Palpable fibrous plaque on dorsal penile shaft indicates-
• Peyronie’s disease (plastic induration of penis/ penile fibromatosis) usually seen over 40 years of age.
• It is due to fibrous plaques in one or both corpus cavernosum of varying sizes involving tunica albuginea which may later calcify or ossify.
• Cause remains obscure, the dense fibrous plaque is microscopically consistent with findings of severe vasculitis.
• Palmar fibromatosis (Dupuytren’s contracture), plantar fibromatosis and penile fibromatosis (Peyronie’s disease) are components of the same pathological process called superficial fibromatosis.
Clinical Features
• Painful erection, curvature of penis and poor erection distal to involved area.
• No pain when the penis is in nonerect state.
• Palpable induration or mass appears usually on the dorsolateral aspect of the penis.
Treatment
• Spontaneous remission occurs in about 50% cases, so observation and emotional support advised initially.
• If the penile deformity is distressing, Nesbitt’s operation can be performed to straighten the penis.
• Nesbitt operation: Straightening of penis by placing non-absorbable sutures in corpus cavernosum opposite to the plaque.
Paget's disease
Potter's syndrome
Prehn's sign
Peyronie's disease