Peyronie’s Disease

Peyronie’s is a condition that causes penile curvature, indentation, and loss of length upon erection. The condition is most common among men in their 50s. Unfortunately, Peyronie’s tends to be under-reported because many men ignore or deny the condition, but it’s estimated that 9% to 12% of men over the age of 50 experience some form of the disease.

In most cases, Peyronie’s disease is a result of inflammation and plaque formed after repeated trauma to the penis, commonly during sexual intercourse. The plaque forms a thick, inflexible scar that can cause the penis to curve upwards, downwards, or sideways.

Symptoms may develop slowly or appear overnight and may or may not be painful, including:

• Reduced flexibility of the penis
• A penis that bends or arcs during erection
• Erectile dysfunction

Occasionally, milder forms of the disease will occur and resolve spontaneously, without problems.

A physician will perform a complete examination that includes feeling the hardened tissue (sometimes it is necessary to do the exam with the penis erect).

Treatment of Peyronie’s disease depends on the degree of penile curvature, severity of penile shortening and/or narrowing, and the presence of erectile dysfunction. Sometimes the patient can delay treatment because the condition may resolve itself, but if not, treatments include:

• Xiaflex: A nonsurgical treatment during which the physician injects the medication to weaken and break down the plaque that is causing an erect penis to curve.
• Verapamil injections: An ongoing treatment during which the physician injects a blood vessel relaxant directly into the scar tissue through a very small needle.
• Extenders: The physician may stretch the penis with vacuum devices.
• Surgery:
  • Shortening the unaffected side: The surgeon shortens the longer side of the penis, creating equal lengths on both sides.
  • Allograft: In more severe cases, the scar tissue is cut or partially removed on the shorter (affected) side of the penis, which is then covered with a natural graft material.
  • Penile prosthesis: The physician implants a bendable or inflatable device into the penis, followed by penile straightening.