About Peyronie’s Disease

Peyronie’s disease is a penile condition in which fibrous scar tissue called plaque forms beneath the skin, causing unnatural curvature, discomfort, or problems with erections. This non-cancerous disorder affects the tunica albuginea, the tough sheath surrounding the spongy erectile tissues of the penis. As the plaque thickens, it restricts elasticity, leading to bending or distortion during erection. Though some men may have mild symptoms, others experience pain, emotional stress, or difficulty with intercourse. Peyronie’s disease can develop gradually or appear suddenly and is most commonly diagnosed in middle-aged or older men.

Common Symptoms for Peyronie’s Disease

Symptoms of Peyronie’s disease vary depending on the extent and location of the plaque:

• Penile Curvature: The penis may bend upward, downward, or to one side during erection
• Painful Erections: Discomfort may occur with or without an erection
• Palpable Lump: A hardened area or band can often be felt beneath the penile skin
• Erectile Dysfunction: Trouble achieving or maintaining erections due to pain or deformity
• Shortened Penis: Noticeable loss of length or girth over time
• Sexual Performance Anxiety: Worry over performance may increase with visible or painful curvature

While some symptoms may improve on their own, persistent or worsening signs require evaluation and early care to avoid long-term dysfunction.

Peyronie’s Disease Causes

The exact cause of Peyronie’s disease is not always known, but several contributing factors have been identified:

• Microtrauma: Repeated injury or bending of the penis during intercourse may trigger scar formation
• Genetic Factors: A family history of Peyronie’s or Dupuytren’s contracture may increase risk
• Connective Tissue Disorders: Men with autoimmune or fibrotic disorders may be predisposed
• Aging: Natural tissue changes and slower healing make older men more susceptible
• Post-Surgical Effects: Scar tissue may form after prostate or pelvic surgery

The disease may appear suddenly or develop over time, and sometimes occurs without any known injury or cause.

Peyronie’s Disease Risk Factors

Men are more likely to develop Peyronie’s disease if they have:

• Middle to Older Age: Most common in men over 40, though it can occur earlier
• Family History: Genetic links increase the chances of fibrotic plaque formation
• Erectile Issues: Men with existing ED are more likely to notice painful erections or curvature
• Prostate Surgery History: Procedures like prostatectomy may lead to penile trauma
• Health Conditions: Diabetes, high blood pressure, and connective tissue disorders are often linked

Having one or more of these factors does not guarantee the condition, but regular checkups can help in early detection.

Peyronie’s Disease Complications

When not treated, Peyronie’s disease can lead to several physical and emotional concerns:

• Sexual Dysfunction: Pain or curvature may make intercourse difficult or impossible
• Psychological Distress: Anxiety, embarrassment, or depression may follow physical changes
• Relationship Tension: Loss of sexual intimacy can create distance between partners
• Low Self-Esteem: Men may feel ashamed or lose confidence in intimate situations
• Penile Deformity: Chronic curvature or indentations may worsen over time

Early treatment reduces the risk of permanent deformity or psychological complications.

Peyronie’s Disease Diagnosis

Our urology team at MASSH MANAS uses a comprehensive process to diagnose Peyronie’s disease:

• Medical Interview: Questions about symptom onset, pain level, and sexual function
• Physical Exam: Palpating the penis to detect plaque location, size, and rigidity
• Erection Assessment: Inducing an erection in a clinical setting to observe curvature
• Penile Ultrasound: Evaluates plaque, blood flow, and the extent of tissue involvement
• Photographic Records: Some patients may be asked to provide home photos of the erect penis for analysis

This approach helps distinguish Peyronie’s from other penile abnormalities and guides the treatment plan.

Peyronie’s Disease Treatment Options

Treatment at MASSH MANAS is tailored to the disease’s phase, severity, and impact on quality of life:

• Observation (Watchful Waiting): For mild cases, where pain is minimal and erections are functional
• Oral Medications: Anti-inflammatory or vitamin-based drugs may reduce pain or early plaque buildup
• Penile Traction Therapy (PTT): Devices that gently stretch the penis to reduce curvature over time
• Injection Therapy: Medications like collagenase (Xiaflex) may be injected directly into the plaque to soften and dissolve it
• Shockwave Therapy: Non-invasive technique that may reduce pain and stabilize the disease
• Surgical Correction: Procedures like plaque excision with grafting or penile implant placement for severe deformities

Treatment depends on whether the disease is still active or has stabilized into a chronic phase.