The goal of treatment is to reduce pain, attain a straight or close-to-straight penis, as well as restore and maintain the ability to have intercourse.
Peyronie’s disease is a disorder in which scar tissue, called plaque, forms under the skin of the penis. The plaque builds up in the thick elastic membrane called the tunica albuginea. The tunica albuginea helps keep the penis stiff during an erection. The plaque can develop anywhere along the penis.
As it develops, the plaque pulls on the surrounding tissues and causes the penis to curve or bend, usually during an erection. Curves in the penis can make erections painful and may make sexual intercourse painful, difficult, or impossible.
Peyronie’s Disease Phases
The disease occurs in two phases:
Acute Phase
During the acute phase, the plaque forms, and this phase can last up to 18 months.
- inflammation may occur and plaque forms on your penis;
- your penis starts to curve;
- your penis may hurt without an erection;
- erections may become painful when scars develop.
Chronic Phase
The chronic phase occurs after the plaque has formed. Usually, the chronic phase begins 12 to 18 months after your symptoms first appear. During this phase:
- plaque and penile curvature may stabilize and not get worse;
- the pain in your penis may lessen;
- erectile dysfunction (ED) may develop or become worse.
How common is Peyronie’s disease?
Approximately 1 in 100 men in the United States over the age of 18 have been diagnosed with Peyronie’s disease. However, based on studies of men who reported having symptoms of Peyronie’s disease, researchers estimate that the actual number of men who have Peyronie’s disease is more than 1 in 10.2,3
The chance of developing Peyronie’s disease increases with age. It is less common for men in their 20s and 30s to have Peyronie’s disease.
Who is more likely to have Peyronie’s disease?
You may be at higher risk of developing Peyronie’s disease if you:
- engage in vigorous sexual or nonsexual activities that cause micro-injuries to the penis;
- have certain connective tissue and autoimmune disorders;
- have a family history of Peyronie’s disease;
- are older;
- have diabetes and erectile dysfunction;
- have a history of prostate cancer treatment with surgery.
What are the complications of Peyronie’s disease?
Complications of Peyronie’s disease may include the inability to have sexual intercourse due to penile curvature:
- erectile dysfunction;
- emotional distress, depression, or anxiety about sexual abilities or the appearance of the penis;
- stress in a relationship with a sexual partner;
- problems fathering a child because intercourse is difficult.
What are the signs and symptoms of Peyronie’s disease?
The signs and symptoms of Peyronie’s disease may include:
- hard lumps on one or more sides of the penis;
- pain during sexual intercourse or during an erection;
- a curve in the penis with or without an erection;
- changes in the shape of the penis, such as narrowing or shortening.
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.
A urologist can usually feel plaques in the penis whether it is erect or not. If the urologist needs to examine your penis during an erection, you will receive an injectable medicine that will cause an erection. Your urologist may also ask you to take pictures of your erect penis at home to evaluate the curvature during your follow-up visits.
How to treat Peyronie’s disease?
The goal of treatment is to reduce pain, attain a straight or close-to-straight penis, as well as restore and maintain the ability to have intercourse.
If you need treatment, your urologist may recommend nonsurgical treatments or surgery depending on the severity of your symptoms, how much your penis curves, and whether your Peyronie’s disease is in the acute or chronic phase.
Your urologist will discuss your treatment options with you and review possible side effects and outcomes.
Nonsurgical Treatments
Nonsurgical treatments include injections, oral medicines, and medical therapies. They may be used when Peyronie’s disease is in the acute phase.
Collagenase. Intralesional collagenase injections (Xiaflex) are currently the only FDA-approved treatment for Peyronie’s disease. Collagenase is an enzyme that helps break down the substances that makeup plaques. Breaking down the plaques reduces penile curving and improves erectile function. This treatment is approved for men with penises curving more than 30 degrees.
Verapamil. Verapamil is used to treat high blood pressure and may reduce penis pain and curving when injected into the plaque.
Interferon-alpha. Interferon is a protein made by white blood cells. Studies show that it reduces pain, penile curving, and plaque size.
Oral medicines. There are no oral medicines that effectively treat penile curvature at this time.7 However, potassium para-aminobenzoate is used to treat Dupuytren’s contracture and may reduce plaque size. It has no effect on penile curving.
Surgery
Surgery may be recommended for men who have Peyronie’s disease when:
- symptoms have not improved;
- erections or intercourse, or both, are painful;
- the curve in the penis prevents sexual intercourse;
- medical experts recommend you don’t have surgery until your plaque and penis curving stabilize.
Can I prevent Peyronie’s disease?
Researchers do not know how to prevent Peyronie’s disease. At this time, diet and nutrition have not been found to play a role in preventing Peyronie’s disease.
If there are more questions that you’d like to ask, please contact us to get a quick reply from a doctor.