Peyronie’s Disease

Peyronie’s Disease is a condition that causes a curved penis, indentation, and limited length of an erection. It can be awkward to discuss with your health care provider. Let us help you start the conversation.

With Peyronie’s Disease, a small scar forms in the lining of the penis that can result in a curved or shortened penis, an indentation in the penis, or pain. The disease is most common in men over the age of 40. It’s estimated that 10-15% of men experience some form of the disease in their lifetime.

Curvature or Shortening of the Penis
One of the most noticeable signs of Peyronie’s Disease is a significant bend or curve in the penis, which may develop gradually or appear suddenly. Some men also experience a reduction in penis length or girth due to the presence of scar tissue.

Indentation or Irregular Shape
Scar tissue can create indentations, narrowing, or an hourglass-like constriction along the shaft of the penis, leading to a visibly distorted appearance.

Pain in the Penis
Many individuals with Peyronie’s Disease experience pain, either during an erection or even when the penis is flaccid. This discomfort may subside over time, but for some, it can persist and affect sexual activity.

Peyronie’s Disease may form from some kind of trauma to the penis during intercourse, but many men do not have any history of injury or trauma. It is thought that local inflammation leads to a penile scar or lump.

• During your visit, your doctor will ask you questions regarding your medical and surgical history, when the curvature was first identified, if the curvature impacts your ability to have intercourse, and the quality of your erections.
• Bringing a digital picture of your erect penis may be requested. This can help to assess the curve in a more natural setting. Taking the picture from multiple angles is ideal. Note: Photographs on your phone may be password protected. iPhones have a special folder that can be used in the Photos app that can be password protected.

Tests that may be performed during or after your visit:

• Curve assessment: Your provider may inject a medication into the side of your penis to cause an erection during your appointment. The degree of the curvature will then be measured. This would typically be done on a second or third visit, but not usually on your initial evaluation.
• Imaging: An ultrasound of the penis may be ordered to determine the degree of curvature and if erectile dysfunction is present.

Active phase (first 12-18 months):

• Ibuprofen may be recommended for pain control.
• Various oral medications may be used during the active phase of disease, but none have proven to work consistently in high level studies.
• You may be asked to place a penile traction device on your penis 60 minutes per day to stretch the penis and mechanically break down the plaque.
• Medical and surgical therapies are usually reserved for patients in the stable phase

Stable phase (typically after 12-18 months) – Non-Surgical:

• Verapamil: Injection of medication into the affected area to help break down the plaque
• Intralesional collagenase (Xiaflex®): A minimally invasive medication is injected into the penile plaque to break down the penile scar.

Stable phase (typically after 12-18 months) – Surgical:

• Penile plication: This minimally invasive surgery involves straightening the penis by tightening the skin on the side opposite the curve.
• Plaque excision and grafting: A surgical procedure straightens the penis by removing the plaque and replacing it with a more pliable grafted material. This is useful for the most severe curves or deformities.
• Penile implant: This surgical procedure involves the placement of cylinders into your penis, a pump in your scrotum and a reservoir of fluid in your abdomen. This is typically utilized when there is Peyronie’s Disease in combination with severe erectile dysfunction.