Q) I am a 58 year-old man and for the past year or so I have had a problem in that, when aroused, my erection bends upwards and is not long enough or hard enough for penetration. My doctor says that there is no cure. Is there any way that we can continue to have sex?
A) Dr Thomas Stuttaford – I am sorry to hear about your erectile problems. You have Peyronie’s disease, a benign condition affecting the penis. About a fifth of men with Peyronie’s disease have, as you do, a soft penis beyond the point of the bend which becomes obvious once the penis is erect.
Only about 8 percent of patients with Peyronie’s disease initially have problems with intercourse. Unfortunately, as time passes, the deflection may so affect over half of those who are troubled by it that penetration is difficult and sometimes impossible.
You are especially unfortunate in having difficulties in penetration already.
Usually those penises with Peyronie’s disease that deviate downwards, or to the left or right, are likely to be difficult to insert.
An upward deviation like yours can usually be accommodated by a vagina. Upward deflection is fairly common and not usually indicative of any abnormality.
Priapus, the Greek god of fertility and eroticism, who was the son of Bacchus and Aphrodite, was unusually well endowed but his phallus is always pictured with a pronounced upward curve.
Peyronie’s disease affects about five men in every 100,000 under the age of 30 but 66 per 100,000 men of your age. The deflection is the result of a hard and inflamed patch forming in the side of the penis which is deflected. This patch (known as plaque) is inflammatory and interferes with the blood supply and, hence, the erection and any pressure on it may be painful. Likewise, intercourse itself may be uncomfortable, even painful.
The cause of the plaque is unknown. The theory which held sway for many years was that the plaques of Peyronie’s disease were a reaction to repeated minor trauma.
Most of the plaques form on the upper surface of the penis where it rubs against the female pelvic bone.
There is now some doubt about this theory. It is thought that patients probably also have a genetic tendency to develop Peyronie’s, for there is some evidence that it is associated with certain tissue types and is found more frequently in those families who have a tendency to develop contracture of the palm of the hand.