In New York, a man who complained of knee pain after a fall was diagnosed this month with full-body ossification of the penis. This is an extremely rare form of Peyronie’s disease.
This (true) story probably reflects many men’s nightmare. This month in the United States, doctors discovered total calcification all along the penis of a 63-year-old man who complained of knee pain after falling on a sidewalk. This is a very rare form of Peyronie’s disease, the review explains Urology Case Report in an article to be published in September.
It all starts when the sixty-something falls on his buttocks on the sidewalk this summer. Patients help him up. If he manages to walk again, this fall triggers a throbbing pain in his left knee. The latter not disappearing, he decides to go to the Emergency Department of Lincoln Hospital in New York. After listening to his story, the doctors perform a pelvic X-ray. They then discover with amazement that the entire body of the penis (composed of the erectile bodies allowing erection) is in the process of ossifying.
“A plain X-ray showed penile ossification of the entire penile shaft which may be secondary to Peyronie’s disease,” the authors of the paper write. Despite this disturbing diagnosis, the patient decides to leave the hospital and disappears into the wild, deplore the specialists. It is therefore impossible to make him pass additional examinations, to carry out a biopsy of the calcified mass or even to organize a medical follow-up.
“A Medical History of Alcoholism”
Calcification of the penis is one of the symptoms of Peyronie’s disease, a deformity of the penis that affects between 3.4% and 9% of men, mainly between the ages of 55 and 65. In 20% of cases, ossifications form, resulting in a hardening of the penis which becomes like a bone. This sclerosis of the cavernous body would be linked to the accumulation of calcium salts in the soft tissues or would result from a metaplastic process (transformation of a cellular tissue into another cellular tissue) caused by repeated trauma or a chronic inflammatory state.
While some studies show a link with obesity, diabetes, tobacco or testosterone deficiency, the New York patient had “a medical history of alcoholism”, report the doctors.
But cases of complete ossification are extremely rare. Indeed, less than 40 such stories have been reported in the international medical literature. The first was told in 1827: ossification concerned the entire length of the body of the penis. In 1899, doctors then evoked the ossification of the corpora cavernosa of a 55-year-old diabetic patient.
Different possible treatments depending on the extent of the disease
As for the treatment of penile ossification, it depends on the extent of penile ossification and the patient’s symptoms. Depending on these, he will be administered creams, analgesics, shock wave therapy or injections into the lesions. In 2015, a new treatment called Xiapex was authorized in France. Injecting directly into the plaque in formation where it dissolves the collagen fibers, it shows promising results with a notable improvement in two thirds of patients, according to the French Association of Urology.
In the event of severe chronic pain or erectile dysfunction, the patient may undergo surgery: the surgeons remove the cavernous plaques and insert a graft to compensate for the hollow. Finally, doctors recently placed an inflatable penile prosthesis on a patient. The latter was suffering from an ossification of the penis which had led to erectile dysfunction resistant to medication.
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