From the Guidelines
Peyronie's disease is primarily caused by abnormal wound healing following trauma to the penis, leading to the formation of fibrous plaques in the tunica albuginea. The exact etiology remains multifactorial, involving both genetic predisposition and environmental factors, as defined by the American Urological Association (AUA) guideline 1. Repeated microtrauma during sexual activity is believed to be the initiating event in many cases, triggering an inflammatory response that fails to resolve normally. This aberrant healing process results in excessive collagen deposition and fibrosis. Genetic factors play a significant role, with approximately 20-30% of patients having a family history or associated conditions like Dupuytren's contracture. Other contributing factors include autoimmune disorders, diabetes, smoking, and certain medications such as beta-blockers.
Key factors to consider in the etiology of Peyronie's disease include:
- Genetic predisposition
- Environmental factors, such as trauma to the penis
- Repeated microtrauma during sexual activity
- Autoimmune disorders
- Diabetes
- Smoking
- Certain medications, such as beta-blockers
The disease typically progresses through an acute inflammatory phase lasting 6-18 months, characterized by pain and evolving deformity, followed by a chronic stable phase where the plaque calcifies and deformity stabilizes, as outlined in the AUA guideline 1. Understanding this pathophysiology helps guide treatment approaches, which differ based on disease phase and severity of symptoms. A thorough diagnostic process, including a careful history and physical exam, is essential to document the signs and symptoms that characterize Peyronie’s disease 1.
From the Research
Peyronie's Disease Etiology
The etiology of Peyronie's disease is a complex and multifactorial process. Some of the key factors that contribute to the development of Peyronie's disease include:
- Penile trauma, which can cause inflammation and scarring in the tunica albuginea, leading to the formation of plaques and curvature of the penis 2, 3, 4
- Genetic predisposition, which may play a role in the development of penile plaque formation 5
- Aberrant wound healing and deposition of extracellular matrix components, leading to fibrotic tissue deposition 5
- Inflammation and fibrosis, which are regulated by a complex pathway of inflammatory and fibrotic mediators 5
- Use of certain medications, such as beta-blockers, which can increase the risk of developing Peyronie's disease 2
Risk Factors
Some of the risk factors that may contribute to the development of Peyronie's disease include:
- Age, with most cases occurring in middle-aged men 2, 3
- Penile trauma, which can occur during sexual intercourse or other activities 4
- Engaging in sexual relations with a partial erection, which may increase the risk of penile trauma 4
- Family history of Peyronie's disease or other fibrotic conditions, such as Dupuytren contracture 6
Pathophysiology
The pathophysiology of Peyronie's disease involves a complex interplay of inflammatory and fibrotic mediators, leading to the formation of plaques and curvature of the penis. The disease process is characterized by: