1. Q: What is Peyronies disease and how is it treated?
A: Peyronies disease is relatively common in the general population and in men who have undergone a radical prostatectomy. It produces curvature and sometimes constriction of the penis from scar tissue that develops in the penis.
This scar tissue is less elastic than the normal tissue and thus does not increase in length and circumference with erection as much as it should.
The most common cause of Peyronies is believed to be vigorous sexual activity without a firm erection that causes trauma to the tissues, specifically, rupture of small vessels with hemorrhage into the tissues and subsequent scarring.
However, Peyronies disease can also occur in men who are not sexually active. The reason for this condition is not completely known. Also, there may be a genetic susceptibility to Peyronies disease.
There is no known cure for Peyronies disease. It has been treated by a variety of methods, including vitamin E, para-amino benzoic acid (Potaba), cortisone-like drugs, radiation therapy, and, more recently, with injections or creams containing a medicine called verapamil. Severe cases require surgical removal of the4 scar tissue and filling the surgical defect with a vein graft or other tissue substitute. When surgery is required, there is a substantial risk for impotency unless a penile prosthesis is also inserted.
Therefore, I usually advise watchful waiting. With time, scar tissue matures and stretches, and often the curvature will improve with time. However, this time course may be a period of up to three years. In the meantime, it is important to take care to avoid injury to the penis by avoiding athletic sexual activity and ensuring that there is adequate lubrication during intercourse.
2. Q: Do vasectomies have any effect on prostate cancer?
A: No. This story was a myth that was passed around. What seems to be true is that men who have vasectomies are more likely to be seen by a urologist, and if a urologist sees them, then they are more likely to be screened and have early detection of prostate cancer.
3. Q: What is the connection of genetics to prostate cancer?
Genetics of prostate cancer is a frequent subject in QUEST. Please use the website search engine for additional coverage of this topic. Also, please see QUEST, Spring 2001, Different From Other Diseases: Genetic Research on Prostate Cancer and QUEST, Spring 2001, In Search of Prostate Cancer Genes: A Journey of DNA Samples.)
A: Genetics plays a significant role in the development and aggressiveness of prostate cancer. Most likely, dozens of genes interact in ways we dont yet understand.
If we can find out which genes are involved in the development of prostate cancer and then figure out what goes wrong when and why they mutate then we can direct our attention to the cure and prevention of prostate cancer.
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