Peyronie's Disease - Symptoms, Diagnosis & Treatment in Sydney

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. The penis deformity is caused by plaque formation, which is a thick, inelastic scar. This thick, inelastic scar can cause the penis to curve upwards, downwards, or sideways.

How to Diagnose Peyronie’s Disease

These penile abnormalities can occur in males of any age but are most prevalent in men in their 50s. Up to 90 per cent of men with Peyronie’s Disease also experience erectile dysfunction.

To understand what Peyronie’s disease looks like, the penile curvature should be observed.

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. In this article, we have included Peyronie’s disease pictures for reference.

Penis with Peyronie's versus normal full

If you’re wondering how to know if you have Peyronie’s Disease, there can be different tests conducted. A physical exam is usually enough to find scar tissue in the penis and diagnose Peyronie’s Disease. However, other conditions can sometimes cause similar symptoms, so it’s important to rule them out.

The following tests may be used to diagnose Peyronie’s Disease and determine exactly what is causing your symptoms:

1. Physical examination

Your physician will palpate your penis when it is not erect to determine the location and quantity of scar tissue (American Urological Organization, 2015). Additionally, they may measure the length of your penis. This initial measurement helps detect whether the penis has shrunk if the problem worsens.

Your doctor may also request that you bring home photographs of your erected penis. This can detect the degree of curvature, the location of scar tissue, and other characteristics that may aid in determining the optimal treatment method.

2. Other tests

Your physician may prescribe an ultrasound or other procedures to evaluate your erect penis. You will likely receive an injection directly into the penis to erect it before testing.

Ultrasound is the most common diagnostic method for penile problems. They provide images of soft tissues using sound waves. Moreover, these examinations can detect scar tissue, blood flow to the penis, and other issues.

What are Peyronies Disease Symptoms?

The signs and symptoms of Peyronie’s Disease may manifest suddenly or develop gradually. These are the most prevalent indications and symptoms or signs of erectile tissue damage:

A bend or curvature in the penis: Your penis may bend upwards, downwards, or to the side.
Scar Tissue: The scar tissue linked with Peyronie’s Disease (called plaque) can be felt as flat lumps or a band of hard tissue under the skin of the penis.
Penis constriction (sometimes referred to as “hourglassing”): In some men with Peyronie’s Disease, the erect penis may exhibit constriction, indentations, or an hourglass-like look with a tight, thin band around the shaft (Martinez et al., 2012).
Erectile dysfunction or difficulty: Men with Peyronie’s Disease may experience difficulty achieving or sustaining an erection. However, men frequently experience erectile dysfunction prior to the onset of Peyronie’s disease symptoms.
Painful erections or sex-related suffering: You may experience penile discomfort with or without an erection.
Shortening of the penis: As a result of Peyronie’s illness, your penis could become shorter.

Knowing about Peyronie symptoms can help you pinpoint the problem faster and seek professional help promptly. It’s important to catch Peyronie’s disease in its early stages to improve your outcomes.

What causes Peyronie’s Disease?

Peyronie’s Disease causes are not well understood. In most cases, the disease results from inflammation and plaque formation after repeated trauma to the penis, most commonly occurring during sexual intercourse. However, this is not always the case.

Although there is still a dark cloud surrounding the cause of Peyronie’s disease, it is crucial to understand its symptoms, stages and available treatments.

Stages of Peyronie’s Disease

Urologists divide Peyronie’s Disease into two stages: the acute stage and the chronic stage (Martinez et al., 2012).

During both stages, a bent or curved penis may interfere with sexual activity. Concurrently, patients may also experience Erectile Dysfunction.

Peyronie’s Disease often develops over the course of six months. During this period, it should be monitored frequently so that the right treatment for its current stage can be administered.

First Stage: The Acute Phase

Plaque begins to form in the penis. It gradually expands in size and develops curvature. In this stage, the plaque will be softer and more malleable. During the first few months of the acute phase, patients may not notice a change in their penis.

Patients will typically suffer pain or discomfort, a bent penis and a localised hardness or lump.

Second Stage: The Chronic Phase

The plaque is fully formed and rigid during the chronic phase, and the discomfort has typically subsided. The blood veins surrounding the affected area are clogged with microscopic plaques, causing the penis to bend during erection. In most cases, the patient will experience partial erectile dysfunction, a reduction of circumference and length, and a softening of the penis tip.

