigid. […] The woman should make sure that the vagina is lubricated. If it is not, the woman should use an over-the-counter vaginal lubricant.
#20 Peyronieâs Disease: How to Prevent This Penis Injury
https://www.verywellhealth.com/protect-from-peyronies-disease-4174864
Here are some measures you might consider: […] Use a lubricant during sexual intercourse: Vaginal or anal sex without lubrication can place undue stress on the penis. […] Adjust your sexual position: Depending on your penis size and natural curve, as well as the anatomy of your partner, certain sexual positions can cause your penis to „bang” against bone and tissue. […] Treat erectile dysfunction: As males age, many have difficulty sustaining the same, rigid erection they had in their youth. […] Wear an athletic cup: An athletic cup is a solid plastic guard worn over the penis and scrotum to protect against groin injuries from contact sports. […] Treat chronic conditions: Autoimmune diseases, diabetes, and hypertension are all linked to PD. […] Stop smoking: Cigarette smoking causes vasoconstriction (the narrowing of blood vessels) throughout the body.
#21 Peyronieâs Disease: Causes, Symptoms, Diagnosis & Treatment
https://my.clevelandclinic.org/health/diseases/10044-peyronies-disease
As you get older, your erections may be softer, or it may be more difficult to maintain firmness. Softer erections are more prone to bending unexpectedly during sex, leading to injury. You and your partner can reduce your chance of this type of injury during sex through the following: […] Erectile dysfunction medications. A healthcare provider may prescribe oral medications, including sildenafil (Viagra), vardenafil (Levitra) or tadalafil (Cialis), if erectile dysfunction makes sex difficult or impossible. Its a good idea to use ED medications as soon as your erections become softer. […] Using lubricants. Lubricants (lubes) reduce friction during sex, which can help reduce your risk of injury. […] Guiding your penis during insertion. If you change positions or your penis slips out during sex, you or your partner should use your hand to carefully guide your penis during insertion.
#22 Peyronie’s Disease | UNC Menâs Health Program
https://www.med.unc.edu/menshealth/peyronies-disease/
If the penis slips out of the vagina during sexual intercourse, the man or his partner should use their hand to guide it back in. […] Sexual intercourse with the partner on top should be avoided or used with caution because this position may increase the chances of the penis bending. […] Regardless of the position, the mans thrusting movements during sexual intercourse should be straight in and out. He should avoid movements that might bend or twist the penis. […] Sexual intercourse should be avoided when the man is tired or has had too much alcohol to drink as erections may be less reliable on these occasions.
#23 Peyronieâs Disease: Causes, Symptoms, Diagnosis & Treatment
https://my.clevelandclinic.org/health/diseases/10044-peyronies-disease
Being careful if your partner is on top. You increase your chances of bending your penis in sexual positions where your partner is on top. […] Maintaining a straight and steady thrusting motion. Avoid any movements that might bend or twist your penis. […] You may still get Peyronies disease even if youre not sexually active. Theres no way to prevent Peyronies disease if genetics or autoimmune diseases are the cause.
#24 Peyronie’s Disease | UNC Menâs Health Program
https://www.med.unc.edu/menshealth/peyronies-disease/
If the penis slips out of the vagina during sexual intercourse, the man or his partner should use their hand to guide it back in. […] Sexual intercourse with the partner on top should be avoided or used with caution because this position may increase the chances of the penis bending. […] Regardless of the position, the mans thrusting movements during sexual intercourse should be straight in and out. He should avoid movements that might bend or twist the penis. […] Sexual intercourse should be avoided when the man is tired or has had too much alcohol to drink as erections may be less reliable on these occasions.
#25 Peyronieâs Disease: Causes, Symptoms, Diagnosis & Treatment
https://my.clevelandclinic.org/health/diseases/10044-peyronies-disease
Being careful if your partner is on top. You increase your chances of bending your penis in sexual positions where your partner is on top. […] Maintaining a straight and steady thrusting motion. Avoid any movements that might bend or twist your penis. […] You may still get Peyronies disease even if youre not sexually active. Theres no way to prevent Peyronies disease if genetics or autoimmune diseases are the cause.
