Peyronie’s Disease

What is Peyronie’s disease?

Peyronie’s disease is the buildup of fibrous scar tissue in the penis, causing it to curve. The curve can be slight to severe. A severe curve can cause erections to be painful or erections that aren’t hard enough for sex. At its worse, Peyronie’s disease can cause impotence.

Symptoms of Peyronie’s disease

The primary symptom of Peyronie’s disease is a curved penis. Your penis could be curved up, down, or to either side. While you may not notice it, another symptom is the scar tissue that causes Peyronie’s disease. You can feel this scar tissue just under the skin of your penis. It feels like a ridge or a row of tiny bumps. Another symptom can be erectile dysfunction (difficulty getting or maintaining an erection). You may also notice that the scar tissue is making your penis shorter. Finally, you may have penile pain as a result of Peyronie’s disease. This pain may be in general or it may be only when you have an erection.

What causes Peyronie’s disease?

Scar tissue under the skin of the penis causes the curve. No one knows for sure why the scar tissue starts. Some men who have Peyronie’s disease have had a penis injury or radiation therapy for prostate cancer that causes scar tissue. Most of the time, though, the cause of the scar tissue isn’t known. The scar tissue can keep getting worse during the first few years, making the penis curve more and more. You might notice this more during an erection. After a few years, the scar tissue usually stops getting worse. Sometimes it even gets better. But in most cases, it doesn’t completely go away.

How is Peyronie’s disease diagnosed?

Your doctor will most likely perform a physical exam. During the exam, they will inspect and feel your penis, looking for scar tissue. This is usually enough for a diagnosis. Sometimes, your doctor will also order an ultrasound to look for scar tissue. If so, you’ll receive an injection that will make you penis erect before the ultrasound.

Can Peyronie’s disease be prevented or avoided?

Since doctors aren’t sure what causes the scar tissue related to Peyronie’s Disease, there is no way to prevent it or avoid it. You may be more at risk for the disease if your father or brother has it. This means that it could run in families. It also becomes more common as you get older. You also have a higher chance of developing this disease if you have a connective tissue disorder.

Peyronie’s disease treatment

There is no cure for Peyronie’s disease. Your treatment plan will depend on your symptoms. If your penis curvature isn’t severe or painful and isn’t interfering with sex, you may not need treatment.

Your doctor may prescribe a medicine that can help reduce inflammation and even curvature. Medicines like aminobenzoate potassium or vitamin E help some people. Aminobenzoate potassium is a prescription medicine. Vitamin E is available over the counter. If you take vitamin E, don’t take more than your doctor tells you. Too much vitamin E or aminobenzoate potassium can hurt your liver. Aminobenzoate potassium can also make you nauseous or take away your appetite. Other medicines your doctor may prescribe include tamoxifen, colchicine, and pentoxifylline.

Another treatment option is an intralesional injection. This means the doctor would give you a shot directly into the scar tissue. The shot may contain these drugs: verapamil, interferon, steroids, or collagenase. These may help break down the scar tissue and allow new tissue to grow. These shots are usually given over 3 months.

Discuss treatment options with your doctor. They can recommend the best treatment for your situation. However, not all treatments are guaranteed to work, and some may make the scaring worse.

Can surgery help?

Surgery might help individuals who have pain during erection or who can’t keep an erection long enough to have sex. There are several surgical procedures that can help. One option is to have a prosthesis (something to make the penis firm) put in the penis. The prosthesis helps make the penis straighter. It also helps erections last longer. Another option is to have the scar tissue removed from the penis. Your doctor can explain all surgical options and can help you decide which is best for you.

Living with Peyronie’s disease

Having Peyronie’s disease can impact your sex life and, as a result, your relationship with your partner. It can make you anxious, even irritable. You may not want to talk about it. This can create barriers in your relationship. Instead, try to be open with your partner. It may be helpful to consult with a doctor or therapist who can help initiate open communication between you and your partner.

Questions to ask your doctor

• What treatment is best for me?
• Is surgery my best option?
• How long is the recovery time after surgery?
• Will I be able to have sex without pain after treatment?
• Are there any support groups in my area?
• Are there any side effects from treatment?

Resources

National Institutes of Health, MedlinePlus: Curvature of the penis
National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases: Penile Curvature (Peyronie’s Disease)