Peyronie's Disease

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Topic Overview

What is Peyronie's disease?

Peyronie's disease is an abnormal curvature of the penis caused by scar tissue in the erectile tissue. Because the scar tissue prevents straightening of the penis, the curvature is most obvious during an erection. The curvature may be so severe that it prevents penetration during intercourse.

Peyronie's disease usually affects men who are 50 and older.

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 (such as being bent or hit).

Peyronie's disease is not caused by cancer and does not increase the risk of cancer. It is not caused by sexually transmitted infections (STIs).

What are the symptoms?

Symptoms of Peyronie's disease may develop slowly or suddenly. Common symptoms include:

• A lump or thickening along the shaft of the penis that is most noticeable when the penis is soft (flaccid).
• A bent or curved appearance of the penis that is most noticeable when the penis is erect.
• A painful erection. Some men do not have pain with an erection but have tenderness when the lump along the side of the penis is touched.
• An inability to keep an erection.
• An inability to achieve penetration during intercourse.

What are the stages of Peyronie's disease?

Peyronie's disease is usually divided into two stages:

• The active phase. The most common symptoms of this phase are painful erections and a change in the curvature of the penis.
• The secondary phase. Stable curvature may be the only symptom of this phase. Pain, if present during the active phase, usually gets better or goes away completely.

How is Peyronie's disease diagnosed?

Peyronie's disease is usually diagnosed using a medical history and physical exam. Your doctor will ask you questions about when you first noticed your symptoms and whether the symptoms were gradual or sudden. This will help determine which stage of Peyronie's disease you are experiencing.

Because symptoms of Peyronie's disease are usually most noticeable when the penis is erect, your doctor may ask you to take a photograph of your penis while it is erect. Other tests that may be ordered include:

• An X-ray or ultrasound, to produce a picture of the structures within the penis.
• Doppler flow studies, which use sound waves to monitor blood flow patterns. It is important for your doctor to find out whether blood flow to the end of your penis is interrupted or decreased during erection.

How is it treated?

Peyronie's disease rarely gets better on its own. But treatment usually is not needed unless Peyronie's disease causes pain or interferes with sexual function.

Most men are able to remain sexually active. Counseling can help couples maintain an active sexual life.

Although there is no standard treatment for Peyronie's disease, vitamin E or medicines such as carnitine, colchicine, or verapamil may help treat pain and reduce curvature during an erection. But the use of medicines has shown only limited success, and none are well studied for the treatment of Peyronie's disease.¹

Surgery is considered for men who have severe pain, a severely curved penis, or sexual dysfunction related to Peyronie's disease. Surgical options include removing the scar tissue or shortening the unaffected side of the penis (plication). In some cases, use of a penile prosthesis may be used to help keep an erection during intercourse.