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 require the help of an experienced medical professional

Understanding the impact and side effects of Peyronie’s Disease is crucial for patients seeking to manage the condition effectively.

What Treatment Options Are There For Peyronie’s Disease?

Peyronie’s disease treatments aim to maintain or regain sexual function by straightening the penis. How long it takes to cure Peyronie’s Disease depends on several factors including, but not limited to, degree of penile curvature, the severity of penile shortening, and the presence of penile narrowing, and whether erectile dysfunction is present.

1. Medications

Several oral treatments have been tested to treat Peyronie’s Disease, but their efficacy has not been consistently demonstrated, and they are not as successful as surgery (Martinez et al., 2012).

Injecting medicines directly into the penis may lessen the curvature and pain associated with Peyronie’s Disease in certain individuals. A local anaesthetic may be administered to prevent pain during injections depending on the treatment.

If you undergo one of these therapies, you will likely need several injections over several months. You may also use injection medications together with oral medications or traction treatments.

2. Oral Drugs

Pentoxifylline (Trental) is often the first medicine that doctors prescribe to help straighten the penis. You have to take the pill for a few months to see if it will work.

Some doctors prescribe vitamin E supplements or a form of potassium called para-aminobenzoate, but there is little evidence that these work (American Urological Organization, 2015).

In men with Peyronie’s Disease who also have some erectile dysfunction, drugs to treat ED may help.

3. Penile Injections

Your doctor may suggest injecting a drug into the penis to break up the scar tissue.

Verapamil is a drug that some doctors use. Studies show that it can help many men feel less pain and lessen the curve.

Collagenase clostridium histolyticum (Xiaflex) is another drug used to treat Peyronie’s that is given by injection.

4. Other Treatments

Iontophoresis is another treatment for penile curvature. It is a non-invasive procedure that uses an electric current to give verapamil and steroid through the skin. However, available research regarding penile curvature and erectile function reveals contradictory outcomes (Babu & Kayes, 2020).

Several non-drug therapies for Peyronie’s Disease are also under investigation (García-Gómez et al., 2020; Miner & Seftel, 2013). However, information about their efficacy and potential adverse effects is inadequate. The use of powerful sound waves (shock wave therapy) to break up scar tissue (Hauck & Weidner, 2007), stem cells, platelet-rich plasma, and radiation therapy are examples of these treatments.

There are many Peyronie’s Disease medical procedures that offer various options to reduce symptoms and improve quality of life. Consulting with a healthcare provider can help determine the most suitable procedure based on the severity of your condition and individual needs.

Peyronie’s Disease Surgery Options

Surgery Options for Peyronie's Disease Part One - Nesbits Plication

Surgery Options for Peyronie's Disease Part Two - Incision & Graft

Surgery Options for Peyronie's Disease Part Three - Penile Prosthesis

There are three techniques to make the penis straight (American Urological Organization, 2015):

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

2. Scar tissue is cut or partially removed on the shorter side. After removing this tissue, the defect is filled with a graft. The 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. For men with erectile dysfunction and Peyronie’s Disease, a penile prosthesis may be placed, followed by penile straightening with manual modelling. Want to know more about Penile prostheses and how they work? Click here.

Peyronie’s Disease Before and After Surgery

Understanding Peyronie’s Disease and how surgery can help is important for anyone considering treatment. Here’s a simple guide on what to expect before and after surgery:

Before Surgery

1. Symptoms and Challenges:

Penile Curvature: Noticeable bending of the penis, especially during erections.
Pain: Pain in the penis, mainly during erections or sexual activity.
Erectile Dysfunction: Trouble getting or keeping an erection due to the scar tissue.
Mental Impact: Feelings of anxiety, depression, and stress in relationships because of changes in sexual function and appearance.

2. Everyday Life:

Sexual Activity: Difficulty with sexual performance and satisfaction because of pain and curvature.
Self-Esteem: Lower self-confidence and concerns about sexual attractiveness.

After Surgery

1. Physical Improvements:

Reduced Curvature: Straighter penis, improving both function and appearance.
Pain Relief: Less or no pain, especially during erections.
Restored Function: Better ability to get and keep an erection, leading to more satisfying sexual experiences.

2. Quality of Life:

Improved Sexual Health: More confidence and enjoyment in sexual activities.
Better Mental Health: Less anxiety and depression, leading to a happier life.
Stronger Relationships: Better intimacy and communication with partners due to improved sexual function and confidence.

