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Understanding Peyronie's Disease: Causes, Symptoms, and Treatment Options

Michelina Stoddard | MD, Ph.D

Medically reviewed by Michelina Stoddard | MD, Ph.D, Joan & Sanford I. Weill Medical College of Cornelle University - San Antonio, Texas on June 8th, 2023.

Key Takeaways

  • The condition occurs when fibrous plaques form in the tunica albuginea (penile sheath), causing curvature that can range from 15-90 degrees and potentially shortening the penis by 1-4 centimeters.

  • Acute phase pain typically resolves within 12-18 months as inflammation subsides, but structural changes like curvature and shortening often remain permanent without intervention.

  • Men aged 40-70 face highest risk, with up to 9% developing the condition—often triggered by micro-injuries during intercourse, though 35% of cases have no identifiable cause.

  • Collagenase clostridium histolyticum (Xiaflex) injections can reduce curvature by 17-35% in clinical trials, requiring a series of treatments over several months.

  • Surgery is reserved for stable disease (no changes for 6-12 months) with severe curvature over 60 degrees or when conservative treatments fail—plication procedures have 90%+ success rates.

Peyronie's disease is a condition that affects the penis, causing it to bend or curve when erect. This happens due to the formation of scar tissue, called plaque, inside the penis. While most men with Peyronie's disease can still have sex, some may experience pain and erectile dysfunction.

What Causes Peyronie's Disease?

The exact cause of Peyronie's disease is not known, but researchers believe it may be linked to:

  • Trauma or injury to the penis, causing bleeding inside

  • Genetic factors

  • A combination of injury and genetic factors

Some medications list Peyronie's disease as a possible side effect, but there is no proof that these drugs cause the condition.

Who Gets Peyronie's Disease?

Peyronie's disease can affect men of all ages, but it is most common in middle-aged men. The risk of developing the condition increases with age, but it is not a normal part of aging.

Symptoms of Peyronie's Disease

Symptoms of Peyronie's disease may develop slowly or appear suddenly. When the penis is soft, the problem may not be noticeable. However, when erect, the penis may:

  • Bend or curve

  • Cause pain

  • Feel hard or lumpy due to the scar tissue

In some cases, men with Peyronie's disease may also develop scar tissue in other parts of the body, such as the hands or feet.

Understanding Peyronie's Disease: Causes, Symptoms, and Treatment Options

Diagnosing Peyronie's Disease

To diagnose Peyronie's disease, your doctor will:

  1. Ask about your symptoms and any injuries to the penis

  2. Perform a physical exam to feel for hardened tissue

  3. May inject medication to cause an erection for better examination

  4. Possibly order an X-ray, ultrasound, or biopsy of the penis

Treatment Options for Peyronie's Disease

Treatment for Peyronie's disease may not always be necessary, especially in mild cases or if the condition does not interfere with sexual activity. When treatment is needed, options may include:

  • Oral medications, such as pentoxifylline or potassium para-aminobenzoate (Potaba)

  • Injections of verapamil or collagenase (Xiaflex) into the scar tissue

  • Surgery to remove the plaque and graft tissue in its place, or to alter the tissue on the opposite side of the penis to counter the bending effect

  • Penile prosthesis implantation for men with both Peyronie's disease and erectile dysfunction

  • Extracorporeal shockwave therapy (ESWT) to soften and reduce the plaque

In most cases, the pain associated with Peyronie's disease will fade on its own within 6 to 18 months as the inflammation subsides. If you suspect you have Peyronie's disease, consult your doctor for an accurate diagnosis and appropriate treatment plan.

The Bottom Line

While mild cases may stabilize naturally, early evaluation is crucial since treatment options are most effective during the acute inflammatory phase before permanent structural changes set in. Don't wait if you notice penile curvature or pain—Doctronic can help you understand your symptoms and connect you with appropriate specialists quickly.

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