#26 Peyronie’s Disease | UNC Menâs Health Program
https://www.med.unc.edu/menshealth/peyronies-disease/
If the penis slips out of the vagina during sexual intercourse, the man or his partner should use their hand to guide it back in. […] Sexual intercourse with the partner on top should be avoided or used with caution because this position may increase the chances of the penis bending. […] Regardless of the position, the mans thrusting movements during sexual intercourse should be straight in and out. He should avoid movements that might bend or twist the penis. […] Sexual intercourse should be avoided when the man is tired or has had too much alcohol to drink as erections may be less reliable on these occasions.
#27 Peyronie’s Disease | UNC Menâs Health Program
https://www.med.unc.edu/menshealth/peyronies-disease/
If the penis slips out of the vagina during sexual intercourse, the man or his partner should use their hand to guide it back in. […] Sexual intercourse with the partner on top should be avoided or used with caution because this position may increase the chances of the penis bending. […] Regardless of the position, the mans thrusting movements during sexual intercourse should be straight in and out. He should avoid movements that might bend or twist the penis. […] Sexual intercourse should be avoided when the man is tired or has had too much alcohol to drink as erections may be less reliable on these occasions.
#28 Peyronieâs Disease: How to Prevent This Penis Injury
https://www.verywellhealth.com/protect-from-peyronies-disease-4174864
Here are some measures you might consider: […] Use a lubricant during sexual intercourse: Vaginal or anal sex without lubrication can place undue stress on the penis. […] Adjust your sexual position: Depending on your penis size and natural curve, as well as the anatomy of your partner, certain sexual positions can cause your penis to „bang” against bone and tissue. […] Treat erectile dysfunction: As males age, many have difficulty sustaining the same, rigid erection they had in their youth. […] Wear an athletic cup: An athletic cup is a solid plastic guard worn over the penis and scrotum to protect against groin injuries from contact sports. […] Treat chronic conditions: Autoimmune diseases, diabetes, and hypertension are all linked to PD. […] Stop smoking: Cigarette smoking causes vasoconstriction (the narrowing of blood vessels) throughout the body.
#29 Peyronieâs Disease: How to Prevent This Penis Injury
https://www.verywellhealth.com/protect-from-peyronies-disease-4174864
Here are some measures you might consider: […] Use a lubricant during sexual intercourse: Vaginal or anal sex without lubrication can place undue stress on the penis. […] Adjust your sexual position: Depending on your penis size and natural curve, as well as the anatomy of your partner, certain sexual positions can cause your penis to „bang” against bone and tissue. […] Treat erectile dysfunction: As males age, many have difficulty sustaining the same, rigid erection they had in their youth. […] Wear an athletic cup: An athletic cup is a solid plastic guard worn over the penis and scrotum to protect against groin injuries from contact sports. […] Treat chronic conditions: Autoimmune diseases, diabetes, and hypertension are all linked to PD. […] Stop smoking: Cigarette smoking causes vasoconstriction (the narrowing of blood vessels) throughout the body.
#30 Peyronieâs Disease: How to Prevent This Penis Injury
https://www.verywellhealth.com/protect-from-peyronies-disease-4174864
Here are some measures you might consider: […] Use a lubricant during sexual intercourse: Vaginal or anal sex without lubrication can place undue stress on the penis. […] Adjust your sexual position: Depending on your penis size and natural curve, as well as the anatomy of your partner, certain sexual positions can cause your penis to „bang” against bone and tissue. […] Treat erectile dysfunction: As males age, many have difficulty sustaining the same, rigid erection they had in their youth. […] Wear an athletic cup: An athletic cup is a solid plastic guard worn over the penis and scrotum to protect against groin injuries from contact sports. […] Treat chronic conditions: Autoimmune diseases, diabetes, and hypertension are all linked to PD. […] Stop smoking: Cigarette smoking causes vasoconstriction (the narrowing of blood vessels) throughout the body.
