Peyronie’s Disease

What is Peyronie’s Disease?

Peyronie’s disease is a condition in which fibrous scar tissue (plaques) develops inside the penis, causing it to bend or curve abnormally during an erection. This curvature can lead to pain, erectile dysfunction, and difficulty with sexual intercourse. While mild cases may not require treatment, severe cases can significantly impact a man’s sexual health and quality of life.

Risk Factors

Several factors may contribute to the development of Peyronie’s disease, including:

• Age – Most common in men over 50, though it can occur at any age.
• Penile Trauma or Injury – Repeated bending, micro-injuries during sex, or sports-related trauma can lead to scar tissue formation.
• Genetics – A family history of Peyronie’s disease increases the risk.
• Connective Tissue Disorders – Conditions such as Dupuytren’s contracture (a hand disorder causing bent fingers) are linked to Peyronie’s disease.
• Inflammation or Autoimmune Conditions – Abnormal immune responses may contribute to scar tissue formation.
• Diabetes and Cardiovascular Disease – Conditions that affect blood flow and tissue healing can increase susceptibility.
• Erectile Dysfunction (ED) – Men with ED who rely on aggressive manual stimulation or vacuum pumps may develop Peyronie’s disease.

Symptoms

Symptoms of Peyronie’s disease can develop gradually or suddenly, and may include:

• Penile curvature – A noticeable bend or curve during erection.
• Pain – Discomfort in the penis, either with or without an erection.
• Lumps or hard plaques – Felt under the skin along the shaft of the penis.
• Erectile dysfunction – Difficulty achieving or maintaining an erection.
• Shortened penis – Some men experience a decrease in penile length due to tissue contraction.
• Narrowing or indentations – Hourglass-like deformities may form, affecting the shape and function of the penis.

Treatment

Treatment depends on the severity of symptoms and whether the condition is stable or worsening.

Non-Surgical Treatments

• Oral Medications – While no pills are FDA-approved for Peyronie’s, some doctors prescribe pentoxifylline to improve blood flow and reduce plaque formation.
• Collagenase Injections (Xiaflex®) – FDA-approved treatment that helps break down scar tissue, improving curvature.
• Traction Therapy – Penile traction devices can help straighten the penis and prevent shortening.
• Shockwave Therapy – Low-intensity shockwave therapy is being studied as a non-invasive way to reduce pain and improve function.

Surgical Treatments (For Severe Cases)

• Plication (Nesbit Procedure) – Sutures are placed on the opposite side of the curve to straighten the penis.
• Plaque Incision or Grafting – The scar tissue is cut or removed, and a graft is placed to restore length and function.
• Penile Prosthesis (Implants) – Recommended for men with Peyronie’s disease and severe erectile dysfunction.

Prevention 

While Peyronie’s disease cannot always be prevented, the following measures may reduce risk:

• Avoid Penile Trauma – Use caution during sexual activity to prevent bending injuries.
• Manage Erectile Dysfunction – Treat ED early to avoid aggressive manual manipulation that could lead to injury.
• Maintain Good Vascular Health – Control diabetes, high blood pressure, and cholesterol to improve blood flow and tissue healing.
• Regularly Monitor Symptoms – If you notice curvature or penile lumps, seek medical evaluation early to prevent progression.

Peyronie’s disease is treatable, and early intervention can help improve outcomes. If you experience penile curvature, pain, or difficulty with sexual function, consult a urology specialist to explore your treatment options.