Understanding Peyronie's Disease

Regain Comfort and Confidence in Your Sexual Health

What Is Peyronie's Disease?

You're Not Alone

If you’ve noticed a significant bend or curve in your penis during erections, and it’s causing you pain or interfering with your sexual activity, you might be experiencing Peyronie’s Disease. If you’ve noticed a significant bend or curve in your penis during erections, and it’s causing you pain or interfering with your sexual activity, you might be experiencing Peyronie’s Disease. This relatively common condition, affecting 4-13% of men (particularly over 40), involves the development of fibrous scar tissue inside the penis. The condition typically progresses through two distinct phases: an acute phase lasting about 3-6 months, marked by active inflammation and potentially changing curvature, followed by a chronic phase where the curve stabilizes but the scar tissue becomes more permanent. While a slight natural curve is normal, Peyronie’s Disease can cause pronounced bending that requires medical attention. Many men hesitate to discuss this condition with their doctor, but understanding that it’s a recognized medical condition with various treatment options is the first step toward getting help.

This condition occurs when inflammation inside the penis leads to the formation of scar tissue (called plaque), though we often can’t pinpoint exactly what triggers this process. It affects about 4-13% of men, particularly those over 40, and can develop after injury or be related to certain health conditions, though sometimes it appears without any clear cause. The disease typically progresses through two phases: first, an acute phase lasting about 3-6 (up to 2 years) months where active inflammation occurs and changes may continue to develop, followed by a chronic phase where the condition stabilizes. During this process, three main problems may develop – you might experience one, two, or all three of them: a curve in the penis (caused by the scar tissue pulling like a short string on one side), pain (typically only during the acute phase and usually settles on its own), and erectile dysfunction (often feeling like a soft or ‘dented’ area around the plaque). It’s important to understand that while the plaque itself becomes a permanent part of your anatomy – meaning your penis won’t return to exactly how it was before – don’t lose hope. Each of these three problems can be effectively treated if they’re bothering you, with options ranging from medication to specialized procedures depending on your specific symptoms.

Possible Causes

  • Injury or Trauma: Accidental bending or hitting of the penis can cause internal scarring.
  • Genetic Factors: A family history may increase your risk.
  • Age-Related Changes: Tissue elasticity decreases over time.
  • Connective Tissue Disorders: Conditions like Dupuytren’s contracture can be related.

Signs to Look Out For

  • Curved Erections: A noticeable bend during an erection.
  • Pain: Discomfort during erections or even when not erect.
  • Scar Tissue: Lumps or hard areas you can feel.
  • Erectile Difficulties: Trouble getting or keeping an erection.
  • Shortening of the Penis: Due to scar tissue buildup.

We're Here to Support You

If these symptoms resonate with you, reaching out can be the first step toward relief.

How We Diagnose Peyronie's Disease

  • Open Conversation: We’ll discuss your symptoms and how they’re affecting you.
  • Physical Examination: Feeling for scar tissue to understand the extent.
  • Erection Assessment: In some cases, we might need to evaluate the curvature during an erection. In clinic this is obtained adminitering a medication with a small injection. 
  • Imaging Tests: An ultrasound can help us see the scar tissue more clearly.

Personalized Treatment Options

Not everyone with Peyronie’s Disease needs treatment, and the decision to treat depends on how bothersome each symptom is – you might need treatment for one, two, or all three problems, or you might not need treatment at all if the changes don’t significantly affect your sexual function or quality of life. There are effective ways to reduce curvature and improve sexual function, to improve erections, and to reliev the pain.

Non-Surgical Approaches:

While numerous medical treatments have been investigated over the years for Peyronie’s Disease, many have shown disappointing results in scientific studies. The treatments listed above represent those currently endorsed by international urological guidelines 

  1. For Pain:
    • Oral pain medications (NSAIDs like ibuprofen)
    • Li-ESWT (demonstrated to be effective for pain)
    • Avoidance of sexual activity if causing discomfort
    • Pentoxifylline tablets (may help reduce inflammation)
    • Options to reduce scar tissue and improve symptoms.
  2. For the Curvature: (correction expected: up to 30% of curvature)
    • Injectable treatments (into the plaque):
      • Collagenase (Xiapex) – no longer easily available
    • Traction devices (penile stretching)
      • Must be worn several hours daily
      • Can be combined with other treatments
    • Vacuum devices
      • Similar principle to traction
      • May help prevent loss of length
  3. For Erectile Dysfunction:
    • Oral medications (PDE5 inhibitors):
      • Sildenafil (Viagra)
      • Tadalafil (Cialis)
      • Vardenafil (Levitra)
      • Avanafil (Spedra)
    • Vacuum erection devices
    • Intraurethral medications (MUSE)
    • Penile injections:
      • Alprostadil
      • Bi-mix/Tri-mix combinations
      • Invicorp
    • Li-ESWT

Surgical Procedures:

Surgery becomes an option when Peyronie’s Disease significantly affects your sex life, but the choice of procedure depends on your erection quality. For men with good erections (with or without the help of medications like Viagra), surgeons can correct the curve through corporoplasty techniques – typically choosing Nesbit procedure for curves less than 60 degrees, or Lue procedure for more severe curves (though the latter carries higher risks of erectile problems). However, if you’re experiencing significant erectile dysfunction alongside Peyronie’s, a different approach is needed – in these cases, the recommended solution is the insertion of a penile implant, which can address both the curve and the erectile problems in a single procedure.

  • Nesbit/Yachia/Plication: Shortening the unaffected side to straighten the penis.
  • Lue/Grafting: Replacing scarred tissue with healthy tissue from another part of your body.
  • Penile Implants: For severe cases, to restore function and confidence.

Taking the Next Step Together

Living with Peyronie’s Disease can be challenging, but you don’t have to face it alone.

Ready to Find Relief?

Let’s schedule a time to talk about your symptoms and explore treatments tailored to you.

Why Choose Me as Your Doctor

With specialized training in men’s sexual health and experience treating Peyronie’s Disease, I’m committed to providing compassionate care that meets your unique needs. Together, we’ll work toward restoring your comfort and confidence.

Frequently Asked Questions

In some cases, mild symptoms may improve without treatment, but many require medical intervention to prevent progression.

No, treatment depends on severity. Non-surgical options may be effective, especially if started early.

Many treatments can significantly reduce curvature and improve function, but results vary.

No, it is a benign condition and not associated with cancer.

Healthy habits may support overall tissue health but are not a substitute for targeted treatments.

Absolutely! Pictures of your penis in full erection are very useful for the consultation on for monitoring the disease. Try to be consistent in how you make the pictures, ideally one from the top one from the front and one from the side. 

This is a very common question. Generally speaking it is a good idea to promote strong erections at all time. Including when you have Peyronie’s disease, so the answer is normally Yes.

Strong erection might actually help in stretching the bending away; however, the decision about appropriateness of medical treatment needs a discussion with your doctor.