Peyronie’s Disease

Peyronie’s disease is a urological condition in men marked by the development of fibrous scar tissue inside the shaft. This scar tissue leads to abnormal curvature in the penis associated with pain and, in some cases, erectile dysfunction. While it may seem like a rare or taboo topic, Peyronie’s disease is more common than many realize, affecting approximately 1 in 10 men, particularly those over the age of 40.

In this article, we will explore what Peyronie’s disease is, its causes, diagnosis, treatment options including surgical intervention, who performs surgery for Peyronie’s, and what happens if the condition is left untreated.

Peyronie’s disease is characterized by the formation of fibrous plaques or scar tissue beneath the skin of the penis, often on the dorsal (top) side. The scarring causes the penis to bend or curve during erections, leading to pain and difficulties during sexual intercourse.

Some men also experience penile shortening, indentation, or a narrowing of the shaft, commonly referred to as a “waist deformity.” While a slight curvature is normal in many men, the curvature in Peyronie’s disease is more pronounced and may worsen over time.

The exact cause of Peyronie’s disease is not always clear, but it is most commonly believed to result from penile trauma or injury. In response, the body naturally forms scar tissue as part of the healing process.

• Repetitive microtrauma during intercourse
• Genetic predisposition (family history of connective tissue disorders)
• Autoimmune conditions
• Aging and reduced tissue elasticity
• Diabetes or vascular issues
• Pre-existing erectile dysfunction

Diagnosis begins with a physical exam to detect plaques under the skin. A urologist may request photographs of the erect penis or induce an erection in-clinic for accurate assessment.

• Ultrasound imaging to locate scar tissue and assess blood flow
• X-rays or MRI in complex cases
• Measurement of penile curvature using goniometers

Understanding whether the disease is in its acute phase (with pain and progressing curvature) or chronic phase (stabilized deformity without pain) is essential for selecting appropriate treatment.

The choice of treatment depends on how severely the condition impacts the patient’s quality of life. Options include non-surgical and surgical approaches.

• Oral Medications: Pentoxifylline, Potassium para-aminobenzoate (POTABA), Vitamin E, L-arginine (effectiveness varies).
• Intralesional Injections: Collagenase Clostridium Histolyticum (Xiaflex) breaks down scar tissue when combined with modeling.
• Penile Traction Therapy (PTT): Devices like RestoreX® help reduce curvature, especially in the acute phase.
• Shockwave Therapy: Li-ESWT may help reduce pain; evidence for curvature correction is limited.

Surgical intervention is recommended for patients in the chronic phase with stabilized deformity or significant functional impact.

• Plication Surgery: Shortens the convex side of the penis to straighten it. May reduce penis length.
• Plaque Incision and Grafting (PIG): Removes or cuts plaque and places a graft. Suitable for severe deformities but with slightly higher ED risk.
• Penile Implants: Ideal for men with erectile dysfunction and curvature. Inflatable or malleable prostheses restore function and shape.

Peyronie’s surgeries are performed by Urologists specializing in male sexual health and reconstructive urology. Choose a board-certified expert with a proven track record for best outcomes.

Yes, it is generally safe and effective when done by experienced urologists. However, risks include:

• Infection
• Erectile dysfunction
• Changes in sensation
• Penile shortening
• Scar recurrence

Most men experience improved function and satisfaction post-surgery.

Without treatment, Peyronie’s disease may lead to:

• Progressive penile curvature
• Loss of erectile function
• Penile shortening
• Emotional and psychological distress

Early intervention can prevent complications and improve both physical and emotional outcomes.

Peyronie’s disease is a treatable condition. From medications and traction therapy to surgical correction, men have multiple effective solutions available. Seeking timely care from a qualified urologist can lead to significant improvements in sexual confidence, comfort, and quality of life.