#31 Peyronie’s Disease: Symptoms, Diagnosis, Treatment, and More
https://www.healthline.com/health/erectile-dysfunction/peyronies-disease
While there is no definitive way to prevent Peyronies disease, you may be able to reduce some of your risk factors by avoiding trauma to the penis and quitting smoking, if you smoke. […] In some cases, Peyronies disease may go away on its own. But if the curvature is severe or you experience severe or lasting pain, a doctor may be able to prescribe treatment and help prevent complications, such as stress and difficulty having sex.
#32 Your Peyronie’s Disease Questions, Answered
https://www.greaterbostonurology.com/blog/your-peyronies-disease-questions-answered
How do you prevent Peyronie’s disease? […] While it is very difficult to prevent Peyronie’s disease specifically, preventing risk factors for erectile dysfunction and diabetes never hurts. Engaging in regular cardiovascular exercise (walking, running, biking, weightlifting) and maintaining a healthy overall weight is certainly beneficial. […] Patients can perform controlled penile stretching using a penile traction device at home. There are several commercially available traction devices that can be purchased online. The penis is stretched for about 4.5-5 hours per day for approximately 6 months. This can improve penile curvature by 15 degrees over a 6-month period. In general, we find this to be an underutilized method of treating Peyronie’s disease, as it can provide significant benefit.
#33 Early treatment for Peyronie’s disease – Mayo Clinic Health System
https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/early-treatment-for-peyronies-disease
Peyronie’s disease is a common yet poorly understood condition. Between 8% and 10% of men in their mid-teens to their 80s have signs or symptoms of Peyronie’s disease. […] Early evaluation and treatment is important, as Peyronie’s disease rarely goes away on its own. Without treatment, only about 10% to 15% of men experience symptom relief in one year, while symptoms worsen for about 45% of men. […] Early diagnosis and treatment may be able to halt or treat the curvature with nonsurgical means. This is why it’s important to seek treatment early.
#34 Peyronie disease – Symptoms and causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/peyronies-disease/symptoms-causes/syc-20353468
Peyronie disease rarely goes away on its own. In most people with the condition, it will remain as is or may get slightly worse early on. Early treatment soon after you get the condition may keep it from getting worse or even improve symptoms. […] See a health care professional if you notice symptoms of Peyronie disease. Early treatment gives you the best chance to improve the condition or keep it from getting worse.
#35 Peyronie’s Disease | WakeMed
https://www.wakemed.org/wakemed-physician-practices/specialties/urology/mens-health/peyronies-disease
Seeing a urologist early for Peyronies disease is very important not only because it improves the chances of effective treatment, but because it will also prevent the condition from worsening. […] Treatment options during the acute phase usually involve anti-inflammatory medications and stretching exercises.
#36 Advances in Treatment for Peyronie’s Disease – Mass General Advances in Motion
https://advances.massgeneral.org/urology/article.aspx?id=1077
Early diagnosis of Peyronie’s disease is critical to treatment efficacy. […] Optimal outcomes from treatment of Peyronie’s disease are associated with care from urologic subspecialists skilled in its diagnosis, timing of appropriate interventions and clinical and surgical command of the full range of therapeutic options, aftercare and recovery. […] „People need to know Peyronie’s disease is entirely treatable, but that early care is essential,” Dr. Nehra says. „Our goal is to preserve nerve and penile function, eliminate pain and optimize sexual function.”
