Peyronie’s Disease

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Overview
Diagnosis
Treatment

What is Peyronie’s Disease?

Peyronie's disease is a condition in which the penis is curved. This curvature is most noticeable during an erection, and it can cause pain and difficulty with penetration during sex. It can also lead to anxiety and stress. Peyronie's disease affects about 6 percent of men, most commonly between the ages of 40 and 70.

Peyronie's Disease Causes

The curvature of the penis comes from a buildup of scar tissue. Normal tissue will stretch with an erection, but scar tissue stays tight. A penis affected by this condition may curve or narrow at the shaft, creating an hourglass shape.

Doctors don't have a definitive explanation for why the condition occurs. However, possible causes include:

An injury, whether from sports, trauma, or even sex, that leads to scar tissue
Genetics: if your father had Peyronie's, you may be more likely to develop it yourself

Peyronie's isn't a life-threatening condition, nor does it increase your risk of cancer or other illnesses. Although doctors don't fully understand the causes of Peyronie's, there are treatments available to improve the symptoms.

Peyronie's Disease Symptoms

A curved penis during an erection is the most common symptom of the condition, but you may notice other symptoms as well. In some cases, you may be able to feel the scar tissue beneath the skin. Other symptoms include:

A lump or thickening along the shaft. You may notice this even when the penis is soft.
Pain, which is most commonly felt during an erection when the scar tissue remains tight. You may also experience tenderness at the site of the scar tissue buildup.
Erectile dysfunction.
Difficulty with penetration during sex.

Symptoms may develop slowly over time, and they may even go away on their own. If you're experiencing pain or trouble having sex, talk to your doctor about treatment options.

Peyronie's Disease Diagnosis

Diagnosing this condition begins with a physical exam and medical history. Your doctor will ask about your symptoms and family history, and they will likely do a physical exam. They may inject a drug into the penis to make it erect, allowing your doctor to see where the scar tissue has built up. Your doctor may also order imaging tests, such as:

An ultrasound or x-ray. This lets your doctor see what's happening under the skin.
Doppler flow study. This uses an ultrasound to measure blood flow within the penis.

Imaging tests also help your doctor make a diagnosis by excluding other possible causes of your symptoms.

Peyronie’s Disease Treatment

Peyronie's disease isn't curable, but doctors have developed a range of treatment options to reduce the symptoms and help your penis function normally. What treatment looks like will depend on your individual situation. If the condition is mild and doesn't interfere with sex or cause pain, your doctor may recommend that you simply monitor the condition and avoid taking any action unless it worsens.

Medication

For mild to moderate cases, your doctor may recommend taking medication that targets the buildup of collagen and tissue to help reduce pain and correct the curve. These medications may be delivered through an injection into the penis or taken orally.

Collagenase: This is delivered by injection to break down collagen causing the curve.
Verapamil: This injection blocks further production of collagen to prevent the curve from worsening.
Interferon: This injection breaks down scar tissue causing the curve.
Pentoxifylline: This oral medication combines vitamin E and colchicine or carnitine to reduce scar tissue.

Surgery

If you have a severe curvature that causes pain and interferes with your daily life, your doctor may recommend surgery. Peyronie's disease can worsen over time; it's best to wait until there's been no change to the condition for at least six months before you undergo surgery. Be sure to discuss the risks and benefits of each procedure in detail with your doctor.

Surgical options include:

Plication: During this procedure, the surgeon removes the scar tissue and stitches the skin together on the opposite side of the shaft. This can cause the penis to look shorter. This procedure has low risks.
Incision and grafting: The surgeon cuts the scar tissue, which allows the penis to straighten. Then the doctor makes a graft, either from your own tissue, donor tissue, or synthetic material, to cover the cuts. In some cases, the procedure has a risk of making erectile dysfunction worse.
Penile implant or prosthesis: Your doctor may recommend this option if you have erectile dysfunction and severe Peyronie's. This involves surgically placing a penile implant.

Some procedures will allow you to go home the same day, while others may require a short hospital stay. Your doctor will base your options and recovery time on the severity of your condition. Most men can return to work within a few days of surgery, but you will likely need to avoid sex for about 2 months.