Peyronie’s Disease (Penile Curvature)

Peyronie’s can make intercourse difficult or impossible. Our compassionate experts offer a full range of treatments to relieve your pain, reduce curvature, and improve erection quality.

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Changes to your penis caused by Peyronie’s disease can have an impact on how you feel about yourself and on your relationship with your partner. Peyronie’s causes pain during erections for many men, along with curvature or other changes in the appearance of the penis.

If you have these symptoms, you may feel anxiety during intimacy, or you may choose to avoid intimacy completely. You may also feel self-conscious about discussing your symptoms. That can lead to frustration and misunderstandings that disrupt your life and your partner’s life and leave you feeling isolated.

The Peyronie’s disease experts at University of Iowa Health Care are fellowship-trained urologists who understand those physical and emotional challenges. They will listen to your concerns and provide you with a personalized care plan to relieve your pain and manage the symptoms of Peyronie’s disease.

Your care team can offer you treatments not available anywhere else in the state, including the latest in minimally invasive surgical options that can help you recover faster so that you can get back to your life.

Symptoms of Peyronie’s disease

Peyronie’s disease causes scar tissue, sometimes called plaque, to form in the penis. That scar tissue forces the penis to bend, leading to changes in the curvature or shape of the penis and, in many cases, causing pain.

Symptoms associated with Peyronie’s disease include:

Hard lumps along the shaft of the penis where the scar tissue has formed
A bend in the erect penis near where the hardened scar tissue can be felt
Changes in penis shape, including narrowing or shortening of the penis
Painful erections
Changes in erection quality
Pain during sex
Erectile dysfunction

Symptoms may develop slowly over time or appear quickly. Talk to your provider if you notice any changes in the shape of your penis or your erections.

Causes of Peyronie’s disease

The reason people get Peyronie’s disease is rarely clear. Some people wonder if they did something wrong that caused the pain or the changes in appearance, but this is very unlikely.

Peyronie’s affects how the tissue in the penis heals after it has been wounded. A wound, also called trauma, could be from a major injury, such as a penile fracture, or it could be from microtraumas during vigorous activities such as sex or sports. These microtraumas usually happen without you noticing.

Not all penile injuries lead to Peyronie’s disease. Your health, genetics, and environment may also play a role in whether you develop Peyronie’s disease.

Who is most at risk for Peyronie’s disease?

You have a higher risk of developing Peyronie’s disease if you:

Are over age 40
Have a family history of Peyronie’s disease
Have a connective tissue disorder, such as Dupuytren contracture
Have an autoimmune disease, such as lupus
Have had surgical treatment for prostate cancer
Have erectile dysfunction caused by diabetes
Engage in vigorous activities, such as sex or sports

How is Peyronie’s disease diagnosed?

Early intervention can help reduce the impact of Peyronie’s disease, so it is important to speak to your provider when you first notice symptoms.

Peyronie’s can usually be diagnosed with a physical examination and a review of your medical history and symptoms. You may also need a penile ultrasound to look at the scar tissue or, if you’re considering surgical options, to examine the curvature of your penis when it is erect.

Phases of Peyronie’s disease

Peyronie’s disease occurs in two phases:

Acute: This is when the curvature of the penis begins to occur as scar tissue begins to develop. At this stage, you may notice pain in your penis with or without an erection. This phase can last up to 18 months.
Chronic: During this phase, the scar tissue begins to stabilize, and the curvature may not get worse. Penile pain may lessen, but erectile dysfunction may develop or become worse. This phase begins after the acute phase, roughly 12 to 18 months after symptoms begin.

Peyronie’s disease treatments

Treatment often depends on the severity of your symptoms. Your provider will work with you to determine which treatment or combination of treatments can best help alleviate your symptoms.

Injections

Injections can help manage symptoms, reduce curvature, and improve erection quality. These include:

Collagenase injections (Xiaflex®): If your penis curves at a 30-degree angle or more, your provider may recommend collagenase injections. Collagenase is an enzyme that can help break down scar tissue. This treatment can reduce curving and improve your erectile function.
Verapamil injections (Isoptin®): Verapamil injections are most often used to treat high blood pressure, but they may also help reduce collagen deposition and reduce curvature.

Procedures

Several available procedures can help reduce curvature and improve erection quality. These include:

Penile plication: During this minimally invasive procedure, a small incision is made along the side of the penis. The surgeon will then tighten the curvature with stitches to help straighten the penis.
Excision and grafting: During this procedure, the scar tissue is cut, and a piece of tissue is then sewn (or grafted) into place. While this helps correct the curvature, it also creates a higher risk of erectile dysfunction.
Penile prosthesis: If you have penile curvature and erectile dysfunction, your provider may recommend an implant. This device can help straighten the penis during an erection, allowing for strong, rigid erections for as long as desired. During this minimally invasive procedure, the surgeon will make a small incision near the penis and implant a concealed inflatable device into your penis.

Depending on the type of procedure, you may be able to go home from the hospital the same day or the day after. You will most likely need to take a few days off to rest, and you may need to wait several weeks before engaging in sexual activity. Your surgeon will provide more detailed recovery instructions.