#37 Treatment of Peyronie’s disease with PDE5 inhibitors: an antifibrotic strategy | Nature Reviews Urology
https://www.nature.com/articles/nrurol.2010.24
Peyronie’s disease (PD) is a localized fibrotic condition of the tunica albuginea that is associated with risk factors for corpora cavernosa fibrosis (such as advanced age and diabetes) and Dupuytren contracture, another localized fibrotic process. […] Evidence gathered in human specimens and animal models of PD have elucidated aspects of its etiology and histopathology, showing that overexpression of transforming growth factor 1, plasminogen activator inhibitor 1, reactive oxygen species and other profibrotic factors, which are, in most cases, assumed to be induced by trauma to the tunica albuginea, leads to myofibroblast accumulation and excessive deposition of collagen. […] Continuous long-term administration of nitric oxide donors and phosphodiesterase 5 inhibitors has shown preventive and corrective effects in a rat model of PD: studies in patients with PD are now needed.
#38 Your Peyronie’s Disease Questions, Answered
https://www.greaterbostonurology.com/blog/your-peyronies-disease-questions-answered
How do you prevent Peyronie’s disease? […] While it is very difficult to prevent Peyronie’s disease specifically, preventing risk factors for erectile dysfunction and diabetes never hurts. Engaging in regular cardiovascular exercise (walking, running, biking, weightlifting) and maintaining a healthy overall weight is certainly beneficial. […] Patients can perform controlled penile stretching using a penile traction device at home. There are several commercially available traction devices that can be purchased online. The penis is stretched for about 4.5-5 hours per day for approximately 6 months. This can improve penile curvature by 15 degrees over a 6-month period. In general, we find this to be an underutilized method of treating Peyronie’s disease, as it can provide significant benefit.
#39 Peyronie’s Disease | WakeMed
https://www.wakemed.org/wakemed-physician-practices/specialties/urology/mens-health/peyronies-disease
Seeing a urologist early for Peyronies disease is very important not only because it improves the chances of effective treatment, but because it will also prevent the condition from worsening. […] Treatment options during the acute phase usually involve anti-inflammatory medications and stretching exercises.
#40 Peyronieâs Disease: Causes, Symptoms, Diagnosis & Treatment
https://my.clevelandclinic.org/health/diseases/10044-peyronies-disease
As you get older, your erections may be softer, or it may be more difficult to maintain firmness. Softer erections are more prone to bending unexpectedly during sex, leading to injury. You and your partner can reduce your chance of this type of injury during sex through the following: […] Erectile dysfunction medications. A healthcare provider may prescribe oral medications, including sildenafil (Viagra), vardenafil (Levitra) or tadalafil (Cialis), if erectile dysfunction makes sex difficult or impossible. Its a good idea to use ED medications as soon as your erections become softer. […] Using lubricants. Lubricants (lubes) reduce friction during sex, which can help reduce your risk of injury. […] Guiding your penis during insertion. If you change positions or your penis slips out during sex, you or your partner should use your hand to carefully guide your penis during insertion.
#41 Peyronie’s Disease | UNC Menâs Health Program
https://www.med.unc.edu/menshealth/peyronies-disease/
Men may not realize that they can damage their penis during sexual intercourse; making it difficult or even impossible to have sex. To avoid this type of injury there are a number of things a man and his partner can do. […] As men age, their erections may be less rigid or there may be difficulty in maintaining firmness. Less rigid erections can be injured because regular thrusting during sexual intercourse bends the penis. The following suggestions can help: […] Doctors will usually prescribe oral medications (Viagra, Levitra, Cialis) when a man has erectile dysfunction and sexual intercourse is either difficult or impossible. The first step in avoiding penile injuries is to begin to use one of these medications as erections become less rigid. […] The woman should make sure that the vagina is lubricated. If it is not, the woman should use an over-the-counter vaginal lubricant.
#42 Peyronie disease – Symptoms and causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/peyronies-disease/symptoms-causes/syc-20353468
Peyronie disease rarely goes away on its own. In most people with the condition, it will remain as is or may get slightly worse early on. Early treatment soon after you get the condition may keep it from getting worse or even improve symptoms. […] See a health care professional if you notice symptoms of Peyronie disease. Early treatment gives you the best chance to improve the condition or keep it from getting worse.
