Peyronie Disease

Peyronie disease causes hard, flat plaque to form under the skin on the tissue of the penis. The plaque often starts as an inflammation that may develop into scar tissue. It can cause pain and a sharp curve in the penis during erections.

Some researchers believe Peyronie disease develops after an injury that causes bleeding inside the penis. This could explain cases of Peyronie that develop quickly. But it does not explain why most cases develop slowly, or what causes the disease after no clear injury.

Most researchers believe that genetics or the environment may play a role. Men with certain connective tissue disorders and men who have a close family member with Peyronie disease are at greater risk. And certain health conditions such as diabetes or tobacco use may also contribute to its development. 

If the disease heals within a year or so, the plaque usually does not get worse. But when the disease lasts for years, the plaque often becomes a tough, fibrous tissue, and calcium deposits may form.

The plaque in Peyronie disease is not cancer.

The following are the most common symptoms of Peyronie disease:

• Changes in the way an erection looks:
  • Plaque on the top of the shaft causes the penis to bend upward when erect. This is the most common condition.
  • Plaques on the side causes the penis to bend to the side of the plaque. 
  • Plaque on the underside causes the penis to bend downward during erection.
  • Plaque on both top and bottom or wraps around the penis, deformity, indentation, and shortening of the penis may occur.
• Painful erections
• Trouble with penetration

Pain, bending, and emotional distress can greatly affect the man’s sex life.

The symptoms of Peyronie disease may look like other conditions or medical problems. Always talk with a healthcare provider for a diagnosis.

Your healthcare provider will review your medical and sexual history and do a physical exam, during which the plaque can usually be felt. Other tests may include:

• Ultrasound of the penis. An imaging technique that uses high-frequency sound waves to create pictures of the inside of the penis and check blood flow.
• X-ray of the penis. This may be done to get a better look at the plaque and check for tiny calcium deposits.

To check how the penis looks during an erection, medication may be injected into the penis to cause an erection in the clinic.

The goal of treatment is to reduce pain and keep you sexually active. There is no cure. Education about the disease and its usual course is often included in the treatment plan. In some cases, treatment is not needed. Peyronie disease often happens in a mild form that heals on its own in 6 to 15 months. Treatment may include:

• Vitamin E. Small studies have reported improvements with oral vitamin E, but larger studies have not been done to prove that this treatment works. Still, this is an easy, low cost treatment choice.
• Various medicines. Many medicines taken by mouth have been tried, but none are proven to work in all men. If your healthcare provider wants to try medicine, be sure you understand what it is, what’s known about it, and what side effects you should watch for.
• Injections of various medicines into the plaques. Injections of various medicines into the plaques have been tried in a small number of men, but none have been proven to work in large numbers of men.
• Surgery may be used to correct the plaque in severe cases, such as when the man has pain during an erection or can’t keep an erection long enough to have sex.

Please talk with your healthcare provider with any questions or concerns you may have regarding this condition.

Peyronie disease affects each man differently. It can be very frustrating and affect your self-confidence in sexual relationships. It is not uncommon for men with Peyronie disease to have depression or relationship difficulties. 

You and your partner should learn as much as you can about the disease

• Peyronie disease causes hard, flat plaque to form beneath the skin on the tissue of the penis. It causes pain and a sharp curve in the penis during erections.
• Some researchers believe Peyronie disease develops after injury that causes bleeding inside the penis, but most cases develop slowly, after no clear injury.
• Peyronie disease causes changes in the way an erection looks, pain when the penis is erect, and trouble with penetration.
• A physical exam (during which the plaque can usually be felt) may be all that’s needed to diagnose Peyronie disease.
• The goal of treatment is to reduce pain and maintain sexual activity. In some cases, treatment is not needed. Peyronie disease often happens in a mild form that heals on its own in 6 to 15 months.
• There is no cure for Peyronie disease. A wide variety of medicines may be tried. Most are taken by mouth, but some are injected into the plaque. In severe cases, surgery may be used to remove the plaque.

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your provider if you have questions.