3. Recovery and Care:

Healing Process: Knowing what to expect during recovery, from immediate care after surgery to long-term follow-up.
Ongoing Care: Following medical advice, attending follow-up appointments, and maintaining a healthy lifestyle to support recovery and prevent complications.

Surgery for Peyronie’s Disease can greatly improve symptoms and quality of life. By reducing penile curvature, relieving pain, and restoring erectile function, surgery helps men regain confidence and enjoy a more satisfying life. Understanding the Peyronie’s Disease surgery before and after helps patients make informed decisions and prepare for a smooth recovery.

Peyronie’s Surgery Recovery Time

Recovering from surgery for Peyronie’s Disease involves several stages, each crucial for ensuring the best possible outcome.

1. Immediate Post-Surgery Phase (First 1-2 Weeks)

Hospital Stay: Depending on the type of surgery performed, you may need to stay in the hospital for a day or two. This allows for close monitoring and immediate management of any complications.
Pain Management: Pain and discomfort are common during the first few days. Pain relievers and anti-inflammatory medications will be prescribed to manage this.
Wound Care: Keeping the surgical site clean and dry is essential to prevent infection. Follow your doctor’s instructions for wound care meticulously.

2. Early Recovery Phase (Weeks 2-6)

Rest and Limited Activity: It’s important to rest and avoid strenuous activities, including heavy lifting and vigorous exercise. Light activities and walking are encouraged to promote blood flow and healing.
Swelling and Bruising: Swelling and bruising around the surgical site are normal and should gradually improve. Using ice packs as recommended can help reduce swelling.
Follow-Up Appointments: Regular follow-up visits with your surgeon are crucial to monitor healing progress and address any concerns promptly.

3. Intermediate Recovery Phase (Weeks 6-12)

Gradual Return to Normal Activities: You can slowly return to more regular activities, but it’s essential to listen to your body and not rush the process.
Physical Therapy: Some patients may benefit from physical therapy or specific exercises to improve penile function and reduce any residual curvature.
Monitoring for Complications: Be vigilant for signs of complications such as infection, excessive pain, or issues with urination, and report these to your doctor immediately.

4. Long-Term Recovery (3-12 Months)

Sexual Activity: Resuming sexual activity is usually possible after about 6-8 weeks, but this can vary. Your doctor will provide specific guidance based on your recovery progress.
Final Results: The final results of the surgery, including improvements in curvature and erectile function, may take several months to become fully apparent.
Ongoing Care: Continue to attend follow-up appointments and maintain communication with your healthcare provider to ensure optimal recovery and address any long-term issues.

By understanding the stages of recovery and following medical advice, patients can optimise their healing process and achieve the best possible outcomes from Peyronie’s surgery.

Frequently Asked Questions

Yes, it is possible to regain length after Peyronie’s Disease with proper treatment. Early intervention with medications and mechanical therapies can help. Surgical options, including grafting and implants, may be necessary for severe cases. Maintaining a healthy lifestyle can also contribute to better outcomes. However, complete restoration of pre-disease length may not always be possible.

Peyronie’s Disease is not life-threatening. It’s a non-cancerous condition that affects the penis, causing it to curve and sometimes be painful. Although it can greatly affect your quality of life and lead to emotional stress, it doesn’t directly harm your overall health. With the right treatment, the symptoms can be managed. It’s important to get support for both the physical and emotional effects.

Reversing Peyronie’s Disease requires a combination of medical treatments and therapies. Medications like Xiaflex and verapamil injections can help break down the scar tissue causing the curve. Devices like penile traction and vacuum erection devices (VEDs) can help stretch the penis and reduce the curve over time. In severe cases, surgery, such as removing the plaque and grafting or using penile implants, might be needed. Getting diagnosed and treated early, along with staying healthy, can greatly improve your chances of reversing the condition.

Peyronie’s Disease cannot kill you. It is a benign condition that affects the penis, causing curvature and pain but not posing a direct threat to life. The primary concern is the impact on sexual function and psychological well-being. Managing the physical and emotional aspects is important for overall quality of life. Seeking medical and psychological support can significantly improve outcomes.

Peyronie’s Disease can be chronic, but it is not necessarily permanent. Some men experience spontaneous improvement, while others require ongoing management. Effective treatments, including medications, mechanical therapies, and surgery, can reduce symptoms. Early intervention during the acute phase can prevent long-term deformity. With appropriate treatment, significant improvement is possible.

