Peyronie’s disease in men is a condition in which scar-like fibrous tissue, called plaque, develops within the tissue surrounding the erectile chambers of the penis.
This can cause the penis to curve or bend during an erection.
Some men may also notice pain, a hard lump, narrowing of the penis or changes in its length or shape. (Mitsui et al. 2023)
Quick Answer
Peyronie’s disease is a condition in which scar-like plaque develops inside the penis, causing curvature or other changes during an erection. It may also cause pain, penile shortening, indentation, erectile difficulties or problems with sexual intercourse. The condition is not cancerous, but significant symptoms can affect sexual function, confidence and quality of life.
Peyronie’s disease can develop gradually, and the curvature may become more noticeable over time.
In some men, the condition remains mild, while others may experience significant changes that interfere with sexual intercourse.
Although it is not cancerous or life-threatening, Peyronie’s disease can affect erectile function, sexual confidence and quality of life, making proper evaluation important.
Key Takeaways
- Peyronie’s disease occurs when fibrous plaque develops within the penis.
- The plaque can cause the penis to curve or bend during an erection.
- Painful erections are more common during the active phase of the condition.
- Some men experience penile shortening, indentation or an hourglass deformity.
- Peyronie’s disease can occur alongside erectile dysfunction.
- Penile trauma or repeated mechanical stress may contribute in susceptible men.
- The condition is not cancerous or life-threatening.
- Mild cases may only require monitoring if sexual function is satisfactory.
- Treatment options can include injections, traction therapy and surgery in selected cases.
- A urologist can help determine the severity of the condition and the most appropriate treatment.
What Is Peyronie’s Disease?
Peyronie’s disease is an acquired fibrotic disorder of the penis.
The plaque develops in the tunica albuginea, a strong layer of tissue surrounding the erectile bodies.
Because scar tissue does not stretch in the same way as healthy tissue, it can cause the penis to bend when it becomes erect. (Feyisetan et al. 2023)
The degree of curvature can range from barely noticeable to severe enough to make sexual intercourse difficult.
What Does Peyronie’s Disease Look Like?
The most noticeable sign is usually a change in the shape of the erect penis.
A man may notice:
- Upward, downward or sideways curvature
- A hard lump or plaque beneath the penile skin
- A narrowing or indentation in the shaft
- A shorter-looking penis
- Pain during erections
- Difficulty achieving or maintaining an erection
The appearance can vary significantly between individuals.
Some men have a relatively small plaque with little change in sexual function, while others develop substantial curvature or deformity.
Does Peyronie’s Disease Cause Pain?
It can.
Pain is more commonly associated with the active or earlier phase of the condition.
The discomfort may occur when the penis becomes erect and can range from mild tenderness to more noticeable pain.
As the disease stabilizes, pain may decrease even if the curvature or plaque remains.
What Causes Peyronie’s Disease?
The exact cause is not completely understood.
One leading explanation involves repeated minor injury or mechanical stress to the penis, followed by an abnormal healing response that results in fibrosis and plaque formation.
However, Peyronie’s disease is considered multifactorial, with genetic susceptibility, tissue-healing mechanisms and other biological factors also potentially contributing. (Mitsui et al. 2023)
This means that simply having an injury does not automatically mean a man will develop Peyronie’s disease.
Can Injury During Sex Cause Peyronie’s Disease?
Penile trauma or repeated mechanical stress may contribute to the development of Peyronie’s disease in susceptible men.
An injury does not always need to be dramatic.
Repeated minor trauma may also be relevant.
However, the relationship between trauma and Peyronie’s disease is complex, and many men develop the condition without remembering a specific injury.
Is Peyronie’s Disease More Common as Men Get Older?
Yes.
Peyronie’s disease can occur at different ages, but it is more frequently recognized in middle-aged and older men.
The condition may also occur alongside other health problems associated with ageing, including erectile dysfunction and metabolic conditions.
Importantly, Peyronie’s disease is not simply a normal part of ageing and should be evaluated when significant penile changes develop.
Can Diabetes Increase the Risk?
Diabetes is one of the medical conditions associated with Peyronie’s disease.
Research suggests that diabetes and its associated metabolic changes may contribute to the development of fibrosis, while erectile dysfunction is also commonly associated with Peyronie’s disease. (Gianazza et al. 2023)
This does not mean that every man with diabetes will develop Peyronie’s disease.
Can Peyronie’s Disease Cause Erectile Dysfunction?
