What Is Peyronie’s Disease?
Peyronie’s disease occurs when
fibrous scar tissue forms within the tunica albuginea, the tissue
surrounding the erectile bodies of the penis.
As the scar tissue does not expand
normally during an erection, it can cause:
- Upward or downward curvature.
- Sideways curvature.
- A narrowed or indented area of the penis.
- Changes in penile shape.
- In some cases, apparent shortening of the penis.
The condition varies considerably
from one man to another.
Causes of Peyronie’s Disease
The exact cause is not always known.
One possible mechanism is repeated
minor trauma to the penis, particularly during sexual activity, which may
trigger abnormal healing and scar formation.
Other possible contributing factors
include:
- Previous penile injury.
- Repeated mechanical stress.
- Connective tissue disorders.
- Previous surgery or trauma.
- Genetic predisposition in some men.
Peyronie’s disease can occur without
any clearly remembered injury.
Risk Factors
Factors that may increase the
likelihood of developing Peyronie’s disease include:
- Increasing age.
- Previous penile trauma.
- Erectile dysfunction.
- Certain connective tissue disorders.
- A family history of Peyronie’s disease.
- Previous pelvic or penile surgery in some cases.
The condition can occur at different
ages but becomes more common in middle-aged and older men.
Symptoms of Peyronie’s Disease
Symptoms may include:
Penile
curvature
The most recognizable symptom is a
noticeable curve of the penis during erection.
Painful
erections
Some men experience pain during the
active phase of the disease.
Penile
plaque
A firm area or lump may be felt
beneath the skin of the penis.
Changes
in penile shape
The penis may develop an
indentation, narrowing, or an hourglass-like appearance.
Shortening
Some men notice that the penis
appears shorter than before.
Erectile
dysfunction
Difficulty achieving or maintaining
an erection can occur alongside Peyronie’s disease.
Stages of Peyronie’s Disease
Peyronie’s disease is often
described in two phases.
Active
Phase
During the active phase:
- Curvature may change.
- Pain may occur during erections.
- The plaque may develop or change.
- Penile deformity may progress.
Stable
Phase
During the stable phase:
- The curvature generally stops changing.
- Pain often improves or disappears.
- The deformity becomes relatively stable.
The distinction between active and
stable disease is important when considering treatment, particularly surgery.
How Is Peyronie’s Disease Diagnosed?
Diagnosis usually begins with a
medical and sexual history and a physical examination.
The urologist may evaluate:
- The location and size of the plaque.
- The direction and degree of curvature.
- Pain during erections.
- Erectile function.
- Changes in penile length or shape.
- How the condition affects sexual activity.
In some cases, the doctor may use
photographs of an erection taken by the patient to assess the curvature.
Penile ultrasound may also be performed when necessary to evaluate plaque and
blood flow.
Treatment Options
Not every man with Peyronie’s
disease requires treatment.
Treatment may be considered when the
condition causes:
- Significant curvature.
- Pain.
- Difficulty with sexual intercourse.
- Erectile dysfunction.
- Significant emotional or psychological distress.
Treatment options may include:
- Observation.
- Pain management.
- Penile traction therapy.
- Injection therapy.
- Treatment of associated erectile dysfunction.
- Surgical correction.
The best option depends on the
individual patient.
Non-Surgical Treatment
For men with mild symptoms or
disease that is still changing, observation may be appropriate.
Pain can sometimes be managed with
appropriate medications under medical guidance.
Non-surgical approaches may include penile
traction therapy or selected injectable treatments.
It is important to understand that
not every treatment works equally well for every patient, and treatment should
be selected by a urologist based on the individual's condition.
Penile Traction Therapy
Penile traction devices apply
controlled stretching to the penis over time.
Depending on the device and
treatment plan, traction may help:
- Reduce penile curvature.
- Improve penile length.
- Limit some deformity.
Treatment generally requires
consistent use over an extended period, and results vary between patients.
A urologist should determine whether
traction therapy is appropriate and explain how to use the device safely.
Injection Therapy
Certain medications can be injected
directly into the Peyronie’s plaque.
Collagenase clostridium histolyticum has been used in selected patients with appropriate
Peyronie’s disease characteristics.
Injection treatment is performed as
part of a structured medical treatment program and may be combined with penile
modelling or other measures.
Potential complications can include:
- Pain.
- Swelling.
- Bruising.
- Bleeding.
- Penile injury.