An enlarged prostate does not cause Peyronie’s Disease. These are two different conditions with different causes: Peyronie’s involves scar tissue forming in the penis, while an enlarged prostate means the prostate gland gets bigger. There’s no direct link between the two. Although they can happen together due to common risk factors like age, one doesn’t cause the other. It’s important to get the right diagnosis and treatment for each condition.

Peyronie’s Disease can be treated with medications, mechanical therapies, and surgery. Medications like Xiaflex and penile traction devices can help reduce curvature. In severe cases, surgical options such as grafting and implants may be necessary. Shockwave therapy is a newer, non-invasive option that may reduce pain and improve erectile function. A healthy lifestyle and early intervention can also contribute to better outcomes.

The length of Peyronie’s Disease can be different for each person. The active phase usually lasts 6 to 18 months, after which the symptoms may stop getting worse. How quickly you recover depends on how well the treatment works and how your body responds. Some men see big improvements in a few months, while others may need longer treatment. Getting the right medical care can greatly reduce symptoms and improve your quality of life.

Peyronie’s Disease is not considered dangerous in terms of life-threatening risks, but it can seriously impact your quality of life. The condition causes your penis to curve, can cause pain, and may lead to erectile dysfunction, making sexual activity uncomfortable and challenging. It can also lead to anxiety, depression, and problems in relationships. While it doesn’t directly harm your overall health, it’s important to treat both the physical and emotional effects. Getting the right medical care and support can greatly improve your symptoms and well-being.

Recognising Peyronie’s Disease involves noting specific symptoms and seeking medical evaluation. Key signs include:

Penile Curvature: A noticeable bend or curve in the penis during an erection.
Pain: Discomfort or pain in the penis, either when erect or flaccid.
Scar Tissue: The presence of hard lumps or a band of tissue under the skin of the penis.
Erectile Dysfunction: Difficulty achieving or maintaining an erection.
Shortening of the Penis: A reduction in penile length or girth.

If you experience these symptoms, it is important to consult a healthcare provider for an accurate diagnosis and appropriate treatment options.

The healing duration for Peyronie’s Disease varies among individuals. The initial phase lasts 6 to 18 months, during which symptoms may worsen. After this phase, the disease often stabilises, and symptoms may remain unchanged. Effective treatments like medications, mechanical therapies, or surgery can influence healing time. Some men see improvement within months, while others require long-term management.

Although rare, like any surgery, there are risks involved. Please discuss these with your urologist to understand any risk application to your 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.

The severity of Peyronie’s Disease is proportional to the degree to which it impacts the lives of persons who have been diagnosed. Although serious, Peyronie’s Disease is not fatal. However, numerous studies show that the disorder contributes to the development of depression and anxiety in male patients (Randhawa & Shukla, 2019). The societal stigma associated with the condition frequently discourages people from obtaining care for their sexual and mental health (Levine, 2013).

The onset of Peyronie’s Disease might be rapid or gradual. Some cases are moderate and require simply an observation, while others are severe and might impair a man’s sexual abilities.

Peyronie’s Disease may occur due to penile trauma. Additionally, genetics and age are risk factors for Peyronie’s Disease. A Peyronie’s disease-causing injury may also arise under the following conditions:

During sex, a person can get hurt from a single event or repeated trauma.
During a sports event, if something hits a man in the penis and causes an injury.
Any time a man’s penis is injured
Injuries to the penile area can lead to the buildup of scar tissue, which can be characterised as “Peyronie’s disease.”

There are also additional risk factors that can make you more likely to get Peyronie’s Disease:

Genetic predisposition
Health disorders such as Dupuytren’s contracture and other connective tissue disorders
Smoking
Prostate surgery
Aging can weaken penile tissue and increase the risk of damage

Here are some early signs that you shouldn’t ignore when dealing with Peyronie’s Disease

The penis curves when erect
Shortening of the penis
Narrowing or “hourglass” of the shaft of the penis
Lumps in the penis
Painful erections or pain during sex
Soft erections

If you experience any of these Peyronie’s Disease early symptoms, it is important to consult a healthcare provider for an accurate diagnosis and appropriate treatment options.

Yes. Peyronie’s Disease develops on the penis and results in painful, curved erections. Penises vary in size and shape, so a curved erection is not necessarily alarming. However, some men with Peyronie’s Disease experience a significant bend or pain.

Peyronie’s Disease rarely goes away on its own, but it can be treated. Your doctor may tell you to wait and see if Peyronie’s Disease resolves itself before giving you any medication.