Yes.
The curvature or deformity itself can make intercourse difficult, while changes in penile tissue and blood-flow mechanics may also contribute to erectile difficulties.
Some men may therefore experience both penile curvature and erectile dysfunction.
The combination can have a greater impact on sexual confidence and quality of life than either problem alone.
Is Peyronie’s Disease Dangerous?
Peyronie’s disease is generally considered a benign condition, meaning it is not itself a cancer.
However, it can significantly affect sexual function, body image, confidence and relationships.
The severity varies widely, so the impact on an individual man’s life is an important part of deciding whether treatment is needed.
When Should You See a Doctor?
Consider seeing a urologist if you notice:
- A new penile curve
- A hard lump or plaque
- Painful erections
- Progressive changes in penile shape
- Penile shortening or narrowing
- Difficulty having intercourse
- New erectile difficulties
Early assessment can help establish whether the condition is changing and whether treatment or observation is appropriate.
How Is Peyronie’s Disease Diagnosed?
Peyronie’s disease is usually diagnosed through a medical history and physical examination.
A urologist may ask when the curvature started, whether it is changing, whether erections are painful and whether the condition is affecting sexual intercourse.
The penis may also be examined for areas of hardened plaque or scar tissue. (American Urological Association (AUA) Guideline, 2015)
Does the Doctor Need to See an Erection?
Not necessarily.
However, documenting the curvature during an erection can help determine its direction and severity.
A doctor may ask a patient to provide photographs of the erect penis taken from different angles.
This can be useful when planning treatment.
Can Ultrasound Detect Peyronie’s Disease?
Yes.
Penile duplex ultrasound can help identify plaques and assess blood flow, particularly when erectile dysfunction is also present.
However, ultrasound is not required for every man.
The need for imaging depends on the examination and the specific symptoms.
What Is the Difference Between Peyronie’s Disease and a Naturally Curved Penis?
A naturally curved penis is generally present from an earlier stage of life and tends to remain relatively stable.
Peyronie’s disease is acquired, meaning the curvature develops after the penis previously had a different or relatively straight shape.
A new or progressively worsening curve during adulthood should therefore be evaluated.
Does Peyronie’s Disease Get Worse Over Time?
It can.
Peyronie’s disease commonly has an active phase, during which pain, plaque formation or curvature can change.
Eventually, the condition may stabilize.
Pain often decreases during this stage, although the curvature may remain.
The timing of progression and stabilization varies considerably between individuals. (American Urological Association (AUA) Guideline, 2015)
Can Peyronie’s Disease Improve Without Treatment?
Yes, some men experience improvement or stabilization without active treatment.
Pain may decrease as the condition moves beyond its active phase.
However, a reduction in pain does not necessarily mean that the curvature will completely disappear.
Men with significant deformity or difficulty during intercourse should discuss their options with a urologist.
What Are the Treatment Options for Peyronie’s Disease?
Treatment depends on the severity of curvature, pain, erectile function and how much the condition affects sexual activity.
Not every man needs immediate treatment.
Observation
Men with mild curvature, little or no pain and satisfactory sexual function may be monitored without active intervention.
The condition can be reassessed if the curvature or symptoms change.
Oral Medication
Several oral treatments have been investigated for Peyronie’s disease.
However, oral medications and supplements have limited evidence for reliably correcting established penile curvature.
Men should be particularly cautious about products marketed online as permanent penis-straightening treatments.
Can Injections Treat Peyronie’s Disease?
Yes.
Certain medications can be injected directly into the penile plaque in appropriately selected patients.
Collagenase clostridium histolyticum has been used for men with suitable Peyronie’s disease characteristics and can help reduce curvature in some patients. (Gelbard et al. 2013)
However, injection treatment is not suitable for every type of plaque or curvature.
Can Penile Traction Devices Help?
Penile traction therapy may be an option for selected men.
These devices apply controlled stretching forces over time, with the goal of improving penile length and potentially reducing curvature.
Evidence suggests that traction can provide improvements in penile curvature and length in some men, although results vary and consistent use is generally required. (American Urological Association (AUA) Guideline, 2015)
A urologist should determine whether a particular device and treatment approach are appropriate.
Can Surgery Correct Peyronie’s Disease?
Yes.
Surgery may be considered when the curvature is stable and severe enough to interfere with sexual intercourse.
The surgical technique depends on the degree of curvature, penile length, erectile function and the type of deformity.
