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Vulva : Overview, Anatomy, structure and function - Sentelhealth

 Overview : The vulva is a part of the female reproductive system and is also part of the external genitalia. The vulva consists of labia minora, labia majora, mons pubis, clitoris, vestibular bulb, vulval vestibule, urinary meatus the vaginal opening, hymen, and Bartholin's glands. other parts of the vulva include sebaceous glands, urogenital triangle, and pudendal cleft. Pelvic floor muscles support the structures of the vulva and vulva including the entrance to the vagina. Vulva goes through changes during childhood, puberty, menopause, and post-menopause. Structure: A) Mons pubis: it is present in both sexes and act as a cushion during sexual intercourse and is more pronounced in female. the mons pubis is a soft fatty tissue at the front of the vulva in the pubic region covering the pubic bone. the lower part of the mons pubis is divided by a fissure called pudendal cleft. it separates mons pubis and labia majora, the mons pubis, and labia majora get covered by pubic hair at pu...
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Peyronie's disease - Overview | causes | symptoms | treatment - Sentelhealth

Peyronie's disease - Overview | causes | symptoms | treatment - Sentelhealth

Overview

peyronie's disease is the formation of scar/fibrosis in the tunica albuginea layer of the penis which can result in the curvature of the penis(bent penis).
The most common age group affected is men over 50 years of age. Over 5-10% of men above 50 are affected by the condition. Although Peyronie's disease mostly occurs in men above 50 years it can also occur in younger men. In simple words chances of getting a disease increase with age but, is not a normal part of aging. If left untreated 10% of the cases will improve,50% will stabilize and the rest will progress to a more severe form of the disease.

Causes of Peyronie's disease 

The exact cause of Peyronie's disease is not fully understood yet. However, according to some researchers, there are some causes that can explain the etiology of Peyronie's disease.
A)Trauma - A trauma to the penis by a blunt object which can cause internal bleeding leading to fibrosis/scar and eventually Peyronie's disease. Rapid or overnight development of Peyronie's disease arise the suspicion of trauma.
B)Genes -Peyronie's disease developing slowly over time is thought to be of genetic origin. according to some specialists, there is a genetic predisposition to the disease. which means a person with a family history of Peyronie's disease is at higher risk of getting a disease than a normal person.
C)Medications - There is a theory that Peyronie's disease can be caused by certain drugs however, no such evidence is noted yet.

Symptoms of Peyronie's disease 

Symptoms of Peyronie's disease mainly include :
 1) pain during erection
 2) curvature of the penis
The symptoms may develop slowly or rapidly depending upon the cause of the disease. A person does not experience any problem in a non-erect state but, there is severe pain during erection which even interferes with normal sexual activity in extreme cases as it causes severe pain while performing the act. The pain usually eases down over time but the curvature of the penis worsens. In some severe cases, the flexibility of the penis can be affected and Peyronie's disease can also cause erectile dysfunction.

When to consult a doctor

You need to consult a doctor when your Peyronie is affecting your sex life. In some people performing sexual activity becomes very painful and at a times impossible due to curvature and pain.

Whom to consult

Urologist: is a doctor with a super specialization degree in urology, a branch of medicine that deals with urinary and genital diseases.

Diagnosis of Peyronie's disease

1)Clinical examination: in over 50% of the cases the disease is diagnosed on clinical examination by a doctor. One should tell the doctor about the history of any trauma to the part or family history of the disease.
2) x-ray and ultrasound: x-ray and ultrasound are the confirmatory investigations and are advised when the clinical examination is inconclusive.
3)Biopsy: When all the measures fail to confirm the disease biopsy of the penis is advised which involves taking a small bit of tissue for lab tests from the affected area.

Treatment of Peyronie's disease

Peyronie's disease can be treated but the treatment is needed in a small number of patients as the disease recovers on its own without treatment. Also, pain due to Peyronie's disease occurs only during erection. The ideal guideline is if your Peyronie's is not affecting your sex life treatment may not be necessary. However. severe cases need to be treated and the treatment for Peyronie's disease is divided into 3 categories

A)Observation: waiting and observation is the most common advice given by doctors for mild cases and it does not require treatment as the condition improves on its own in 1-2 years.

B)Medications: medications(drugs) can be prescribed in patients with severe pain and other problems. the common drugs prescribed are
1)Verapamil
2)Pentoxyphylline
3) Analgesics
Verapamil is more potent and used if pentoxifylline fails to give a response.
If both the above treatment measures fail then doctors would advise you to go for surgery

C)Surgery: Surgical treatment is advised in a small number of patients as it comes with many side effects. It is advised only in those patients who are unable to perform sex due to their Peyronie's disease. There are mainly two types of surgeries performed

1)Removal of scar tissue and putting a tissue graft in its place but, it can cause problems with erection.

2)Remove the normal tissue of the opposite side of the scar which can counter the curvature of the penis. This surgery removes the normal tissue of the opposite side which results in decreased penile length.

Penile prosthesis :
It can be a good treatment option but, it is reserved for the patients of Peyronie's disease who also have erectile dysfunction.


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