Tunica albuginea (penis) in the context of "Peyronie's disease"

Peyronie's disease (PD) is a benign, acquired penile connective tissue disease characterized by the occurrence of fibrotic plaques within the tunica albuginea — the dense elastic covering of the corpora cavernosa. The plaques cause abnormal curvature, pain, penile deformities (e.g., narrowing or indentation), and usually erectile dysfunction, particularly during erection. The condition typically leads to significant sexual and psychological effects, including difficulty with penetration and lowered self-esteem or evasiveness. Peyronie's disease is most often seen in middle-aged and older men with a median age of onset between 55 and 60 years, however it is also common in younger individuals and adolescents.

While the etiology of Peyronie's disease is still uncertain, the leading hypothesis is that it arises from dysregulated wound healing in response to chronic microtrauma of the erect penis. This triggers a cascade of profibrotic molecular pathways — most notably overexpression of transforming growth factor-beta 1 (TGF-β1) — that end in fibroblast proliferation, myofibroblast differentiation, and overproduction of type I collagen. Genetic predisposition is supported by family clustering and linkage with systemic fibrosing disorders such as Dupuytren's contracture. Risk factors include age, penile injury, diabetes mellitus, and cigarette smoking.