Overview – Peyronie’s (pay-roe-NEEZ) disease is a noncancerous condition resulting from fibrous scar tissue that develops on the penis and causes curved, painful erections. Penises vary in shape and size, and having a curved erection isn’t necessarily a cause for concern.
- But Peyronie’s disease causes a significant bend or pain in some men.
- This can prevent you from having sex or might make it difficult to get or maintain an erection (erectile dysfunction).
- For many men, Peyronie’s disease also causes stress and anxiety.
- Penile shortening is another common concern.
- Peyronie’s disease rarely goes away on its own.
In most men with Peyronie’s disease, the condition will remain as is or worsen. Early treatment soon after developing the condition may keep it from getting worse or even improve symptoms. Even if you’ve had the condition for some time, treatment may help improve bothersome symptoms, such as pain, curvature and penile shortening.
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Can Peyronie’s go away?
Early treatment for Peyronie’s disease Peyronie’s disease is a common yet poorly understood condition. Between 8% and 10% of men in their mid-teens to their 80s have signs or symptoms of Peyronie’s disease. It is a noncancerous condition that is a result of scar tissue developing on the penis.
This causes curved and painful erections. It can prevent sexual intercourse, lead to penile shortening, and could make it difficult to get or maintain an erection. Peyronie’s disease can cause significant stress and anxiety. Early evaluation and treatment is important, as Peyronie’s disease rarely goes away on its own.
Without treatment, only about 10% to 15% of men experience symptom relief in one year, while symptoms worsen for about 45% of men.
What is the best treatment for Peyronie disease?
Surgery – Surgery has been shown to be the most effective treatment for Peyronie’s disease to correct the curvature of the penis. However, it is usually only recommended in severe cases for patients who fail to respond to non-surgical therapy and have curvature for longer than 12 months.
- The two most common surgical methods are the cutting of the plaque followed by placement of a patch of vein or artificial material, or stitching of tissue from the side of the penis opposite the plaque, which corrects the penile curvature.
- Some men choose to receive an implanted device, or penile prosthesis, that increases the rigidity of the penis.
In some cases, a penile implant alone will adequately straighten the penis. For more detailed information on the three surgical procedures offered at UCSF Medical Center, please see Surgical Treatment for Peyronie’s Disease,
What happens if Peyronie’s is left untreated?
If left untreated, Peyronie’s disease may cause fibrotic, nonexpansile thickening of relatively discrete areas of the corpora tunica, typically resulting in focal bend, pain or other functional or structural abnormalities of the erect penis. Many cases resolve without treatment.
What does the start of Peyronie’s disease look like?
Mens Health Urological Conditions Urological Conditions Diagnosis and Screening of Urologic Conditions Peyronie’s disease is a connective tissue disorder of the penis that can be likened to Dupuytren’s contracture of the hand. It is characterized by the triad of bent erections, pain in the penis with erections and palpable penile plaque.
- Peyronie’s disease is quite common, affecting as many as one in 11 men, despite the lack of public awareness.
- The penis is composed of the same connective tissue as every other joint in the body.
- The anatomy of the penis is composed of three cylinders: the paired erectile bodies and the urethra.
- The erectile bodies (corpora cavernosa) are made up of sinusoidal tissue that fills up with blood during an erection and an outer covering (tunica albuginea) composed of tough fibroelastic tissue.
The outer covering determines the size and shape of the erection. The principal finding in men with Peyronie’s disease is the deposition of scar tissue in the tunica albuginea. All of the clinical symptoms are derived from this event. The curvature of the penis is due to the fact that scar tissue does not stretch as well as normal tissue.
The normal tunica albuginea is composed of elastin fibers and collagen. The site of scar tissue from Peyronie’s disease is composed mostly of collagen that can harden to the thickness of bone. Although most men with Peyronie’s disease report that their penis is bent upwards, a variety of other abnormalities are frequently observed, including bends in other directions, complex bends, divots in the side of the penis and hourglass deformities.
The palpable plaque is the actual scar tissue that has been deposited on the outer covering of the erectile bodies. This is present in the vast majority — but not all — patients with Peyronie’s disease. The plaque may become calcified, like bone, with severe disease.
Finally, the pain experienced with erections is thought to be due to active inflammation in the plaque and usually disappears on its own with time (usually by 12 months). Erectile function may be adversely affected by Peyronie’s disease. It is unclear whether erectile dysfunction causes Peyronie’s disease or vice versa.
