Peyronie’s Disease

Peyronie’s disease is a condition in which scar tissue, known as plaque, forms inside the penis. The scar tissue causes curvature of the penis, which can result in painful erections and difficulty having sexual intercourse.

Symptoms

The main symptom of Peyronie’s disease is curvature of the penis. In some men, an extensive plaque that goes all the way around the penis may develop. These plaques typically do not cause curvature but may cause a “waisting” or “bottleneck” deformity of the penile shaft. Other symptoms may include erectile dysfunction, shortening of the penis, an area of hard tissue or a lump in the penis, and pain during an erection.

Causes

It is unclear what causes Peyronie’s disease. Some researchers believe it is a genetic disorder; others believe it is an autoimmune disorder. One common theory is that it is a result of a previous injury that caused internal bleeding in the penis. Even if the injury was not traumatic enough to have caused a great deal of pain, scar tissue built up in the tissue as it healed. During an erection, when the penis stretches, the scar tissue doesn’t stretch with it, causing the penis to curve.

Testing

Peyronie’s disease can be diagnosed during a physical exam. You will also be asked some questions about any previous injuries to your groin area. During your physical exam, the doctor will need to feel your penis for scar tissue. It may be necessary for the doctor to examine your penis when it is limp and again made erect with medication.

Treatment

Treatment for Peyronie’s disease is focused on helping a man regain the sexual function that he has lost due to the disease. It is unlikely that the penis can be restored to its pre-Peyronie’s condition. Many treatments suggested for Peyronie’s Disease have been studied and found to offer no convincing evidence of improvement.

Treatments include:

• Oral Medications: Thought to prevent scaring, not remove existing scar tissue. Used in early stages of the disease.
• Penile Traction Therapy: A stretching device is thought to lead to a reduction in curvature. Has been shown to improve curvature. Side effects and cost are minimal, making it a reasonable therapy to try.
• Injections: Injecting a drug directly into the plaque to break down the hard plaque tissue. Injections with Verapamil and Interferon have shown some improvement and are reasonable treatments to try. Xiaflex is an injectable medication, and is the first FDA-approved treatment for Peyronie’s. Steroids should never be injected into the plaque.
• Topical Medications: Topical medications applied to the penis without iontophoresis (including topical Verapamil) have been shown to be ineffective.
• Iontophoresis: Uses a mild electric current to deliver topical Varapamil through the layers of tissue. Results are inconsistent, but it is a reasonable therapy to try if a man cannot have injections.
• Plication and Grafting Surgeries: Plication involves pinching the tissue together on the outer side of the bend. Grafting replaces or expands scarred penile tissue with healthy tissue. Both offer good results to properly-selected candidates.
• Penile Implant Surgery: Involves inserting a penile prosthesis into the penis. Good results in correcting curvature in all patients. Should only be considered after other options have been tried or ruled out.

Download our Peyronie’s educational handout.

Where can I get reliable information about Peyronie’s Disease?

In addition to speaking with your urologist, the Association of Peyronie’s Disease Advocates, provides credible information.

Does Verapamil cream work for Peyronie’s Disease?

Studies of penile tissue have shown that Verapamil cream applied to the penis does not penetrate into the plaque and is not effective for Peyronie’s.