Plastic Induration of the Penis

Plastic induration of the penis is not frequently encountered, about 200 cases having been reported. Believing that this subject presents several problems of interest, we have surveyed all the available reports and have included brief descriptions of 6 additional cases which we have treated. The disease was described in 1743 by La Peyronie and was classified in 1847 by Ricord (1) who, after excluding traumatic, inflammatory, and syphilitic forms, recognized plastic induration as a definite clinical entity. The lesion consists in a firm nodule or plaque appearing spontaneously in the penis, apparently independent of previous pathologic conditions. It may be single or multiple; in shape it is round to oval, with a smooth surface and regular, well defined margins. The plaque is usually 1 to 3 mm. in thickness and 1 to 2 cm. in length or width. The indurated areas usually occur dorsally in the median line or septum, or laterally in the corpora cavernosa. There is practically no agreement as to the etiology. Ricord believed that the induration was situated in the corpora cavernosa and beneath the tunica albuginea and that it was a fibrosis resulting from phlebitis. Tuffier (2) in 1885 showed that plastic induration always occurs on the surface of the fibrous sheath of the corpora cavernosa and not in the vascular structures. He noted the frequent association of the disease with gout and diabetes, and believed the probable origin to be in a degeneration of the elastic sheath. Zur Verth and Scheele (7) (1913) attributed the disease to changes in the elastic tissue and regarded arteriosclerosis as one of the essential factors.