Introduction
Have you noticed a curve in your penis that wasn’t there before? Does it hurt when you get an erection? You might have Peyronie’s disease. This condition affects millions of men worldwide, yet many suffer in silence.
What Is Peyronie’s Disease?
Peyronie’s disease causes curved, painful erections. It happens when scar tissue forms inside the penis. This scar tissue prevents normal stretching during erections. The result is a bend or curve that can be painful.
The condition is named after François Gigot de La Peyronie, a French doctor who first described it in 1743. Despite being known for centuries, better treatments have only emerged recently.
Quick Facts:
- Affects 4-13% of men, mostly between ages 40-70
- Many men don’t report it due to embarrassment
- Can develop suddenly or slowly over time
- Often causes both physical pain and emotional stress
- Has two phases: painful (acute) and stable (chronic)
What Causes It?
Doctors don’t fully understand what causes Peyronie’s disease, but several factors play a role:
Injury to the Penis
Most experts believe Peyronie’s disease starts with an injury to the penis. This often happens during sex. These injuries might be too small to notice. In some men, the healing process goes wrong.
Dr. Mohit Khera from Baylor College of Medicine explains: “After penis injury, the body tries to heal. In some men, this process goes wrong. Too much scar tissue forms instead of normal healing.”
Family History
Your genes matter too:
- About 20-30% of men with Peyronie’s have family members with it
- It’s more common in men with certain genetic conditions
- Some gene variations affect how your body handles injury and healing
Immune System Problems
Some research suggests the body’s defense system might attack its own tissues. This creates swelling that leads to scar tissue.
Risk Factors
You’re more likely to get Peyronie’s disease if you:
- Are middle-aged or older
- Have certain tissue disorders
- Have diabetes
- Smoke
- Take certain medicines
- Had prostate surgery
- Engage in rough sex or activities that might hurt the penis
Signs and Symptoms
Peyronie’s disease develops in two main stages:
Early Stage (6-18 months)
- Painful erections
- Soft lumps forming in the penis
- Growing curve in the penis
- Hard nodules may form
- Trouble getting or keeping erections
Later Stage
- Pain often goes away
- Scar tissue becomes harder
- Curve stops changing (gets better in 15%, worse in 45%, stays the same in 40%)
- Penis may become shorter
- Erection problems may continue or get worse
Main Symptoms
- Curved Penis: Bends up, down, or to either side when erect
- Lumps: Hard spots you can feel under the skin
- Pain: Especially during erections, though this often goes away with time
- Erection Problems: Trouble getting or keeping erections
- Shorter Penis: Length loss due to scarring
- Mental Distress: Worry, sadness, and relationship problems
How It’s Diagnosed
To diagnose Peyronie’s disease, doctors will:
Talk and Examine
Your doctor will ask about your symptoms and medical history. They will feel for scar tissue in your penis.
Look and Measure
During the exam, the doctor may:
- Measure your penis when it’s soft and (if possible) erect
- Measure the angle of the curve
- Check for shortening or narrowing
Special Tests
- Ultrasound: Uses sound waves to see inside the penis, check blood flow, and measure scar tissue
- Injection Test: Medicine injected into the penis to cause an erection, allowing better assessment
- MRI: Sometimes used for detailed pictures of the scar tissue
Ruling Out Other Conditions
Doctors must make sure it’s not:
- A curve you were born with
- A broken penis (from sudden injury)
- A narrow urethra
- Penis cancer (rare)
Treatment Options
Treatment depends on how long you’ve had it, how bad it is, and what you prefer:
Watching and Waiting
For mild cases or early stages:
- Monitoring to see if it gets worse
- Avoiding activities that might cause more damage
- Quitting smoking
- Managing other health issues like diabetes
Non-Surgical Treatments
Pills
Many drugs have been tried, but results are mixed:
- Pentoxifylline: May improve blood flow and reduce swelling
- Potaba: May shrink scar tissue in early disease
- ED Medications: May help with erection problems
- Colchicine: Anti-swelling drug with mixed results
- Vitamin E: Often suggested, but recent studies show limited benefit
Injections
- Xiaflex: The only FDA-approved drug for Peyronie’s disease. Studies show:
- 34% less curve (compared to 18% with fake treatment)
- Less bother from symptoms
- Works best for curves between 30-90 degrees
- Verapamil Shots: May prevent scar tissue growth
- Interferon Shots: May disrupt scar tissue formation
Mechanical Devices
- Stretching Devices: Devices that pull on the penis for several hours each day
- Studies show they might improve length and curve
- Often used with other treatments
- Must be used 3-8 hours daily for months
- Vacuum Devices: May help prevent shortening during early stages
Surgery
Surgery is usually only for stable disease (unchanged for at least 6-12 months) with severe curve or erection problems:
Plication
- Shortens the longer side of the penis without removing scar tissue
- Keeps erection function but may reduce length
- Examples include the Nesbit procedure and 16-dot technique
Cutting or Removing Scar Tissue
- Involves cutting or removing scar tissue and replacing with graft material
- Can fix severe curves while keeping length
- Higher risk of erection problems
- Longer recovery time
Penile Implants
- Best for men with both Peyronie’s disease and erection problems
- Straightens the penis and restores erection function
- May be combined with other techniques for severe cases
Dr. Wayne Hellstrom from Tulane University notes: “Choosing the right surgery depends on the curve, erection function, patient age, and expectations. The patient and surgeon must decide together.”