It is probably a little bit of both. While most patients with Peyronie’s disease report normal penile rigidity during erections, some have trouble maintaining erections due to leaky veins in the penis (a process called veno-occlussive disease of the penis).
- The disease process of Peyronie’s disease does not normally affect the sinusoidal tissue within the erectile bodies, but it can affect the veins exiting the erectile bodies and prevent their proper closure.
- The main sexual complaint despite the physical deformity is the bend itself, preventing vaginal intromission or causing pain to the partner.
The exact etiology of Peyronie’s disease is unknown. There is evidence that it may have a genetic basis. A positive family history is common but not typical. There is an association with other connective tissue disorders, specifically Dupuytren’s contracture, affecting the palms of the hands.
The most popular theory today is that Peyronie’s disease is induced by trauma. The trauma may be acute and distinct such as a penile fracture, but more often it is chronic and low grade, such as repeated attempts at sexual intercourse with weak or incomplete erections. The natural history of Peyronie’s disease is unique in that spontaneous resolution is not uncommon.
In general, the disease course is one of sudden onset, progression and then stabilization. Whether or not it is getting better or worse, the deformity may resolve spontaneously if it has not been stable for more than six months. When a patient presents with active disease, the chance of spontaneous improvement is approximately 20 percent, the chance of stabilization is 40 percent and the chance of further progression is 40 percent.
The management of Peyronie’s disease is dependent upon the extent of stabilization of the disease state, the severity of the penile defect and erectile function. Medical therapy has been ineffective. With the exception of anti-inflammatory agents, medical therapy is no longer recommended by the American Urological Association.
Surgical therapy is employed when there is a significant penile defect preventing sexual relations. Patients with concomitant erectile dysfunction should undergo therapy for the erectile dysfunction first. Patients with bent erections who have been stable for more than six months and prevent sex undergo penile-straightening surgery.
This an outpatient procedure with a recovery time of less than one week. The exact method of straightening the penis is determined by the site and severity of the curvature as well as the penile anatomy assessed by penile ultrasonography. The potential complications of penile-straightening surgery are palpable suture knots, penile shortening (approximately 1 centimeter for every 15 degrees correction), numbness of the penis, residual curvature and worsening erectile dysfunction.
With the exception of penile shortening (which is not perceptible in most men), they are all rare. As an alternative to surgery for men with normal erectile function, some men are undergoing penile traction therapy in the active and chronic phases. However, traction therapy requires a time commitment of AT LEAST three hours a day and is still investigational.
What is the main cause of Peyronie’s disease?
Causes – The cause of Peyronie’s disease isn’t completely understood, but a number of factors appear to be involved. It’s thought Peyronie’s disease generally results from repeated injury to the penis. For example, the penis might be damaged during sex, athletic activity or as the result of an accident.
- However, most often, no specific trauma to the penis is recalled.
- During the healing process after injury to the penis, scar tissue forms in a disorganized manner.
- This can lead to a nodule you can feel or development of curvature.
- Each side of the penis contains a spongelike tube (corpus cavernosum) that contains many tiny blood vessels.
Each of the corpora cavernosa is encased in a sheath of elastic tissue called the tunica albuginea (TOO-nih-kuh al-BYOO-JIN-e-uh), which stretches during an erection. When you become sexually aroused, blood flow to these chambers increases. As the chambers fill with blood, the penis expands, straightens and stiffens into an erection.
How do you check if you have Peyronie’s disease?
How do health care professionals diagnose Peyronie’s disease? –
- Men with Peyronie’s disease are usually referred to a urologist—a doctor who specializes in sexual and urinary problems.
- A urologist diagnoses Peyronie’s disease based on your medical and family history and a physical exam.
- Imaging tests are usually not necessary to diagnose Peyronie’s disease but may be used to gather additional information about the plaque.
Can I fix Peyronie’s disease myself?
Consult a Sexual Health Professional for a Medical Approach to Treating Peyronie’s Disease – 
- While Peyronie’s Disease is often treated by surgery, there are alternatives to support in reducing the physical deformities of your penis by taking a multi-faceted approach to treatment.
- Using a combination of massages, stretches, and other penile exercises, there have been many successful attempts in curing Peyronie’s disease without surgery.
