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Peyronie’s Disease

Peyronie’s Disease is a condition that causes a curved penis, indentation, and limited length of an erection. It can be awkward to discuss with your health care provider. Let us help you start the conversation.

What is Peyronie’s Disease?

With Peyronie’s Disease, a small scar forms in the lining of the penis that can result in a curved or shortened penis, an indentation in the penis, or pain. The disease is most common in men over the age of 40. It’s estimated that 10-15% of men experience some form of the disease in their lifetime.

What are the symptoms of Peyronie’s Disease?

Symptoms of Peyronie’s Disease include:

A curved or shortened penis
An indentation in the penis
Or pain in the penis

What causes Peyronie’s Disease?

Peyronie’s Disease may form from some kind of trauma to the penis during intercourse, but many men do not have any history of injury or trauma. It is thought that local inflammation leads to a penile scar or lump.

How is Peyronie’s Disease diagnosed?

During your visit, your doctor will ask you questions regarding your medical and surgical history, when the curvature was first identified, if the curvature impacts your ability to have intercourse, and the quality of your erections.

Bringing a digital picture of your erect penis may be requested. This can help to assess the curve in a more natural setting. Taking the picture from multiple angles is ideal. Note: Photographs on your phone may be password protected. iPhones have a special folder that can be used in the Photos app that can be password protected.

Tests that may be performed during or after your visit:

Curve assessment: Your provider may inject a medication into the side of your penis to cause an erection during your appointment. The degree of the curvature will then be measured. This would typically be done on a second or third visit, but not on your initial evaluation.
Imaging: An ultrasound of the penis may be ordered to determine the degree of curvature and if erectile dysfunction is present.

How is Peyronie’s Disease treated?

Active phase (first 12-18 months):

Ibuprofen may be recommended for pain control.
Various oral medications may be used during the active phase of disease, but none have proven to work consistently in high level studies.
You may be asked to place a penile traction device on your penis 60 minutes per day to stretch the penis and mechanically break down the plaque.
Medical and surgical therapies are usually reserved for patients in the stable phase (see below)

Stable phase (typically after 12-18 months) – Non-Surgical:

Verapamil: Injection of medication into the affected area to help break down the plaque
Intralesional collagenase (Xiaflex^®): A minimally invasive medication is injected into the penile plaque to break-down the penile scar.

Stable phase (typically after 12-18 months) – Surgical:

Penile plication: This minimally invasive surgery involves straightening the penis by tightening the skin on the side opposite the curve.
Plaque excision and grafting: A surgical procedure straightens the penis by removing the plaque and replacing it with a more pliable grafted material. This is useful for the most severe curves or deformities.
Penile implant: This surgical procedure involves the placement of cylinders/implant into your penis, a pump in your scrotum and a reservoir of fluid in your abdomen. This is typically utilized when there is Peyronie’s Disease in combination with severe erectile dysfunction.