Plication Surgery
Plication shortens the longer side of the penis to straighten the curve.
It is generally considered for men with adequate penile length and satisfactory erectile function.
Plaque Incision or Excision With Grafting
In selected men with more complex or severe curvature, the plaque may be incised and a graft placed to help restore a straighter shape.
This approach is more extensive and may carry a greater risk of postoperative erectile difficulties.
Penile Prosthesis
Men with Peyronie’s disease and significant erectile dysfunction that does not respond adequately to other treatments may be candidates for a penile prosthesis.
This can address erectile dysfunction while also helping correct penile deformity in appropriately selected patients.
Can Peyronie’s Disease Affect Sexual Confidence?
Yes.
Peyronie’s disease can affect more than the physical shape of the penis.
Changes in appearance, pain during erections and difficulty with intercourse can contribute to embarrassment, anxiety and reduced sexual confidence.
Some men may also avoid sexual activity because they are worried about pain or how their partner will react.
Can Peyronie’s Disease Cause Erectile Dysfunction?
Yes.
Peyronie’s disease and erectile dysfunction can occur together.
Penile deformity may make intercourse difficult, while changes in penile tissue and blood-flow mechanics may also contribute to erection problems.
When both conditions are present, treatment planning becomes more individualized because improving the curvature alone may not fully address sexual difficulties.
Can Peyronie’s Disease Shorten the Penis?
It can.
Some men notice a reduction in apparent penile length after Peyronie’s disease develops.
This can occur because the scar tissue restricts normal expansion of the affected side of the penis during an erection.
Penile shortening can be particularly distressing when it occurs alongside curvature or narrowing.
Can Peyronie’s Disease Cause an Hourglass Shape?
Yes.
Some men develop a waisting or hourglass deformity, in which one portion of the penile shaft becomes narrower during an erection.
This is different from a simple bend and can sometimes make the penis feel less stable or affect sexual penetration.
Complex deformities such as hourglass narrowing may require more detailed assessment by a urologist.
Can Peyronie’s Disease Go Away Completely?
Sometimes symptoms improve, but complete spontaneous disappearance of established plaque and curvature is not guaranteed.
Pain often improves as the condition stabilizes, but the physical deformity may persist.
The likelihood of improvement varies between individuals, which is why monitoring and individualized assessment are important.
Does Peyronie’s Disease Increase the Risk of Other Health Problems?
Peyronie’s disease has been associated with several conditions involving connective-tissue fibrosis.
For example, men with Peyronie’s disease may also develop Dupuytren’s contracture, a condition in which thickened tissue in the palm causes the fingers to bend toward the hand.
This association suggests that abnormal fibrotic processes may contribute to both conditions. (Bjekic et al. 2006)
Did You Know?
Peyronie’s disease does not always cause a simple bend. Some men develop indentation, narrowing or an hourglass-shaped deformity instead. These changes can affect penile rigidity and sexual function even when the overall degree of curvature appears modest.
Lesser-Known Fact: Peyronie’s Disease Can Affect More Than Curvature
One lesser-known feature is that Peyronie’s disease does not always produce a simple bend.
Some men develop indentation, narrowing, hourglass deformity or changes in penile length.
These changes can be important because the severity of Peyronie’s disease is not determined solely by the angle of curvature.
Is Surgery Always Necessary?
No.
Surgery is generally reserved for men with a stable deformity that significantly interferes with sexual intercourse or causes substantial functional problems.
Men with mild curvature and satisfactory sexual function may not need surgery at all.
The decision depends on the severity of the deformity, erectile function, penile length, sexual goals and the individual’s preferences.
Can Peyronie’s Disease Be Prevented?
There is no guaranteed way to prevent Peyronie’s disease.
Because repeated penile trauma may contribute to the abnormal healing process in susceptible men, avoiding unnecessary force or injury during sexual activity may be sensible.
However, many men develop Peyronie’s disease without remembering a specific injury, so prevention is not always possible.
When Should You See a Urologist?
You should consider a urological evaluation if you notice:
- A new penile curve
- A hard plaque or lump
- Painful erections
- Progressive curvature
- Penile shortening
- Hourglass narrowing
- Difficulty with penetration
- New erectile difficulties
- Significant distress about the changes
Early assessment can establish the severity of the condition and help determine whether observation or treatment is appropriate.
Conclusion
Peyronie’s disease is a benign but potentially disruptive condition that can change the shape, length and function of the penis.
