causes of erectile dysfunction



hello, my name’s david ralph, i’m a consultant urologist at university college hospital london, and with regards to peyronie’s disease this is my special interest having done 25 yearsof research on the topic – cumulating in being president of the internationalconsensus panel on peyronie’s disease which is an international body giving guidelineson the topic.



causes of erectile dysfunction

causes of erectile dysfunction, peyronie’s disease is a condition of thepenis where there is fibrous plaques developing which may cause penile pain, curvature, anda degree of sexual dysfunction. some patients wonder why it’s called peyronie’sdisease – it’s named after the surgeon franã§ois de lapeyronie who identified thiscondition on three separate individuals


back in the 1700’s.this is just a medical terminology, there is a physical abnormality which can be seen by pathology and therefore it’s given the classification of a disease. it is a common condition, patients of course don’t discuss this but we feel from the studies that have been done, particularly in cologne, that the incidence increases with age, and around about patients in their 50’si would say it’s between 3 and 5 percent incidence of patients having peyronie’sdisease. it is a condition which is prevalent in westernsocieties, particularly in europe and in america and in the middle east, and if you go to the far east, in the asian


population it is extremely rare.this may give us some insight into, perhaps, the causes of the condition but as i’ve said, whereas we think perhaps it’s related toan injury, it can’t just be an injury, it must be that patients have a genetic predispositionto developing this condition. peyronie’s disease can occur quite abruptly:one minute the patient feels that their penis is normal, the next minute they feel thatthey have suddenly developed pain and possibly a curvature.in others, it has a slow progression over many months.the patients initially, if they have some discomfort, or perhaps they feel a slightlumpiness in the penis which is the inflammation


and the plaque formation, may feel that thisis not significant and hope that it will just disappear. certainly if they notice that if there is a curvature, then they would usually seekmedical help. when i first see a patient, in the early stagesof the condition, they may have inflammation, and therefore penile pain when the penis is erect. they may have a curvature which has alreadystarted and of course over the next few months that curvature may progress.but clearly, it’s for me to reassure the patients that it’s not a malignant condition,it’s totally benign, but to understand that this is going to havequite a lot of functional and psychological


effects on all patients and experienced atdifferent levels. most patients have read up on the internetand they look at some of the ghastly pictures that are there showing really extreme varietiesof this condition. one has to remember that the vast majorityof the patients, they don’t need any surgical intervention and they usually can manage witha mild degree of curvature. and it’s therefore important to reassurethe patients that: a) it is a benign condition, b) that somethingcan be done about it, most patients when they notice that they havea problem, and it sometimes takes quite a while for them to pluck up courage to go andsee their family doctor,


but that’s usually the first port of callafter they’ve done a little bit of internet search themselves.they will then go and see their family doctor mainly to get a diagnosis and to assure themthat this actually is peyronie’s disease. i would see the patients on a regular basis,ask them to take photographs or i can examine them and assess the curvature at regular intervals to assess whether or not the condition has stabilized out or whether it is still active. peyronie’s disease is a benign condition which causes a curvature of the erection, possibly a bit of erectile difficulties. it’s not a life-threatening condition. but it does cause a lot of psychological and relationship issues. one minute the penis is absolutely normal,


the next minute the patient has a crookedpenis and is unable to have sexual intercourse with their partner.you can just imagine the distress that it causes both the patient and his partner, andthat then reflecting and impacting on the relationship. anyone, if you’re a patient with peyronie’s disease then be reassured there is help for you. there are patient organisations which youcan get information from, the peyronie’s disease advocates for example, but there are many also in europe. i think the usual thing in medicine is thatmen suffer in silence. this is an embarrassing condition.men don’t tend to talk to men with regards


to sexual issues.this condition is quite common. there are celebrities that have this condition,patients know about peyronie’s disease and curvatures – it’s becoming common talk.and hopefully therefore in the future it may be easier to discuss this with your friendsand colleagues and of course that will then help becausethey can give you suggestions as to where to go and seek treatment, and you never know– they may have the condition themselves. so my advice to any patient with peyronie’sdisease is to actually discuss it with your partner.it’s much easier if the partner knows what the problem is and you can address the solutiontogether, go to the doctor together and keep


your partner involved at all time.it’s much easier and less stressful for you if you involve your other half.


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