#43 Advances in Treatment for Peyronie’s Disease – Mass General Advances in Motion
https://advances.massgeneral.org/urology/article.aspx?id=1077
Early diagnosis of Peyronie’s disease is critical to treatment efficacy. […] Optimal outcomes from treatment of Peyronie’s disease are associated with care from urologic subspecialists skilled in its diagnosis, timing of appropriate interventions and clinical and surgical command of the full range of therapeutic options, aftercare and recovery. […] „People need to know Peyronie’s disease is entirely treatable, but that early care is essential,” Dr. Nehra says. „Our goal is to preserve nerve and penile function, eliminate pain and optimize sexual function.”
#44 Peyronieâs Disease: Causes, Symptoms, Diagnosis & Treatment
https://my.clevelandclinic.org/health/diseases/10044-peyronies-disease
As you get older, your erections may be softer, or it may be more difficult to maintain firmness. Softer erections are more prone to bending unexpectedly during sex, leading to injury. You and your partner can reduce your chance of this type of injury during sex through the following: […] Erectile dysfunction medications. A healthcare provider may prescribe oral medications, including sildenafil (Viagra), vardenafil (Levitra) or tadalafil (Cialis), if erectile dysfunction makes sex difficult or impossible. Its a good idea to use ED medications as soon as your erections become softer. […] Using lubricants. Lubricants (lubes) reduce friction during sex, which can help reduce your risk of injury. […] Guiding your penis during insertion. If you change positions or your penis slips out during sex, you or your partner should use your hand to carefully guide your penis during insertion.
#45 Peyronie’s Disease | UNC Menâs Health Program
https://www.med.unc.edu/menshealth/peyronies-disease/
Men may not realize that they can damage their penis during sexual intercourse; making it difficult or even impossible to have sex. To avoid this type of injury there are a number of things a man and his partner can do. […] As men age, their erections may be less rigid or there may be difficulty in maintaining firmness. Less rigid erections can be injured because regular thrusting during sexual intercourse bends the penis. The following suggestions can help: […] Doctors will usually prescribe oral medications (Viagra, Levitra, Cialis) when a man has erectile dysfunction and sexual intercourse is either difficult or impossible. The first step in avoiding penile injuries is to begin to use one of these medications as erections become less rigid. […] The woman should make sure that the vagina is lubricated. If it is not, the woman should use an over-the-counter vaginal lubricant.
#46 Peyronieâs Disease: How to Prevent This Penis Injury
https://www.verywellhealth.com/protect-from-peyronies-disease-4174864
Here are some measures you might consider: […] Use a lubricant during sexual intercourse: Vaginal or anal sex without lubrication can place undue stress on the penis. […] Adjust your sexual position: Depending on your penis size and natural curve, as well as the anatomy of your partner, certain sexual positions can cause your penis to „bang” against bone and tissue. […] Treat erectile dysfunction: As males age, many have difficulty sustaining the same, rigid erection they had in their youth. […] Wear an athletic cup: An athletic cup is a solid plastic guard worn over the penis and scrotum to protect against groin injuries from contact sports. […] Treat chronic conditions: Autoimmune diseases, diabetes, and hypertension are all linked to PD. […] Stop smoking: Cigarette smoking causes vasoconstriction (the narrowing of blood vessels) throughout the body.
#47 Peyronieâs Disease: How to Prevent This Penis Injury
https://www.verywellhealth.com/protect-from-peyronies-disease-4174864
Here are some measures you might consider: […] Use a lubricant during sexual intercourse: Vaginal or anal sex without lubrication can place undue stress on the penis. […] Adjust your sexual position: Depending on your penis size and natural curve, as well as the anatomy of your partner, certain sexual positions can cause your penis to „bang” against bone and tissue. […] Treat erectile dysfunction: As males age, many have difficulty sustaining the same, rigid erection they had in their youth. […] Wear an athletic cup: An athletic cup is a solid plastic guard worn over the penis and scrotum to protect against groin injuries from contact sports. […] Treat chronic conditions: Autoimmune diseases, diabetes, and hypertension are all linked to PD. […] Stop smoking: Cigarette smoking causes vasoconstriction (the narrowing of blood vessels) throughout the body.
