Peyronie's Disease

Symptoms of Peyronie’s Disease

Peyronie’s disease can cause erectile dysfunction, and in some cases, the condition may make it painful to have sex. Other symptoms include scar tissue which may feel like flat lumps or a band of hard tissue under the skin of the penis. The condition may come on slowly over time or suddenly. Experts believe Peyronie’s disease is most often caused by repeated injury to the penis — typically either during sex or due to an athletic injury, although most patients can’t recall a specific event that caused the injury. Those at an increased risk for Peyronie’s disease include those with family history, people with connective tissue disorders, or men in their 50s and 60s.

Peyronie’s disease occurs in two phases — acute and chronic. At the onset of Peyronie’s disease, you’re likely to notice the curvature, change in shape and/or pain when the penis is erect or flaccid. This is the acute phase, which normally lasts anywhere from 6 to 12 months. While the pain may subside after this point, symptoms of erectile dysfunction may occur or continue. It’s unlikely that Peyronie’s disease will ever clear up on its own without treatment. Treatment options during the acute phase usually involve anti-inflammatory medications and stretching exercises.

The chronic phase of Peyronie's disease is characterized by stabilization of the plaques within the penis, meaning the curvature stops changing, the pain can resolve, and the decrease in erectile function usually stabilizes. The good news is that it usually does not reactivate in the absence of additional trauma. This is the time when most treatment options become available.

Seeing a urologist early for Peyronie’s disease is very important — not only because it improves the chances of effective treatment, but because it will also prevent the condition from worsening.

Treatment Options for Peyronie’s Disease

WakeMed Physician Practices – Urology provides a wide range of treatment options for men with Peyronie’s disease — ranging from medical therapies or devices to surgical procedures. What works for each patient will vary based on the stage (acute or chronic), location of the scar tissue, how severe the symptoms are, and other considerations that your urologist will review with you.

• Medication therapies such as collagenase (Xiaflex) is the only FDA-approved medication for Peyronie’s disease and in used in men with moderate to severe curvature. Other options include verapamil, which is a blood pressure medication that disrupts collagen production; or interferon, a drug that helps stop the production of fibrous tissue and helps break it down.
• Penile traction therapy is generally recommended during the early stage (acute) of Peyronie’s disease, but may be used in the chronic stage alongside other therapies. It’s performed using a mechanical device that involves stretching the penis. It reduces the curvature/deformity and improves penile length.
• Surgical options include a suturing (plicating) procedure designed to help straighten the penis; or a grafting procedure that allows the sheath of the penis to stretch out and the penis to straighten.
• Also a surgical procedure, the placement of penile implants, which are typically used to treat erectile dysfunction, can also help improve symptoms of Peyronie’s disease. Not only do the implants help correct the curvature by up to 20-30 degrees when placed, the straightening helps increase penile length, and symptoms of erectile dysfunction are generally resolved. Similar to the implants offered for erectile dysfunction, there are numerous types including semi-rigid and inflatable options. Penile implants for Peyronie’s disease have shown very positive results for many patients.

To determine the best course of treatment for Peyronie’s disease, consult a board-certified urologist who can help explain your options and the pros and cons of each.