New Treatments Being Studied
Researchers are exploring several promising options:
Stem Cell Therapy
- Early studies suggest stem cells from fat tissue may help repair damage
- Clinical trials show potential for reducing scar tissue and improving erections
Shockwave Therapy
- Low-intensity sound waves being studied to reduce scar tissue
- May improve blood flow and tissue healing
- Mixed results so far
PRP (Platelet-Rich Plasma)
- Involves injecting concentrated platelets from your own blood
- Contains growth factors that may help healing
- Still considered experimental for Peyronie’s disease
Emotional Impact and Support
Peyronie’s disease often causes significant emotional distress:
- Up to 81% of men report feeling depressed about it
- Many worry about sex performance
- Strain on relationships is common
- Self-image issues and lower self-esteem often occur
Coping Tips
- Talk Openly: Discuss concerns with partners
- Get Counseling: Individual or couples therapy can help
- Join Support Groups: Connect with others facing similar challenges
- Learn More: Understanding the condition helps reduce fear
Doctors often use special surveys to measure emotional impact and track improvements after treatment.
Living With Peyronie’s Disease
Daily Management
- Follow treatment plans consistently
- Keep regular doctor appointments
- Stay physically healthy
- Manage stress and mental health
Sex Adjustments
- Try comfortable positions with partners
- Use supportive devices if needed
- Consider alternatives to penetrative sex during painful phases
When to See a Doctor
Talk to a doctor if you notice:
- New curve in your penis
- Painful erections
- Hard lumps in your penis
- Sex problems due to curve or pain
- Worsening of existing symptoms
Getting help early may prevent worsening and reduce the need for surgery.
Common Questions
Can Peyronie’s disease go away on its own?
In about 15% of cases, it gets better without treatment. However, in 40-45% of cases, it gets worse without help. In the rest, it stays the same. It’s best to see a doctor early.
Is Peyronie’s disease the same as erectile dysfunction?
They’re different but related. Peyronie’s can cause erection problems. The scar tissue may block blood flow needed for erections. Pain or worry about the condition can also make erections difficult.
What age does Peyronie’s disease usually start?
While it can affect men of any age, it most often appears between ages 40 and 70. The average age when symptoms start is around 55.
Will insurance cover treatment?
Coverage varies by insurance plan. FDA-approved treatments like Xiaflex are more likely to be covered than experimental therapies. Check with your insurance company about your specific coverage.
Can I still have children if I have Peyronie’s disease?
Peyronie’s disease doesn’t affect fertility or sperm production. However, if severe curve makes sex difficult or impossible, you might need other methods to conceive.
Summary
Peyronie’s disease can be challenging both physically and emotionally. But treatments are getting better. Early diagnosis and treatment offer the best chance for good results. The condition affects each person differently, so treatment must be tailored to you.
If you have Peyronie’s disease, learning about it, talking openly with doctors and partners, and exploring all treatment options can help you cope. Medical advances continue to improve outcomes, offering hope to the millions of men with this condition.