What is Peyronie’s disease?

Peyronie’s disease overview

Peyronie’s disease is caused by scar tissue, called plaque, which forms along the length of the penis in the corpora cavernosa. This plaque is not visible, and depending on the severity of the condition, the plaque can cause the penis to bend, making sexual intercourse difficult and occasionally painful.

Symptoms of Peyronie’s disease

Peyronie’s disease signs and symptoms might appear suddenly or develop gradually. The most common signs and symptoms include:

• Scar tissue. The scar tissue (plaques) associated with Peyronie’s disease can be felt under the skin of the penis as flat lumps or a band of hard tissue.
• A significant bend to the penis. Your penis might be curved upward, downward or bent to one side. In some cases, the erect penis might have narrowing, indentations or an hourglass appearance, with a tight, narrow band around the shaft.
• Erection problems. Peyronie’s disease might cause problems getting or maintaining an erection (erectile dysfunction).
• Shortening of the penis. Your penis might become shorter as a result of Peyronie’s disease.
• Pain. You might have penile pain, with or without an erection.

The curvature associated with Peyronie’s disease might gradually worsen. At some point, however, it stabilizes in the majority of men.

In most men, pain during erections improves within one to two years, but the scar tissue and curvature often remain. For a few men, both the curvature and pain associated with Peyronie’s disease improve without treatment.

How to Know if You’re at Risk

Genetics and age both appear to play a role in Peyronie’s disease. Tissue changes can lead to easier injury and slower healing as men get older, putting them at greater risk for developing Peyronie’s disease.

Men with a connective tissue disorder called Dupuytren’s contracture have a higher chance of developing Peyronie’s disease. Dupuytren’s contracture is a thickening in the hand that makes your fingers pull inward.

Are any other conditions seen in people who get Peyronie’s disease?

Peyronie’s disease is seen more frequently in people who have diabetes mellitus (sugar diabetes), hypertension (high blood pressure), hyperlipidaemia (raised blood fats), conditions affecting the heart muscle and Dupuytren’s contracture (a thickened band of fibrous tissue develops across the palm). It is seen more commonly in people who smoke or drink a lot. It occasionally develops in people taking the anti-epileptic medicine phenytoin.

Treatment for Peyronie’s disease

Treatment options include:

• A ‘watch and wait’ approach – in some cases, Peyronie’s disease goes away with no medical intervention at all. The reasons for this are unknown.

• Medications – including anti-inflammatory drugs, colchicine, vitamin E and pentoxifylline. If symptoms haven’t eased within one year of treatment, it is assumed that medications won’t fix the condition.

• Injections directly into the plaque – an enzyme called collagenase may be used to soften the plaque, or a medication called verapamil may be used to relax the blood vessels.

• Penile traction device – this has proved useful, along with medical therapy, to lengthen the penis and reduce the curve in the erect state. Studies have also shown that use of a penile traction device may increase penile width, suggesting a benefit in the management of Peyronie’s disease. It has also been used pre- and post-surgery to prevent penile shortening.

• Surgery – this is an option for men with Peyronie’s disease who do not respond to conservative or medical therapy for approximately one year and are still having difficulty with sexual intercourse.