- Nonetheless, having a doctor supervise your Peyronie’s disease treatment is not just optimal—it’s mandatory.
The medical professionals at specialize in treating conditions that impact men’s health, including Peyronie’s Disease. Our concierge approach positions each patient’s at the centerpoint of our focus. We don’t just give you a pill for ED and send you on your way.
How long can the average man stay erect?
Erections typically last a few minutes or, in some cases, up to about a half hour. If you have an erection that lasts more than a four hours (priapism) or one that’s unrelated to sex, talk to your doctor right away or seek emergency care.
Does Peyronie’s disease affect size?
Abstract – Loss of penile length is a common complaint of men with Peyronie’s disease (PD), both before and after corrective intervention, which has a significant negative effect on patient quality of life. We sought to identify and describe the methods by which penile length can be preserved or increased.
We conducted an extensive, systematic literature review, based on a search of the PUBMED database for articles published between 1990 and 2015. Articles with the key words “Peyronie’s disease”, “penile length” and/or “penile lengthening” were reviewed if they contained subjective or objective penile length outcomes.
Only English-language articles that were related to PD and penile size were included. We found no evidence in the literature that medical therapy alone increases penile length. Classic inflatable penile prosthesis (IPP) placement, plication procedures, and the Nesbit procedure appear likely to maintain or decrease penile length.
- Plaque incision (PI) and grafting appears likely to maintain or increase penile length, but is complicated by risk of post-operative erectile dysfunction (ED).
- There are several surgical procedures performed concomitantly with IPP placement that may be suitable treatment options for men with comorbid ED, and consistently increase penile length with otherwise good outcomes concerning sexual function.
These include the subcoronal penile prosthesis (scIPP), Egydio circumferential technique, the sliding technique, the modified sliding technique (MoST), and the multiple slice technique (MuST). In addition, adjuvant therapies such as penile traction therapy (PTT), post-operative inflation protocols, suspensory ligament relaxation, lipectomy, and adjuvant medical therapy for glans engorgement appear to increase subjective and/or objective penile length for men at high risk of decreased penile length after PD surgery.
Considering the psychological burden of length loss in men with PD, providers with adequate volume and expertise should attempt, if possible, to maintain or increase penile length for men undergoing surgical intervention. There are several evidence-based, safe, and effective ways to increase penile length for these men and multiple emerging adjuvant therapies that may help ensure adequate length.
Peyronie’s Disease: Definition, Diagnosis and Treatment
Keywords: Peyronie’s disease (PD), length, lengthening, sliding technique, modified sliding technique (MoST), multiple slice technique (MuST), plaque incision (PI) and grafting, subcoronal penile prosthesis (scIPP)
What does Peyronie’s pain feel like?
Symptoms of Peyronie’s disease – The primary symptom of Peyronie’s disease is a curved penis. Your penis could be curved up, down, or to either side. While you may not notice it, another symptom is the scar tissue that causes Peyronie’s disease. You can feel this scar tissue just under the skin of your penis.
Will Viagra help Peyronie’s disease?
Peyronie’s disease is an acquired condition that affects 9% of men. One in 11 will present with Peyronie’s disease in their lifetime. Peyronie’s disease is a scarring process in the penis that leads to a plaque buildup and development of a curvature and narrowing or indentations of the penis.
- Patients may have painful erections as the curvature evolves or it may resolve by itself.
- Patients often ask whether pills, such as Viagra, have any benefit in the management of Peyronie’s disease.
- Unfortunately, oral therapies such as Viagra and other pills have not been shown to successfully improve either the curvature or the condition related to Peyronie’s disease.
While Viagra has not shown any evidence of improving penile deformity associated with Peyronie’s disease, Viagra does help with vasodilation or increasing the blood flow into the penis and therefore improving erections in men with Peyronie’s disease.
As such, all international societies such as the American Urologic Association, the International Society for Sexual Medicine, and the Sexual Medicine Society of North America all recommend against using Viagra for the management of Peyronie’s disease. There is currently no evidence to support the use of Viagra or any other oral pills or supplements for the management of Peyronie’s disease.
Viagra has not been shown to improve the curvature or the deformity that is associated with Peyronie’s disease. As such, it is not recommended.
Can you cure Peyronie’s without surgery?
