Peyronie’s Disease Diagnosis, Symptoms & Treatment

What is Peyronie’s Disease?

Peyronie’s disease is a condition marked by penile curvature, indentation and loss of penile length upon erection. This can be with or without pain.

These deformities of the penis can appear in men of all ages but is most commonly present in men in their 50’s. Not commonly known is the fact erectile dysfunction is also found to occur in up to 90% of men with Peyronie’s disease.

The formation of scar tissue on one side of the penis shortens that respective side of the penis, resulting in a curvature i.e. if the scar tissue is on the right side of the penis, the right side will become slightly shortened creating a pull of the penis to the right.

Penis with Peyronie's versus normal full

The deformity of the penis is due to plaque formation that is, in fact, a thick inelastic scar. This thick inelastic scar can create the curvature of the penis upwards, downwards, or sideways.

So what causes Peyronie’s disease?

The cause of Peyronie’s disease is not well understood. In most cases, the disease is a result of inflammation and plaque formation after repeated trauma to the penis; most commonly occurring during sexual intercourse. However, this is not always the case.

What is the impact of having Peyronie’s disease?

Individuals with Peyronie’s disease are at risk for the following conditions:

Penile Deformity

Resulting in an indentation, narrowing, or loss of length
Can interfere with the ability to engage in sexual activity and penetration

Penile Dysfunction

Peyronie’s disease is associated with a reduction in rigidity, or hardness, of erections.
Correction of the curvature rarely leads to correction of erectile dysfunction.
If erectile dysfunction coexists with Peyronie’s disease, treatment options exist that will correct both problems
This condition has been recognised to affect a man’s psyche markedly, including causation of depression and anxiety disorders. Appropriate diagnosis and treatment requires the help of an experienced medical professional

What Treatment Options Are There For Peyronie’s Disease?

The goal of Peyronie’s disease treatment is to maintain or regain sexual function by straightening the penis. Treatment should be individualised based on a number of factors including, but not limited to, degree of penile curvature, the severity of penile shortening, the presence of penile narrowing, and whether erectile dysfunction is present. There are a number of interventions available including:

Other treatment options include:

Oral medications
Topical electric current therapy (iontophoresis)
Verapamil injections into the plaque
Mechanical stretching with vacuum devices or external penile extenders
Surgical penile reconstruction with or without grafting (iontophoresis)
Placement of penile prosthesis with straightening
Peyronie's Disease Treatment Options

Surgical Options for Peyronie’s Disease

There are three techniques to make the penis straight:

  1. Shortening the longer side of the penis to create equal length on both sides. Although shortening may occur, the amount of shortening is typically no more than 1-2 cm. This procedure is utilised for less severe cases of Peyronie’s disease.
Peyronie's Disease Treatment Options

2. Scar tissue is cut or partially removed on the shorter side. After removal of this tissue, the defect is filled with a graft. Resultant penile length is approximately equivalent to the longer side of the penis. This operation is reserved for men with severe deformity and no erectile dysfunction.

3 Techniques to make penis straight

3. For men with erectile dysfunction and Peyronie’s disease, a penile prothesis may be placed followed by penile straightenning with manual modelling. Want to know more about Penile Prothesis and how they work? Click here

scar tissue treatment option

Surgery Options: Penile Prosthesis

Surgery Options: Incision & Graft

Surgery Options: Nesbits Plication

What are the risks of surgery?

The key in a successful outcome is utilising the services of an experienced urologist. Dr Phillip Katelaris has over 30 years decorated experience in Urological Practice including treating Peyronie’s disease in Sydney.

Although rare, like any surgery there are risks involved. Please discuss these at length with your urologist to understand any risk application to your personal circumstances. Risks include:

Change in penile sensation (usually returns in 1-2 months after surgery)
Recurrent curvature (rare if the deformity is stable for 6-9 months before surgery)
Erectile dysfunction (this is less likely to occur in men with strong pre-operative erections)
Penile shortening (usually 1-2 cm if at all)
Bleeding and infection are complications associated with most surgical procedures but are quite rare with these operations

Frequently Asked Questions

The cure for Peyronie’s disease is dependent on several factors, including severity and the presence of other symptoms. Some common treatments include medication, injection treatment, electric current therapy, mechanical stretching or surgery.

Penile stretching has been known to relieve Peyronie’s, through penile traction therapy or by massaging the area with a lubricant. Speak to your urologist to find a treatment that works for you.

It is completely normal for the penis to have curvature – it’s when that curvature is causing pain that you want to be concerned. Peyronie’s disease happens when there is scar tissue on the penis which has formed plaque. Where there is scar tissue, the penis will bend in that direction due to it shortening that side of the penis – for example, if there is scar tissue on the top of the shaft, then the penis will have to bend upwards to compensate, causing a pull on the penis. This can become painful when having an erection, and in some cases Peyronie’s disease can even create an hourglass shape on the shaft.

Peyronie’s disease does not contribute to infertility and cannot cause it.

Peyronie’s disease is not life threatening, however it goes without saying that it can have a negative impact on a patient’s life due to pain or performance issues.

Peyronie’s disease can be caused by both minor trauma to the penis (ie. bending during intercourse or sports accidents) but has also been recorded in men who haven’t endured any physical force – which researchers believe may be genetic or environmental. It is unknown if a vasectomy causes Peyronie’s disease.

The best treatment for Peyronie’s disease is individualised to the particular patient. Some men are managed conservatively whilst others need careful reconstructive surgery.

When men with Peyronie’s disease are managed carefully by an experienced urologist the results are very good.

For any questions on Peyronie’s disease, treatment alternative or pricing arrangements, please call our office on (02) 9477 7904 or fill out the contact form on this page.