I’m 56 and was diagnosed with PD 9 years ago. I am diabetic, and was also diagnosed with Dupuytren’s contracture. In the last few years, my erections have really shrunk. I used to have about a 6-inch erection now my erections are about the size of my thumb (both in length and thickness). My wife and I haven’t had sex in about 6 years and I can’t even discuss this with her. Over the last 13 months I have added Plavix, Toprol XL, and Zocor to the insulin I take. Is there anything that can help me or is there something else coming along in the next year or two?

You clearly have an advanced problem with fibrotic disorders including the Peyronie’s disease and Dupuytren’s contracture. The PD is likely causing the loss of elasticity of the penis and subsequent loss of length and girth. It is also likely that the combination of diabetes, elevated blood pressure, and elevated cholesterol have injured your penile blood vessels resulting in ED. At this point there is no new therapy which might benefit your situation. It is my opinion when patients have a combination of both Peyronie’s disease and advanced erectile dysfunction associated with underlining vascular disorders that a penile prosthesis should be placed. The deformity will be corrected during the operation with a maneuver known as “manual modeling.” This is an outpatient surgical procedure, which has a very high rate of success allowing the patient, once he heals to engage in sexual activity with a straight and rigid penis. Needless to say, the 6-inch erection that you used to have is gone. If you want to know what the length of your penis will be with a prosthesis in place, grasp the glans (head) of the penis and pull it straight out from the body, this stretched length will approximate what you can obtain with a penile prosthesis. I would recommend a consultation with a urologist who is familiar with penile prosthesis implantation.