Non-Surgical Options for Peyronie’s Disease – There are several non-surgical options when it comes to treating Peyronie’s disease. These non-invasive treatments include pills, injectables, and therapies to improve penile curvature and discomfort associated with PD.
Is Peyronie disease a STD?
What causes Peyronie’s disease? – Although the exact cause of Peyronie’s disease is unknown, some experts believe the scarring is caused by injury to the penis from accidents, sports, or vigorous sex. During sexual intercourse, the penis can be injured by being bent during penetration or by pressure from a partner’s pubic bone.
Should I be worried if I have Peyronie’s disease?
Six Peyronie’s Disease Signs That You Shouldn’t Ignore By: Urology Care Foundation | Posted on: 25 Oct 2017 Peyronie’s disease occurs when scar tissue called plaques form under the skin of the penis. These plaques can build up and lead to curved erections.
- These erections can be painful.
- Peyronie’s disease can cause stress, anxiety and depression in men.
- Some studies show over half of men diagnosed with Peyronie’s will suffer with depression.
- If not diagnosed early, the disease can cause problems with erections and lead to less satisfied sexual relations.
This can cause problems with intimate relationships. Due to the sensitive nature of this disease, many men don’t talk about Peyronie’s disease with their friends, family or doctor. This is unfortunate, because the sooner that someone with Peyronie’s disease sees a doctor, the better the chances for good outcomes.
The penis curves when erect Shortening of the penis Narrowing or “hour glass” of the shaft of the penis Lumps in the penis Painful erections or pain during sex Soft erections
Can a man live with Peyronie’s disease?
Other Considerations – Peyronie’s disease doesn’t need to affect most areas of your life. In general, problems associated with Peyronie’s are restricted to the bedroom. However, if your Peyronie’s disease needs treatment, it’s important to think about how you are going to deal with aftercare in advance.
Is there a pill for Peyronie’s disease?
Why Peyronie’s disease (PD) and why me? – It is estimated that about 1 in 10 men may have PD in the U.S.* * Based on a survey of about 7,700 U.S. adult men with a PD diagnosis, PD-related symptoms, or a history of seeking treatment for the condition. PD is a condition involving a buildup of scar tissue that develops under the skin of the penis and causes an abnormal bend with a bump in the erection.
- The exact cause of PD is unknown, but in some men, it may be caused by a minor injury or repeated injuries during sex or other physical activity.
- A bend with a bump in your erection may be difficult to talk about, but getting diagnosed and learning about your treatment options can make a difference.
- What is XIAFLEX ® ? XIAFLEX is a prescription medicine used to treat adult men with Peyronie’s disease who have a “plaque” that can be felt and a curve in their penis greater than 30 degrees when treatment is started.
It is not known if XIAFLEX is safe and effective in children under the age of 18. Important Safety Information Do not receive XIAFLEX if:
- the Peyronie’s plaque to be treated involves the “tube” that your urine passes through (urethra).
- you are allergic to collagenase clostridium histolyticum or any of the ingredients in XIAFLEX, or to any other collagenase product. See the end of the Medication Guide for a complete list of ingredients in XIAFLEX.
XIAFLEX can cause serious side effects, including:
- Penile fracture (corporal rupture) or other serious injury to the penis. Receiving an injection of XIAFLEX may cause damage to the tubes in your penis called the corpora. After treatment with XIAFLEX, one of these tubes may break during an erection. This is called a corporal rupture or penile fracture. This could require surgery to fix the damaged area. Damage to your penis might not get better after a corporal rupture.
- After treatment with XIAFLEX, blood vessels in your penis may also break, causing blood to collect under the skin (hematoma). This could require a procedure to drain the blood from under the skin. If a hematoma appears, skin and soft tissue necrosis (death of skin cells) may develop in that area, which could require surgery.
Symptoms of corporal rupture or other serious injury to your penis may include:
- a popping sound or sensation in an erect penis
- sudden loss of the ability to maintain an erection
- pain in your penis
- purple bruising and swelling of your penis
- difficulty urinating or blood in the urine
Call your healthcare provider right away if you have any of the symptoms of corporal rupture or serious injury to the penis listed above. Do not have sex or any other sexual activity between the first and second injections of a treatment cycle. Do not have sex or have any other sexual activity for at least 4 weeks after the second injection of a treatment cycle with XIAFLEX and after any pain and swelling has gone away. XIAFLEX for the treatment of Peyronie’s disease is only available through a restricted program called the XIAFLEX Risk Evaluation and Mitigation Strategy (REMS) Program.
