- Things to Know
- 2 Phases
Things to know about Peyronie's disease
- Peyronie's disease is the development of scar tissue inside the penis that results in an abnormal curvature of the penis.
- The exact cause of Peyronie's disease is not known; however, research has suggested these agents as possible causes of plaque or scar formation in the penile shaft.
- Some of the symptoms of Peyronie's disease include:
- Pain during erections and/or during sex
- Erectile dysfunction
- Anxiety or stress
- The inability to have intercourse
- Peyronie's disease is diagnosed by physical examination of the penis that shows abnormal curvature and plaque/scar formation that may be palpated.
- There is no cure for Peyronie's disease; however, symptoms can be treated with vitamins, supplements, and other medications.
- Complications of the disease include pain with intercourse, inability to have intercourse, erectile dysfunction, depression, and permanent abnormal angulation of the penis.
- The prognosis of Peyronie's disease varies from good to poor, depending on the individual's response to treatments.
What is Peyronie's disease?
Peyronie's disease (also termed Peyronie disease) is the development of scar tissue inside the penis that causes the penis to develop abnormal curvature (contracture) in the scarred area. The disease may occur in about 1% to 8% of men, most frequently in men aged about 40 to 70 years old. The disease also may occur more frequently in men who develop:
Occasionally, the disease can occur in younger men.
What are the symptoms of Peyronie's disease?
The symptoms of Peyronie's disease usually are a combination of one or more symptoms as follows:
- Unusual angulation of the penile shaft (either when flaccid or erect or both)
- Pain during erections and/or during sex
- Scarring or plaque palpated at the abnormal bend or angle of the penis
- An indentation of the penis shaft at the site of the plaque or scarring
- Erectile dysfunction
- Inability to have intercourse
What causes Peyronie's disease?
The exact cause of Peyronie's disease is not known. However, whatever can cause plaque or scar formation in the penile shaft is a likely causal candidate.
- Researchers have suggested several possible agents such as vitamin E deficiency, beta-blocking medications, elevations in serotonin, and genetic causes.
- Some researchers think that minor vascular traumas to the penis (during sex, athletic, or exercise endeavors) that occur repeatedly over time may lead to scar formation.
- None of these possible agents or processes is proven to be the cause to date.
What are the two phases of Peyronie's disease?
There are, in general, two phases of Peyronie's disease.
- The acute phase lasts about 18 to 24 months and usually has the highest pain component.
- The chronic phase (which begins about 18 to 24 months after the first symptoms) usually has less pain but in this stage, the plaque or scarring is more refractory to treatment (see below) and may begin to develop large calcium deposits (calcified plaque or scarring).
What procedures and tests diagnose Peyronie's disease?
The patient's history of pain with erections and/or sex and the physical examination of the penis that shows abnormal angulation of the penile shaft or the presence of plaque or scarring felt or palpated in the penis is usually the basis for diagnosis.
- Urologists are specialists who usually diagnose and treat this disease.
- There are no definitive blood tests for this disease, although a human cell antigen, HLA-B7 has been associated with the disease.
- In general, no additional tests are necessary, but ultrasound techniques, when accompanied by an injection of the drug into the penis (intercavernous injection) can help show the doctor where and how extensive is the scarring and aid the doctor in determining treatments.
What is the treatment for Peyronie's disease?
Several types of treatments are designed to reduce the symptoms of Peyronie's disease.
- Chinese Company May Help Ease U.S. Shortage of Cancer Drug
- Opdivo Could Boost Outcomes for People Battling Hodgkin Lymphoma
- More U.S. Kids, Teens Are Getting Weight-Loss Surgeries
- Could a Nitroglycerin Patch Ease Hot Flashes?
- One Form of Menopause Hormone Therapy Might Raise Blood Pressure
- More Health News »
Medications, home remedies, vitamins, and supplements
In December, 2013, the FDA approved collagenase clostridium histolyticum (Xiaflex) to treat individuals with Peyronie's disease. Each treatment cycle consists of two Xiaflex injections into the plaque in the penis to break up the collagen that causes the curvature deformity. Treatments consist of a maximum four injections.
Oral therapy with vitamin E, colchicine, PABA, tamoxifen, and other medications have been tried with limited success in some patients. Usually those in the acute phase of the disease responded best.
In the early stages of the disease, erectile dysfunction (ED) may be treated with such drugs as sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis, Adcirca).
Injection therapy uses combinations of drugs mentioned above and adds prostaglandin E1 or other drugs such as betamethasone alone or with hyaluronidase; PABA has been reported to reduce the penile plaque size.
Other drugs have also been used with varying degree of success. Verapamil (Calan, Verelan, Verelan PM, Isoptin, Isoptin SR, Covera-HS [a medication usually used for high blood pressure treatment]) appears to disrupt the production of a protein involved in the formation of Peyronie's disease lesions.
Another method is iontophoresis (also termed electromotive administration or EMDA) where verapamil and other drugs are applied to the penile skin and pushed through the skin with a low electrical current.
Shockwave therapy (done with a lithotripter device like those used to break up kidney stones) has been used on plaque or scarring that is calcified. Other mechanical devices, including vacuum-based machines and low-dose radiotherapy, have been tried. Although some successes are seen with these methods, the best results are in acute phase patients.
There are ongoing studies with different drugs (for example, interferons, and collagenase) and surgical techniques.
Surgical therapy is done on some patients. These surgical patients usually have to meet criteria that may vary from surgeon to surgeon. In general, surgical therapy is done when other methods have failed or the patient is in the chronic stage of the disease and erectile dysfunction is part of the patient's symptoms.
Surgical therapy may involve
- incision or cutting the scarred tissue,
- scar tissue removal,
- scar tissue removal with auto-grafting, or
- artificial graft material.