The suitability and availability of
injectable treatment depend on the patient's condition and local medical
practice.
Surgery for Peyronie’s Disease
Surgery may be considered when:
- The curvature is significant.
- The disease has become stable.
- Sexual intercourse is difficult or impossible.
- Non-surgical treatment has not provided adequate
improvement.
- The patient wants definitive correction.
The main surgical approaches
include:
Plication
Surgery
The shorter side of the penis is
surgically shortened to straighten the penis.
It is generally used when erectile
function is adequate and the curvature can be corrected without major loss of
length.
Plaque
Incision or Excision With Grafting
The scar tissue is partially opened
or removed and a graft is placed to help restore a straighter shape.
This approach may be considered for
more complex or severe deformities.
Penile
Implant
For men who have significant
Peyronie’s disease combined with erectile dysfunction that does not respond
adequately to medication, a penile implant may be considered.
The implant can restore rigidity,
and additional surgical techniques may be used to correct residual curvature
when necessary.
Recovery After Surgery
Recovery varies according to the
type of procedure.
Patients may experience:
- Swelling or bruising.
- Temporary discomfort.
- Changes in penile sensation.
- Temporary restrictions on sexual activity.
The surgeon will provide specific
instructions regarding wound care, physical activity, and when sexual activity
can safely resume.
Follow-up appointments are important
to assess healing and the final result.
Peyronie’s Disease and Erectile Dysfunction
Peyronie’s disease and erectile
dysfunction can occur together.
Erectile difficulties may result
from:
- Changes in blood flow.
- Pain.
- Penile deformity.
- Anxiety or psychological distress.
- Underlying vascular disease.
Treatment may therefore address both
the curvature and erectile function.
For men with severe erectile
dysfunction, penile implantation can sometimes address both problems during the
same treatment strategy.
When Should You See a Urologist?
You should consider seeing a
urologist if you notice:
- A new curvature of the penis.
- A hard plaque or lump.
- Pain during erections.
- Changes in penile shape.
- Difficulty with sexual intercourse.
- New erectile dysfunction.
- Progressive changes in curvature or penile appearance.
Early assessment can help determine
whether the condition is still active and which treatment options may be
appropriate.
A Message to Our Patients
Peyronie’s disease is a treatable
urological condition. Although penile curvature can be
concerning and may affect sexual confidence and relationships, several
treatment options are available.
The appropriate treatment depends on
the severity and stability of the curvature, the presence of pain, erectile
function, and the patient's individual goals.
Our urology specialists provide
confidential assessment and individualized treatment plans for men with
Peyronie’s disease, ranging from observation and non-surgical treatments to
corrective surgery and penile implants when appropriate.
Frequently Asked Questions
What
is Peyronie’s disease?
Peyronie’s disease is a condition in
which scar tissue, or plaque, forms inside the penis and can cause curvature,
pain, or changes in penile shape during erection.
Is
Peyronie’s disease dangerous?
Peyronie’s disease is not cancer and
is not contagious. However, significant curvature or associated erectile
dysfunction can interfere with sexual activity and quality of life.
Can
Peyronie’s disease go away on its own?
Some men experience stabilization or
improvement in symptoms, particularly pain. However, significant curvature may
persist, so medical assessment can help determine whether treatment is needed.
Can
Peyronie’s disease cause erectile dysfunction?
Yes. Peyronie’s disease can occur
together with erectile dysfunction. The two conditions may share vascular or
other underlying risk factors.
Does
Peyronie’s disease always require surgery?
No. Many men do not require surgery.
Observation, traction therapy, selected injection treatments, and treatment of
erectile dysfunction may be appropriate depending on the case.
When
is surgery recommended?
Surgery may be considered when the
curvature is significant, the disease has stabilized, sexual intercourse is
difficult, and non-surgical treatments have not provided sufficient
improvement.
Can
surgery completely straighten the penis?
Surgery can significantly improve
curvature in appropriately selected patients, but the exact result varies. The
surgeon should discuss the expected benefits and potential risks before the
procedure.
Can
Peyronie’s disease shorten the penis?
Yes. Peyronie’s disease itself can
cause an apparent or actual reduction in penile length, particularly when
significant scarring or curvature is present.
Which
doctor treats Peyronie’s disease?
A urologist, particularly one experienced in
male sexual health and reconstructive urology, can diagnose Peyronie’s disease
and discuss appropriate treatment options.