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Peyronie’s Disease Symptoms
A bend that appears only when the penis is erect is the hallmark of Peyronie’s disease. Penile curvature can point upward, downward, or to either side and may be accompanied by a “hinge” or hourglass narrowing. In some men, the curvature can make intercourse difficult or impossible.
In the acute phase, microscopic inflammation around the plaque and stretching of tissue during erection can cause penile pain ranging from discomfort to sharp pain. Pain usually lessens as the disease enters the chronic phase.
Men may notice difficulty achieving or maintaining an erection for several reasons: reduced elasticity from the plaque, impaired blood flow in nearby blood vessels, or performance anxiety due to curvature.
As the plaque matures, the scarred area becomes less elastic. During an erection, the healthy side expands while the scarred side resists, which can result in visibly shortened erect penis.
Causes of Peyronie’s Disease
The exact cause of Peyronie’s Disease is unknown. Most evidence points to micro-trauma (often unrecognized) to the tunica albuginea during sexual intercourse.
In men with a genetic predisposition or certain connective tissue disorders, normal healing may be altered: excess collagen is laid down, scar tissue forms, and a firm plaque develops. Less commonly, a single significant penile trauma can trigger the same abnormal healing response.
Peyronie’s Disease Risk Factors
More common in men over 50, as tissue elasticity naturally declines and healing responses change.
Genetic predisposition to connective tissue disorders.
Conditions like Dupuytren’s contracture are associated with a higher risk.
A specific injury or repeated bending of the penis, often resulting from intercourse, can initiate the abnormal healing cascade that leads to plaque formation.
Peyronie’s Disease Investigations
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Your urologist will review symptom onset, changes in curvature, pain, and erectile quality. A careful physical exam may identify a palpable plaque, measure curvature, and assess any hourglass deformity or hinge effect.
Ultrasound helps visualize the plaque, its size and location, and whether it contains calcification.
Photographs: Taken during erection to document the degree of curvature. These are often patient-taken photos at home following simple instructions from the urologist.
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Peyronie’s Disease Treatment & Management Options
Oral Medications: Some oral medications may be considered in selected cases, especially early on
Intralesional Injections: Verapamil, collagenase clostridium histolyticum to break down scar tissue. These injections are given directly into the plaque over multiple sessions in the clinic.
Surgery to straighten the penis by suturing the longer side to match the shorter, scarred side. This can slightly shorten the penis but is effective for many men with good erections.
For more complex deformities (severe curvature, indentation, or hinge), the plaque is incised or partially removed and a graft is placed to restore symmetry. This option is usually for more severe cases and has a higher risk of affecting erectile function, so careful selection is important.
For men with severe curvature and erectile dysfunction, implants can correct curvature and restore erectile function. Usually considered when medications and less invasive treatments have not worked and erectile dysfunction is significant.
A medical traction device gently stretches the penis for set periods each day. With consistent use, traction can reduce curvature. Traction requires daily use over months and results are gradual; your urologist can advise if it’s suitable for you.
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