I’m Dr. Sébastien Beley, urological surgeonin Paris, and today I’d like to address a crucial question surrounding Lapeyronie’s disease: should this pathology be considered a medical emergency? There are still a lot of preconceived ideas surrounding this condition, and it’s important to clarify things in order to better guide patients and healthcare professionals. In this article, I’ll explain why Lapeyronie’s disease should not be taken lightly, why early treatment is essential, and what you can do to limit its consequences.

What is Lapeyronie’s disease?

Lapeyronie’s disease is a condition characterized by the formation of fibrous plaques within the erectile tissue of the penis, resulting in a deformity, often a curvature, which can be painful and embarrassing during intercourse. It can also lead to loss of penis length, erectile dysfunction and even significant psychological discomfort for affected patients.

Contrary to popular belief, it is not restricted to older men. It can occur at any adult age, and requires special attention from the very first symptoms.

Preconceived ideas about Lapeyronie’s disease

Unfortunately, there are still many misconceptions about this disease:

• We don’t know much about the disease: Although some aspects of Lapeyronie’s disease are still poorly understood, research and medical practice have evolved considerably. We now know better how to diagnose and treat it.
• It can’t be treated: Not true. There are a number of treatment options available today, especially when implemented promptly.
• It only affects the elderly: This statement is incorrect. The disease can affect young or middle-aged men.
• We can wait before treating: Many people believe that we should let the disease evolve before intervening, which is a major mistake.

Another common misconception is that of vitamin E treatment, which is often prescribed systematically, with long-term follow-up and no prompt intervention. However, vitamin E has been scientifically shown to have little effect, and waiting without taking action can make the situation worse.

Why should Lapeyronie’s disease be treated as an emergency?

Lapeyronie’s disease begins with an active inflammatory phase. It is at this stage that treatment is most effective. During this phase, the fibrous plaque is forming and the deformity evolves, often accompanied by pain and unusual sensations (tingling, paresthesias).

Acting early will :

• Limit the initial inflammation that causes the disease.
• Prevent worsening of penile deformity.
• Implement treatments that can reduce curvature and preserve erectile function.
• Avoid excessive loss of penis length.

In other words, it’s not a disease to “let go” and hope that symptoms improve spontaneously. The longer you wait, the more the plaque stabilizes and becomes difficult to treat without surgery.

An analogy with the management of heart attacks

To illustrate this point, we can draw a parallel with the management of myocardial infarctions. A few decades ago, when a patient suffered a heart attack, we would wait for the heart tissue to die before considering surgical intervention. Today, thanks to modern medicine, emergency services can intervene rapidly (with the SAMU), enabling damage to the heart muscle to be limited, thanks to emergency treatments such as stenting.

Similarly, Lapeyronie’s disease requires rapid treatment to limit the damage. All too often, however, patients are still advised to wait a year before considering treatment, which is tantamount to letting the disease progress without taking action.

What treatments are available in the acute phase?

When the disease is detected early, several treatment options can be implemented:

Anti-inflammatory treatment

The first objective is to calm the initial inflammation. This may involve anti-inflammatory drugs to halt the inflammatory reaction that triggers plaque formation. This step is crucial in limiting disease progression.

Mechanical treatments: traction devices

Penile traction devices are also very useful. They exert tension on the penis, helping to limit deformation and may even enable partial or total recovery of the penis’s original shape.

These mechanical treatments should be used early, as soon as the disease is detected, to obtain the best possible results.

Other treatment options

Depending on progression and severity, other medical treatments may be proposed, such as intraplaque injections (e.g. collagenase), which can help dissolve fibrous plaques. These treatments are most effective when used in the active phase of the disease.

Surgery: a last resort, but not the only option

It’s important to understand that surgery is not the only treatment option, nor should it be considered systematically. Traditionally, surgery was considered the only possible treatment, but only once the disease had stabilized, i.e. when the deformity was no longer progressing.

This approach led to a significant delay in treatment, as we waited until the end of the progressive phase to operate. This means that the disease has had plenty of time to cause sometimes irreversible damage.

Today, surgery remains an option for stabilized and severe cases, but it comes after early treatments have been attempted. The aim of surgery is to restore the penis to a functional and acceptable shape, minimizing loss of length and correcting curvature.

What objectives should we aim to achieve?

When managing Lapeyronie’s disease, the main objectives are :

• Reduce pain and discomfort associated with deformity.
• Regain a functional penis, enabling satisfactory sexual relations.
• Achieve a shape that neither surprises nor embarrasses the patient or partner.
• Preserve penis length as much as possible.

These objectives are realistic, but they require rapid and appropriate action.

What to do if you think you have Lapeyronie’s disease?

If you have noticed pain in the penis, an evolving deformity, or unusual sensations such as tingling or paresthesia, especially after trauma or shock, it’s essential to consult a specialist urologist as soon as possible.

Don’t waste time thinking that it will go away, or that you can wait a year before consulting a specialist. The earlier you seek treatment, the better your chances of limiting the damage and avoiding more serious complications.

What about old cases?

If you’ve had Lapeyronie’s disease for several years, don’t despair. Even in these cases, it is possible to improve the situation. I strongly encourage you to consult a urologist to assess the treatment options appropriate to your situation.

Lapeyronie’s disease is not a fatality, but a pathology that requires specialized monitoring and personalized care.

Conclusion: don’t let Lapeyronie’s disease develop without taking action

In short, Lapeyronie’s disease is indeed a medical emergency, provided it is diagnosed early. The initial inflammatory phase is the window of opportunity for effective action to limit deformity, reduce pain and preserve sexual function.

It’s time to move beyond conventional wisdom and stop telling patients to take vitamin E and come back in a year. Modern medicine now makes it possible to intervene rapidly, with effective medical and mechanical treatments.

If you suspect Lapeyronie’s disease, don’t wait. Consult a specialized urologist who will be able to guide you towards the best possible treatment, adapted to your condition and progress.

Don’t let Lapeyronie’s disease dictate your sex life and your self-confidence. Early treatment is the key to regaining a fulfilling sex life and a functional penis.

If you have any questions or would like to make an appointment, please do not hesitate to contact a specialist. Sexual health is an essential pillar of overall well-being.