The condition may cause curvature, pain, indentation, hourglass deformity or erectile difficulties, and its impact can extend to sexual confidence and relationships.
Not every man needs treatment.
Men with mild symptoms and satisfactory sexual function may simply require monitoring, while more significant curvature or erectile problems may require medical or surgical treatment.
The important thing is not to self-diagnose or rely on unproven penis-straightening products.
A urologist can assess the plaque, curvature, erectile function and overall sexual impact and then discuss the most appropriate options.
Peyronie’s disease is treatable and manageable, and seeking professional evaluation can help prevent the condition from unnecessarily affecting sexual health and quality of life.
Peyronie’s Disease: Myth vs Fact
| Myth | Fact |
|---|---|
| Peyronie’s disease is a type of penile cancer. | Peyronie’s disease is a benign fibrotic condition and is not itself cancer. |
| A curved penis always means Peyronie’s disease. | Some men naturally have a stable penile curvature. Peyronie’s disease is an acquired condition that develops later. |
| Peyronie’s disease always causes severe pain. | Pain varies considerably. Some men have little or no pain. |
| Peyronie’s disease only causes penile curvature. | It can also cause shortening, indentation, hourglass deformity, pain and erectile difficulties. |
| Peyronie’s disease always requires surgery. | Many men do not require surgery. Observation and non-surgical treatments may be appropriate depending on symptoms. |
| Peyronie’s disease means a man cannot have sex. | Many men with Peyronie’s disease remain sexually active, although severe curvature can sometimes make intercourse difficult. |
| Peyronie’s disease only affects older men. | It is more commonly recognized with increasing age but can occur in younger men as well. |
| Pain disappearing means the curvature has disappeared. | Pain may improve as the condition stabilizes while the penile curvature remains. |
| Online penis-straightening products can cure Peyronie’s disease. | Unproven supplements and products should not be relied upon to reverse established Peyronie’s plaque. |
Frequently Asked Questions About Peyronie’s Disease
1. What is Peyronie’s disease?
Peyronie’s disease is a condition in which fibrous plaque develops inside the penis and can cause curvature, pain or other changes during an erection.
2. What causes Peyronie’s disease?
The exact cause is not fully understood. Penile trauma or repeated mechanical stress may contribute to an abnormal healing response in susceptible men.
3. Is Peyronie’s disease painful?
It can be. Pain is more commonly experienced during the active phase and may occur when the penis becomes erect.
4. Can Peyronie’s disease cause erectile dysfunction?
Yes. Peyronie’s disease can occur alongside erectile dysfunction, and penile deformity may also make sexual intercourse more difficult.
5. Can Peyronie’s disease shorten the penis?
Yes. Some men notice a reduction in apparent penile length after developing Peyronie’s disease.
6. Can Peyronie’s disease go away on its own?
Symptoms may stabilize or improve in some men, particularly pain. However, established curvature may remain and should be assessed if it affects sexual function.
7. Can Peyronie’s disease be treated without surgery?
Yes. Depending on the condition, options may include observation, penile traction or injectable treatments. Surgery is reserved for selected cases.
8. Can traction devices help Peyronie’s disease?
Penile traction therapy may help improve curvature or penile length in some men, although results vary and consistent use is generally required.
9. Does Peyronie’s disease always require surgery?
No. Surgery is generally considered when the deformity is stable and significantly interferes with sexual intercourse or causes substantial functional problems.
10. When should I see a doctor for Peyronie’s disease?
Consider seeing a urologist if you develop a new penile curve, hard plaque, painful erections, progressive deformity, penile shortening or difficulty with sexual intercourse.
Final Thoughts
Peyronie’s disease can change the shape and function of the penis, but it is a manageable medical condition. Mild cases may only require monitoring, while significant curvature, pain or erectile difficulties may benefit from treatment.
If you notice a new or worsening penile curve, a hard plaque, painful erections or difficulty during intercourse, speaking with a urologist can help identify the condition and determine the most appropriate treatment.
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Medical Disclaimer!
This article has been reviewed and written under the guidance of our Head Physiotherapist, Dr. Kruti Raj (PT, MUHS,CPT,CMPT). The information shared is intended for educational purposes only and should not be considered a substitute for personalized medical advice, diagnosis, or treatment.
Please consult us or any other qualified healthcare professional before beginning any exercise program, especially if you are experiencing pain, recovering from injury, or managing a medical condition.
