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Conditions: Peyronies Disease

Causes - Peyronie’s Disease

 

Much is still unknown about the causes of PD, but research suggests it is a disorder of wound healing. The PD plaques are actually hardened scar tissue. It’s widely believed that the disease is triggered by an injury to the erect penis—often one that goes unnoticed by the man. What is unclear is why a relatively minor injury would lead to such excessive scarring.
 
Normally, wounds heal in three phases: First, enzymes clean the wound of dead or damaged tissue. Second, the body repairs the wound by forming a scar that strengthens the injured tissue. Finally, the collagen fibers that make up the scar are broken down and realigned leaving a smaller “remodeled” scar. In PD, not only is scar formation extreme, but scar remodeling either fails to occur or is insufficient.
 
The abnormal scarring of PD is believed to be related to the actions of fibrin and cytokines, which stimulate the formation of scar tissue in the second phase of wound healing. It seems that, in PD, these substances allow excessive amounts of collagen to collect. The enzymes protease and collagenase, which are responsible for remodeling scar tissue in the third phase of wound healing, also may play a role. Patients with PD may produce too few of these enzymes or the enzymes they produce may not function properly to remodel the scar.
 
Some investigators believe that the tendency to develop PD may be inherited. There is a reported association between PD and a genetic disorder called Dupuytren’s contracture, in which scar tissue forms along the sheath surrounding tendons in the palm of the hand, causing the ring finger to contract inward.

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