- In addition, implanted devices (penile implants) that allow the patient to sustain an erection are also utilized in some individuals.
Subscribe to MedicineNet's General Health Newsletter
Can exercises help Peyronie's disease?
Some individuals suggest stretching and/or milking the penis are exercises that can help reduce the penile curvature that occurs in the disease. Patients should discuss these techniques with their doctor (urologist) before using these methods.
What are the complications of Peyronie's disease?
The complications of the disease are mainly the symptoms of:
- Painful intercourse
- Inability to have intercourse due to pain or erectile dysfunction
- Permanent angulation of the penis
In addition, surgical complications may include:
- Reduction in penis length
- Loss of any erectile functions
Depression and stress can become significant complications.
What is the prognosis for Peyronie's disease? Can it be cured?
The prognosis (outcome) of this disease is variable, from good to poor, depending on the response to treatment and the patient's emotional response to the symptoms and treatments. There is no treatment that will cure Peyronie's disease, but symptoms can be reduced.
Health Solutions From Our Sponsors
Health Solutions From Our Sponsors
Brant, WO, MD, et al. "Peyronie's disease: Diagnosis and medical management." UpToDate. Updated: Dec. 18, 2018.
Top Peyronie's Disease (Curvature of the Penis) Related Articles
Men's SecretsWhat do men really want you to know about them? For better intimacy, learn these 18 secrets guys wish you Knew about sex, love, and marriage.
Anxiety DisordersAnxiety is a feeling of apprehension and fear characterized by symptoms such as trouble concentrating, headaches, sleep problems, and irritability. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults. Treatment for anxiety may incorporate medications and psychotherapy.
DepressionDepression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. The principal types of depression are major depression, dysthymia, and bipolar disease (also called manic-depressive disease).
Diabetes (Type 1 and Type 2)Diabetes is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
Erectile Dysfunction (ED, Impotence)Erectile dysfunction (ED, impotence) is the failure to achieve or maintain an erection. There are many potential underlying causes of erectile dysfunction, including stress and emotional problems, brain dysfunction, problems with blood supply to the penis, and structural problems with the penis.
High Blood Pressure (Hypertension)
High blood pressure (hypertension) is a disease in which pressure within the arteries of the body is elevated. About 75 million people in the US have hypertension (1 in 3 adults), and only half of them are able to manage it. Many people do not know that they have high blood pressure because it often has no has no warning signs or symptoms.
Systolic and diastolic are the two readings in which blood pressure is measured. The American College of Cardiology released new guidelines for high blood pressure in 2017. The guidelines now state that blood normal blood pressure is 120/80 mmHg. If either one of those numbers is higher, you have high blood pressure.
The American Academy of Cardiology defines high blood pressure slightly differently. The AAC considers 130/80 mm Hg. or greater (either number) stage 1 hypertension. Stage 2 hypertension is considered 140/90 mm Hg. or greater.
If you have high blood pressure you are at risk of developing life threatening diseases like stroke and heart attack.
REFERENCE: CDC. High Blood Pressure. Updated: Nov 13, 2017.
Impotence QuizDid you know that certain medical condition may be responsible for ED? Some causes of impotence are medically treatable and reversible. Learn more about what can be done about erectile dysfunction with the Impotence Quiz.
Impotence SlideshowHaving erection problems? What is erectile dysfunction (ED)? Learn about erectile dysfunction causes and treatments such as drugs (pills), pumps, and more.
Is Your Penis NormalCan a man break his penis? Take this quiz to learn myths about size, common conditions, general facts, and other things you should know!
Penile Implantsenile implants can help you get an erection if you suffer from erectile dysfunction (ED). Penile implants may either be malleable or inflatable. Potential risks of surgery include bleeding, infection, scar tissue formation, and mechanical failure. Check out the center below for more medical references on ED, including multimedia (slideshows, images, and quizzes), related diseases, treatment, diagnosis, medications, and prevention or wellness.
Penis PictureThe penis is the male sex organ, reaching its full size during puberty. See a picture of the Penis and learn more about the health topic.
Radiation TherapyRadiation therapy is a cancer-fighting technique. In radiation therapy, a radiation oncologist uses high-energy rays to kill cancer cells and stop them from growing and dividing. The two types of radiation therapy are external and internal. Potential side effects of radiation therapy include:
- skin redness,
- permanent pigmentation,
- diarrhea, and
- a reduction in white blood cells.
Sex & Love QuizRelationships, sex, and love! Could it be that what motivates physical attraction in us may be all in our minds? Take the Sex & Love Quiz to challenge yourself on healthy human sexuality!
Sex-Drive KillersNoticing a lack of intimacy with your partner? Here we explore how stress, lack of sleep, weight gain, depression and low T can cause low sex drive in men and women.
Sexual Problems in MenMale sexual dysfunction can be caused by physical or psychological problems. Common sexual problems in men include erectile dysfunction (impotence or ED), premature ejaculation, and loss of libido. Treatment for sexual dysfunction in men may involve medication, hormone therapy, psychological therapy, and the use of mechanical aids.
Benefits of SexHow would you like a stronger immune system or better sleep? Action between the sheets can help you get all of this and more. Read on to discover the surprising health benefits of sex.
StressStress is a normal part of life, but chronic or severe stress can be harmful to your health. Learn what happens in your body when you are stressed and how you can manage your response.
UltrasoundUltrasound (and ultrasonography) is imaging of the body used in the medical diagnosis and screening of diseases and conditions such as:
- heart valve irregularities,
- carotid artery disease,
- heart disease,
- kidney stones,
- liver disease,
- diseases of the female reproductive, and
- diseases of the male reproductive organs.