Some symptoms may stay the same or get worse over time. Curvature, shortening, and pain are all bothersome symptoms, but some treatments can help.

Untreated Peyronie’s Disease can worsen symptoms, including a greater degree of curvature, a shorter penis, an inability to engage in enjoyable sexual activity, and/or erectile dysfunction.

It is entirely normal for the penis to have curvature – it’s when that curvature is causing pain that you want to be concerned about. Peyronie’s Disease happens when scar tissue on the penis 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 can be caused by minor trauma to the penis (i.e. bending during intercourse or sports accidents) and 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.

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, 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.

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

It can happen in men who are frequently sexually active or in men who are not very sexually active. There are no particular risk factors for Peyronie’s disease, other than being a man and having a penis. Now for men listening to me talk about Peyronie’s disease, I want to emphasize its nothing you’ve done or haven’t done. It just happens. It’s not your fault. It does get inside a man’s head having a bent erection. Therefore, come forward, come and see me.

The frank answer is we don’t know.

Men with mild Peyronie’s disease do not need surgery, and they do not need treatment. If they have a lump in the penis, but good erections with a minimal deformity, no treatment is required.

Dr Katerlaris talks about the different forms of Peyronie’s disease and discusses the non-operative treatment options available for the disease and other treatment methods to avoid here:

Peyronie’s Disease Treatment in Australia

If you’re struggling with Peyronie’s Disease, know that there are many effective treatments available to help you. Depending on how severe your condition is, these options include non-invasive therapies or, if needed, surgical solutions. The goal is to find the right treatment that fits your needs and helps you feel better. Don’t worry. You’re not alone in this. We are here to help you.

As such, if you’re experiencing symptoms of Peyronie’s Disease, early intervention is key to effective treatment. At Katelaris Urology Clinic, Dr. Katelaris and his team offer personalised care and advanced treatment options tailored to your specific needs. Don’t let Peyronie’s Disease control your life. Contact Katelaris Urology Clinic today to schedule a consultation and take the first step toward recovery.

References:

American Urological Association. (2015). Peyronie’s Disease. Peyronie’s disease guideline – american urological association. Retrieved May 23, 2022, from https://www.auanet.org/guidelines/guidelines/peyronies-disease-guideline

Babu, A., & Kayes, O. (2020). Recent advances in managing Peyronie’s disease. F1000Research, 9, 381. https://doi.org/10.12688/f1000research.20557.1

Bilgutay, A. N., & Pastuszak, A. W. (2015). Peyronie’s disease: A review of etiology, diagnosis, and management. Current Sexual Health Reports, 7(2), 117-131. https://doi.org/10.1007/s11930-015-0045-y

García-Gómez, B., García-Rojo, E., Alonso-Isa, M., Medina-Polo, J., Santos-Pérez de la Blanca, R., Justo-Quintas, J., Parnham, A., Rodríguez-Antolín, A., & Romero-Otero, J. (2020). Treatment of Peyronie’s disease with combination of clostridium histolyticum collagenase and penile traction therapy: A prospective, multicenter, single-arm study. International Journal of Impotence Research, 33(3), 325-331. https://doi.org/10.1038/s41443-020-0292-y

Hauck, E. W., & Weidner, W. (2007). Extracorporeal shockwave therapy in Peyronie’s disease. Peyronie’S Disease, 121-131. https://doi.org/10.1007/978-1-59745-161-1_11

Levine, L. (2013). The clinical and psychosocial impact of Peyronie’s disease. AJMC. Retrieved May 23, 2022, from https://www.ajmc.com/view/a449_13mar_peyronies_levine_s55

Martinez, D., Ercole, C. E., Hakky, T. S., Kramer, A., & Carrion, R. (2012). Peyronie’s disease: Still a surgical disease. Advances in Urology, 2012, 1-5. https://doi.org/10.1155/2012/206284

Miner, M. M., & Seftel, A. D. (2013). Peyronie’s disease: Epidemiology, diagnosis, and Management. Current Medical Research and Opinion, 30(1), 113-120. https://doi.org/10.1185/03007995.2013.842544

Randhawa, K., & Shukla, C. J. (2019). Non-invasive treatment in the management of Peyronie’s disease. Therapeutic Advances in Urology, 11, 175628721882367. https://doi.org/10.1177/1756287218823671

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Peyronie’s Disease Diagnosis, Symptoms & Treatment