What is Peyronie disease?

Peyronie disease causes hard, flat plaque to form under the skin on the tissue of the penis. The plaque often starts as an inflammation that may turn into scar tissue.

The plaque builds up inside the penis in the thick elastic membrane called the tunica albuginea. This membrane helps keep the penis stiff during an erection. Peyronie disease can cause pain and a sharp curve in the penis during erections.

Peyronie disease occurs in two phases.

Acute phase

During the acute phase, the plaque forms. This phase can last up to 18 months. During this phase:

• Inflammation may occur, and plaque forms in 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 starts 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 decrease.

• Erectile dysfunction may develop or become worse.

What causes Peyronie disease?

Some researchers believe that Peyronie disease develops after an injury that causes bleeding inside the penis. This could explain cases of Peyronie that develop quickly. But it doesn't explain why most cases develop slowly or what causes the disease after no clear injury.

Most researchers believe that genetics or the environment may play a role. People with certain connective tissue disorders and those who have a close family member with Peyronie disease are at greater risk. And certain health conditions, such as diabetes or tobacco use, may also contribute to its development. 

Men in their 60s are most often affected by Peyronie disease. If the disease heals in a year or so, the plaque often doesn't get worse. But when the disease lasts for years, the plaque often becomes a tough, fibrous tissue, and calcium deposits may form.

The plaque in Peyronie disease is not cancer.

What are the symptoms of Peyronie disease?

The most common symptoms of Peyronie disease include:

• Changes in the way an erection looks, such as:

  • Plaque on the top of the shaft, causing the penis to bend upward when erect. This is the most common symptom.

  • Plaque on the side, causing the penis to bend to the side of the plaque. 

  • Plaque on the underside, causing the penis to bend downward during erection.

  • Plaque on both the top and bottom, or that wraps around the penis. This can cause deformity, indentation, and shortening of the penis.

• Painful erections.

• Trouble with sexual penetration.

Pain, bending, and emotional distress can greatly affect the person’s sex life.

The symptoms of Peyronie disease may look like other conditions or health problems. Always talk with a doctor for a diagnosis.

How is Peyronie disease diagnosed?

Your doctor will review your health and sexual history. The doctor will also do a physical exam, during which the plaque can often be felt. You may also have an ultrasound of the penis. This uses high-frequency sound waves to create pictures of the inside of the penis and check blood flow.

To check how the penis looks during an erection, your doctor may inject medicine into your penis to cause an erection in the clinic.

How is Peyronie disease treated?

The goal of treatment is to reduce pain and keep you sexually active. There is no cure. Education about the disease and its usual course is often included in the treatment plan. If your penis curvature isn’t severe or painful and isn’t interfering with sex, treatment isn't needed. Peyronie disease often happens in a mild form that heals on its own in 6 to 15 months. Treatment may include:

• Vitamin E. Small studies have reported improvements with vitamin E taken by mouth (oral). But larger studies have not been done to prove that this treatment works. Still, this is an easy, low-cost treatment choice.

• Medicines. Non-steroidal anti-inflammatory agents are used to help manage pain during the active period. There are no oral medicines that work well to treat Peyronie disease.

• Shots (injections) of medicines into the plaques. Injections of various medicines into the plaques have been tried in a small number of people. Injectable treatments involve a series of penile injections that break down the buildup of collagen.

• Surgery. This treatment may be used to correct the plaque in severe cases. This includes when the person has pain during an erection. Or it may be done when they can’t keep an erection long enough to have sex. In severe cases, you may need a penile implant to straighten the penis.

Talk with your doctor about any questions or concerns you may have about this condition.

Living with Peyronie disease

Peyronie disease affects each person differently. It can be very frustrating and affect your self-confidence in sexual relationships. It's not uncommon for those with Peyronie disease to have depression or relationship problems. 

You and your partner should learn as much as you can about the disease

Key points about Peyronie disease

• Peyronie disease causes hard, flat plaque to form beneath the skin on the tissue of the penis. It can cause pain and a sharp curve in the penis during erections.

• Some researchers believe that Peyronie disease develops after injury that causes bleeding inside the penis. But most cases develop slowly, after no clear injury.

• Peyronie disease causes changes in the way an erection looks, pain when the penis is erect, and trouble with sexual penetration.

• A physical exam (during which the plaque can often be felt) may be all that’s needed to diagnose Peyronie disease.

• The goal of treatment is to reduce pain and maintain sexual activity. In some cases, treatment isn't needed. Peyronie disease often happens in a mild form that heals on its own in 6 to 15 months.

• There is no cure for Peyronie disease. A wide variety of medicines may be tried. Most are taken by mouth, but some are injected into the plaque. In severe cases, surgery may be used to remove the plaque.

Next steps

Here are some tips to help you get the most from a visit to your doctor:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down the questions you want answered.

• Bring someone with you to help you ask questions and remember what your doctor tells you.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your doctor gives you.

• Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you don't take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your doctor if you have questions, especially after office hours or on weekends.