Peyronie’s disease, happens when scar tissue called plaque develops under the skin of the penis, in the tunica albuginea, a fibrous layer of connective tissue that helps maintain an erection. The plaque can make the penis bend abnormally when erect and cause pain. Depending on where the plaque forms, the bend can be upward, downward or sideways. It can cause indentation of the penis as well.

Peyronie’s disease may affect a person in multiple ways. It may cause uncomfortable sexual intercourse due to curved and painful penis or lead to anxiety, depression or emotional distress about penis appearance or sexual abilities. Many patients also report erectile dysfunction.

Some of Peyronie’s disease symptoms include:

• Curved or bent penis with or without erection
• Palpable plaques in the penis
• Narrowing or shortening of the penis
• Abnormal indentations in the penis
• Painful erections or sexual intercourse
• Erectile dysfunction

What Causes Peyronie’s Disease?

Peyronie’s disease is not contagious or infectious and is not caused by sexually transmitted infections. Although the exact cause is unknown it is thought that trauma to the penis, either a single large trauma or small repetitive traumas causes most cases. Injury to the penis might occur during sexual intercourse, sports or other activities. The following may increase a person’s risk of developing this disease:

• Injury to the penis
• An autoimmune disease or connective tissue disorder
• A family history of Peyronie’s disease
• Erectile dysfunction
• Diabetes
• Previous prostate cancer surgery
• Aging

Peyronie’s disease has two stages:

• Acute phase – usually lasts from 6 months to a year. In rare cases, symptoms from the disease can last up to 18 months. During this time, the pain and curving of the penis worsen as the plaque stabilizes.
• Chronic phase – the plaque stops changing/developing at this time, and the penis does not curve any further.

How Is Peyronie’s Disease Diagnosed?

Consult with a urologist or healthcare provider if you experience symptoms such as a curved or painful penis and difficulty with erections for proper diagnosis and treatment options. Your urologist will ask about your medical and family history. Your doctor will examine your penis during the physical exam to feel possible plaques. An injectable medicine may be injected to create an erection in the office. Your doctor may also take pictures to study or order a dynamic ultrasound to check for plaque or calcium buildup.

Is Peyronie’s Disease Curable?

A small subset of men with Peyronie’s disease will resolve on its own with time otherwise most men with bothersome symptoms will need treatment. Men with minimal penile curving, a small plaque and no pain or problems with sexual intercourse may not need treatment. Treatment may include medications or surgical intervention, depending on the severity of the condition and patients’ goals.

If you need to be treated, your urologist will discuss your treatment options and possible side effects.

Non-surgical Peyronie's disease treatment options may include:

• Penile injections – this is an injection directly into the plaque to break it up or dissolve it.

Can Surgery Fix Peyronie’s Disease?

Peyronie's disease surgery may be recommended after physical examination and discussion. Your urologist will perform several tests to determine the severity of curvature and current erectile function. Surgical treatment options may include:

• Grafting – the plaque is removed and a grafting material is used to cover the area where the plaque was removed.
• Plication – this involves straightening the penis by shortening the side opposite of the curvature.
• Penile implant surgery – may be recommended if the patient has both erectile dysfunction and Peyronie’s disease. An artificial device / medical device is surgically placed within the penis to create an erection and help correct curvature.

What Is the Best Treatment for Peyronie’s Disease?

Peyronie's disease treatment depends on several factors, including severity of curvature, discomfort with intercourse and impact on sexual function. An appropriate treatment plan should be tailored to the patient's unique needs and consider their preferences and overall health. As such, treatment options should be discussed with a urologist.