Breaking the curve: Understanding Peyronie disease and solutions at Mayo Clinic

Matthew Ziegelmann, M.D., Urologist: If you're out with your buddies and you've got six or ten guys around the table, probably someone else at that table is suffering from sexual dysfunction like Peyronie's disease, and you're just not talking about it.

I focus on men's health and specifically my clinical interest is in Peyronie's disease and erectile dysfunction. Peyronie's disease is actually a lot more common than you might imagine. Scar tissue forms on the erectile bodies of the penis and creates specific constellation of symptoms, and that can be pain with erections, curvature of the penis, indentation or loss of girth with an erection. Here we offer essentially the gamut of evidence-based therapies for Peyronie's Disease. We have high volumes of all of those treatments, whether that's non-surgical therapies, whether that's injection therapies. And ultimately a big part of my practice is offering surgical management for Peyronie's Disease.

I love the idea of being able to be involved in what many people consider an intimate and private portion of their life, and provide patients with comfort and understanding, but also meaningful treatments that really do impact patients quality of life.

Patient: The level of a relationship do you have to have with a doctor in order to discuss. This is probably the reason why most men don't get this done or don't seek treatment. I did my homework. My criterion where I wanted an academic medical center, I wanted the place that had volume, and I want a place that's considered a thought leader in this area.

Dr. Ziegelmann: Peyronie's disease is not likely to get any better without some type of intervention. So if somebody is bothered by their symptoms and they've had this condition for a long time and they've been reticent to come in and get evaluated, that's okay. We haven't missed some window of opportunity.

When Marc came to see me, he came in the context of having started his care elsewhere and that included injections.

Patient: I did a month of injections, no result. So I was very frustrated and I knew I wanted to have a surgery, and I knew I wanted to have a world-class facility do it.

Dr. Ziegelmann: He estimated about 45 to 60 degrees of curvature. When we ultimately brought him to the operating room and performed his surgery, it was actually even more severe. It was about 70 degrees of curvature, which is quite substantial. The more experience you have in operative management of any condition, the better. There's lots of literature that suggests that higher volumes are associated with better outcomes with surgery. When it comes to Peyronie's disease, I think this is absolutely true because of the complex nature of the anatomy that's involved in the complex approaches that we use to treat Peyronie's disease. And so you want someone who has a lot of experience, who really has made this a big part of their practice.

Patient: I felt great after the procedure, had no pain and I was on cloud nine.

Dr. Ziegelmann: I love the mix of medical and surgical practice and procedural practice that we offer at Mayo Clinic. I'm enthusiastic about the types of problems that men come in with and how we have actual, real solutions for them.

One of the things I love about working at Mayo is that I have the opportunity to really subspecialize and focus my practice so I get to really understand this disease process in a very specific way. You are their mission when you come here.

Patient: If I could send a message to any man out there that has this problem, get on a plane and come here right away and find out what your options are.

Dr. Ziegelmann: At Mayo Clinic, we have the ability to see a large number of patients with a specific type of problem, to offer the ability to diagnose that problem, to offer the ability to counsel as effectively as possible, and ultimately to offer a spectrum of appropriate treatments with high volume so that we have the experience to get you the best outcomes possible. Again, I really think that's a unique aspect of our practice here at Mayo Clinic.