#48 Your Peyronie’s Disease Questions, Answered
https://www.greaterbostonurology.com/blog/your-peyronies-disease-questions-answered
How do you prevent Peyronie’s disease? […] While it is very difficult to prevent Peyronie’s disease specifically, preventing risk factors for erectile dysfunction and diabetes never hurts. Engaging in regular cardiovascular exercise (walking, running, biking, weightlifting) and maintaining a healthy overall weight is certainly beneficial. […] Patients can perform controlled penile stretching using a penile traction device at home. There are several commercially available traction devices that can be purchased online. The penis is stretched for about 4.5-5 hours per day for approximately 6 months. This can improve penile curvature by 15 degrees over a 6-month period. In general, we find this to be an underutilized method of treating Peyronie’s disease, as it can provide significant benefit.
#49 Peyronieâs Disease: How to Prevent This Penis Injury
https://www.verywellhealth.com/protect-from-peyronies-disease-4174864
Here are some measures you might consider: […] Use a lubricant during sexual intercourse: Vaginal or anal sex without lubrication can place undue stress on the penis. […] Adjust your sexual position: Depending on your penis size and natural curve, as well as the anatomy of your partner, certain sexual positions can cause your penis to „bang” against bone and tissue. […] Treat erectile dysfunction: As males age, many have difficulty sustaining the same, rigid erection they had in their youth. […] Wear an athletic cup: An athletic cup is a solid plastic guard worn over the penis and scrotum to protect against groin injuries from contact sports. […] Treat chronic conditions: Autoimmune diseases, diabetes, and hypertension are all linked to PD. […] Stop smoking: Cigarette smoking causes vasoconstriction (the narrowing of blood vessels) throughout the body.
#50 Your Peyronie’s Disease Questions, Answered
https://www.greaterbostonurology.com/blog/your-peyronies-disease-questions-answered
How do you prevent Peyronie’s disease? […] While it is very difficult to prevent Peyronie’s disease specifically, preventing risk factors for erectile dysfunction and diabetes never hurts. Engaging in regular cardiovascular exercise (walking, running, biking, weightlifting) and maintaining a healthy overall weight is certainly beneficial. […] Patients can perform controlled penile stretching using a penile traction device at home. There are several commercially available traction devices that can be purchased online. The penis is stretched for about 4.5-5 hours per day for approximately 6 months. This can improve penile curvature by 15 degrees over a 6-month period. In general, we find this to be an underutilized method of treating Peyronie’s disease, as it can provide significant benefit.
#51 Peyronie disease – Symptoms and causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/peyronies-disease/symptoms-causes/syc-20353468
Peyronie disease rarely goes away on its own. In most people with the condition, it will remain as is or may get slightly worse early on. Early treatment soon after you get the condition may keep it from getting worse or even improve symptoms. […] See a health care professional if you notice symptoms of Peyronie disease. Early treatment gives you the best chance to improve the condition or keep it from getting worse.
#52 Peyronie’s Disease: Symptoms, Diagnosis, Treatment, and More
https://www.healthline.com/health/erectile-dysfunction/peyronies-disease
While there is no definitive way to prevent Peyronies disease, you may be able to reduce some of your risk factors by avoiding trauma to the penis and quitting smoking, if you smoke. […] In some cases, Peyronies disease may go away on its own. But if the curvature is severe or you experience severe or lasting pain, a doctor may be able to prescribe treatment and help prevent complications, such as stress and difficulty having sex.