- Hypersensitivity reactions, including anaphylaxis. Severe allergic reactions can happen in people who receive XIAFLEX, because it contains foreign proteins. Call your healthcare provider right away if you have any of these symptoms of an allergic reaction after an injection of XIAFLEX:
- hives
- swollen face
- breathing trouble
- chest pain
- low blood pressure
- dizziness or fainting
- Back pain reactions. After receiving an injection of XIAFLEX for Peyronie’s disease, you may suddenly feel back pain, including severe lower back pain moving to your legs, feet, chest and arms. The back pain may also include spasms and make it hard to walk. These symptoms usually go away in 15 minutes or less, but may last longer. Tell your healthcare provider right away if you have sudden back pain, chest pain, or hard time walking after an injection.
- Fainting. Fainting (passing out) or near fainting can happen in men who receive XIAFLEX, especially if they have severe penile pain. If you have dizziness or feel faint after receiving XIAFLEX, lie down until the symptoms go away.
Before receiving XIAFLEX, tell your healthcare provider if you have had an allergic reaction to a previous XIAFLEX injection, have a bleeding problem, received XIAFLEX for another condition, or any other medical conditions. Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
Using XIAFLEX with certain other medicines can cause serious side effects. Especially tell your healthcare provider if you take medicines to thin your blood (anticoagulants). If you are told to stop taking a blood thinner before your XIAFLEX injection, your healthcare provider should tell you when to restart the blood thinner.
Ask your healthcare provider or pharmacist for a list of these medicines, if you are not sure. What should I avoid while receiving XIAFLEX? Avoid situations that may cause you to strain your stomach (abdominal) muscles, such as straining during bowel movements.
- Do not use a vacuum erection device during your treatment with XIAFLEX.
- XIAFLEX can cause serious side effects, including increased chance of bleeding.
- Bleeding or bruising at the injection site can happen in people who receive XIAFLEX.
- Talk to your healthcare provider if you have a problem with your blood clotting.
XIAFLEX may not be right for you. The most common side effects with XIAFLEX for the treatment of Peyronie’s disease include:
- a small collection of blood under the skin at the injection site (hematoma)
- swelling at the injection site or along your penis
- pain or tenderness at the injection site, along your penis and above your penis
- penis bruising
- itching of your penis or scrotum (genitals)
- painful erection
- erection problems (erectile dysfunction)
- changes in the color of the skin of your penis
- blisters at the injection site
- pain with sex
- a lump at the injection site (nodule)
Tell your healthcare provider if you have any side effect that bothers you or does not go away. These are not all of the possible side effects with XIAFLEX. For more information, ask your healthcare provider or pharmacist. You may report side effects to FDA at 1-800-FDA-1088. Please see full Prescribing Information, including Boxed Warning and Medication Guide.
Can stretching fix Peyronie’s?
– Yes, certain types of exercise can help Peyronie’s disease. According to Massachusetts General Hospital, gentle stretching of the sheath can correct the curvature by breaking down some of the scar tissue. Recent research has also shown that exercises with special devices can be effective at straightening and stretching the penis back into its normal shape and length during erection.
How fast does Peyronie’s progress?
Key practice points –
Penile bend, palpable lump in the penis and some discomfort are common presenting features of Peyronie’s disease; however, it should be noted that Peyronie’s disease can have a variable onset, and this variability and unpredictability are features of this condition. There is often a history of some erectile dysfunction, usually based on vascular risk factors, preceding the development of Peyronie’s disease. Peyronie’s disease is a wound healing disorder, the injury or trauma that initiates it often being subclinical, and the symptoms usually develop and change over some 6–12 months before the chronic phase ensues. Diagnosis of Peyronie’s disease is largely based on history and examination, and specific investigation, at the general practice level, is not usually indicated. Referral to a specialist urologist should be considered if Peyronie’s disease is causing sexual difficulties or patient anxiety, curvature continues to progress or the diagnosis is not clear. The goal of surgery is to achieve a functionally straight erection. There is no treatment that can reverse Peyronie’s disease and thereby restore the penis back to the pre-disease state. Surgical treatments for the curvature of Peyronie’s disease remain the gold standard, but should only be performed in the stable or chronic phase, and patients must have realistic expectations about outcome.
