Peyronie's Disease

Conditions Basics

What is Peyronie's disease?

Peyronie's disease is an abnormal curvature of the penis caused by scar tissue in the lining of the penis. Because the scar tissue prevents straightening of the penis, the curvature is most obvious during an erection. The curvature may cause pain for the person or their partner, or it may be so severe that it prevents penetration during intercourse.

Peyronie's disease usually affects people who are 50 and older.

What causes it?

Although the exact cause of Peyronie's disease is unknown, some experts think the scarring may be caused by minor injuries to the penis during sexual intercourse. Peyronie's disease is not caused by cancer and does not increase the risk of cancer. It is not caused by sexually transmitted infections (STIs).

What are the symptoms?

Symptoms of Peyronie's disease may develop slowly or suddenly. Common symptoms include:

• A lump or thickening along the shaft of the penis that is most noticeable when the penis is soft (flaccid).
• A bent or curved appearance of the penis that is most noticeable when the penis is erect.
• A narrowing of the erect penis that causes an hourglass shape to the penis.
• A painful erection. Some people do not have pain with an erection but have tenderness when the lump along the side of the penis is touched.
• An inability to keep an erection or problems with the entire penis being erect. Some parts of the penis may be more rigid, usually nearest the body, while the areas closer to the tip of the penis may be less rigid.
• An inability to achieve penetration during intercourse.

What are the stages?

Peyronie's disease is usually divided into two stages:

• The acute phase. The most common symptoms of this phase are painful erections and a change in the look of the penis. For example, it may curve or have an hourglass shape when erect. In some people the condition goes away on its own after several months. But in others it becomes chronic.
• The chronic phase. During the chronic phase, the disease is stable. The pain is gone and there are no more changes to the curve in the penis.

How is it diagnosed?

Peyronie's disease is usually diagnosed using a medical history and physical exam. Your doctor will ask you questions about when you first noticed your symptoms and whether the symptoms were gradual or sudden. This will help determine which stage of Peyronie's disease you are experiencing.

Because symptoms of Peyronie's disease are usually most noticeable when the penis is erect, your doctor will likely ask that you use your cell phone to take a photo of your erect penis. Or your doctor may inject a drug into your penis to make it erect. This will help your doctor see where the curve is and how severe it is. Other tests that may be ordered include:

• An X-ray or ultrasound, to produce a picture of the structures within the penis.
• Doppler flow studies, which use sound waves to monitor blood-flow patterns.

How is Peyronie's disease treated?

Peyronie's disease can sometimes get better without treatment during the acute phase. Once the disease is stable and the chronic phase begins, it usually doesn't get better on its own. If you have a slight curve that isn't getting worse and have good erectile function, treatment usually is not needed. But if pain is a problem, or if the curve is getting worse and interfering with your sexual activity, then getting treatment may help.

If your doctor is a primary care doctor, you may be referred to a urologist.

Most people are able to remain sexually active. Counselling can help you maintain an active sexual life.

Medicines, such as NSAIDS, may help treat pain.

Surgery is only considered if you have a severely curved penis or sexual dysfunction related to Peyronie's disease. Surgical options include removing the scar tissue or shortening the unaffected side of the penis (plication). Experts usually suggest that before trying surgery, you wait at least a year.

If a penis is severely curved with poor erections, a penile prosthesis may be used to help straighten the penis and keep an erection during intercourse.