Peyronies Disease

Peyronies Disease

  • Affects approximately 1%
  • Can start at any age
  • Peak incidence around 55 years
  • Increased incidence in those with diabetes
  • Increased incidence in smokers who should be advised to stop

Peyronies Disease has 2 phases: (Please see additional information under assessment)

  • Acute phase
    • 48 hours to 2 years (18 months typical)
  • Chronic or burn out phase

Indications for referral:

  • Stable disease with degree of bend inhibiting intercourse
  • Most men just require diagnosis and reassurance

Please note pre-referral criteria are applicable in this referral and Pre-Choice Triage is in place.

​Assessment

  • Affects approximately 1%
  • Can start at any age
  • Peak incidence around 55 years
The disease has 2 phases:

The first acute phase is when the disease is active and the scar tissue is being laid down. The patient will notice a progressive change in shape of his penis (for worse or better). About 10% of patients have pain (not pain on erections/intercourse which many get). This phase can last anywhere between 48 hours – 2 years (18 months typical).

If erections are altered treat as per any other case of Erectile Dysfunction:

The second chronic or burnt out phase follows. This is painless other than on erections or intercourse. The shape will be stable. The only indication to do anything, which is usually surgical on the NHS, is if the bend is so severe intercourse is impossible. Otherwise best left alone. Collagenase injections are available, patients will often have read about these. This is the only licensed injectable for Peyronies but due to very high cost currently the NHS does not fund. Collagenase injections are non-formulary for this indication.

Management

Acute phase

If erections are altered treat as per any other case of Erectile Dysfunction.

Chronic phase

The only indication to do anything, which is usually surgical on the NHS, is if the bend is so severe intercourse is impossible. Otherwise best left alone. Collagenase injections are available, patients will often have read about these. This is the only licensed injectable for Peyronies but due to very high cost currently the NHS does not fund. Collagenase injections are non-formulary for this indication.

Referral

Referral Criteria

Most men just require diagnosis and reassurance.

Please include the following information within the referral or it may be returned for additional information via Pre-choice Triage.

  • Disease should be stable with degree of bend inhibiting intercourse
  • Advise patients to look at the BAUS information leaflet & BAUS penile straightening leaflet – before referral to ensure they understand the implications of surgery
  • Advise patients to bring photos (on digital device) of the problem with them to clinic to demonstrate problem

Referral Instructions

Refer to Urology

e-Referral Service Selection

  • Service: Urology
  • Clinic type: Erectile Dysfunction/Andrology
  • Service: DRSS-Eastern-Urology- Devon CCG- 15N

Referral Forms

DRSS referral proforma

Supporting Information

Patient Information

BAUS information leaflet

BAUS penile straightening leaflet

Pathway Group

This guideline has been signed off by the Eastern Locality on behalf of NEW Devon CCG.

Publication date: June 2018

 

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