Peyronie’s disease is a connective tissue disorder of the penis that leads to the formation of fibrous scar tissue (plaques) under the skin. This buildup causes the penis to curve or bend, most noticeably during erections. While mild curvature may not cause problems, more severe cases can interfere with sexual function, cause pain, and lead to emotional distress.
Symptoms of Peyronie’s Disease
The most common sign of Peyronie’s disease is a curved or bent erection. Other symptoms may include:
- Palpable lumps or hardened tissue beneath the penile skin
- Painful erections, especially in the early stages
- Erectile dysfunction
- Narrowing or shortening of the penis
- Difficulty with sexual penetration due to curvature
Symptoms may appear suddenly or develop gradually. The condition can stabilize over time, but in many cases the curvature worsens if left untreated.
Causes and Risk Factors
The exact cause is not always clear, but the most common theory involves repetitive microtrauma to the penis during intercourse or physical activity, especially when not fully erect. This trauma may trigger abnormal wound healing in some men, leading to scar tissue formation. Risk factors include:
- Age (typically affects men over 40)
- A family history of Peyronie’s disease
- Connective tissue disorders (e.g., Dupuytren’s contracture)
- Diabetes or other vascular conditions
- Erectile dysfunction
Diagnosis
Diagnosis typically involves a physical examination to locate plaques and assess curvature. An ultrasound may be used to evaluate plaque size and blood flow. Patients may be asked to provide photographs of their erection at home to help assess deformity and guide treatment.
Treatment Options
Treatment depends on the severity of symptoms and the degree of penile curvature.
- Observation: Mild cases without pain or interference with intercourse may not require active treatment. Monitoring is often recommended during the early, active phase of the disease.
- Oral Medications: Some oral therapies, such as pentoxifylline, may be used early in the disease, though evidence of benefit is limited.
- Injection Therapy: Medications such as collagenase clostridium histolyticum (Xiaflex®) may be injected directly into the plaque to soften it and reduce curvature. This is usually combined with penile modeling exercises.
- Traction Therapy: Penile traction devices can help stretch and straighten the penis over time. These are often used alongside other therapies.
- Surgery: In more advanced or bothersome cases, surgical correction may be recommended. Options include plaque incision with grafting, penile plication, or implantation of a penile prosthesis for men with significant erectile dysfunction.
Next Steps
If you’re experiencing symptoms of Peyronie’s disease, a consultation with a urologist is recommended. Early evaluation can help determine the stage of the condition and identify whether treatment is appropriate.