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Penile Curvature/Peyronie's Disease

Overview

Peyronie’s disease is an abnormal, and sometimes painful, curvature of the penis caused by hardened scar tissue in the penis. The scar tissue prevents straightening of the penis, making the curvature most obvious during an erection. Normally, when the penis hardens and stretches, the skin and connective tissue of the penis remain loose and elastic to accommodate the changes. But the hardened scar tissue makes a normal straightening of the penis virtually impossible. The curvature may be so severe that it prevents penetration during intercourse.

Studies show that Peyronie’s disease can be found in up to 9 percent of men between the ages of 40 and 70. The incidence may be higher than that due to embarrassment and hesitancy to report the condition to doctors.

Education/General Information

The plaques of Peyronie’s disease most commonly develop on the upper side of the penis, but they may also occur on the bottom or side of the penis. Some men have more than one plaque, which may cause complex curvatures.

In addition to curvature, many patients also experience shrinkage or shortening of their penis. Men with Peyronie’s disease may complain about symptoms such as lumps in the penis, painful erections, soft erections and difficulty with penile penetration due to curvature.

Some experts believe that the scarring that causes Peyronie’s disease is caused by injury to the penis, such as bending or hitting. Peyronie’s disease is not caused by cancer and does not increase the risk of cancer. It is not caused by sexually transmitted diseases (STDs). Symptoms of Peyronie’s disease may develop slowly or suddenly. Common symptoms include:

  • A lump or thickening along the side of the penis that is most noticeable when the penis is soft
  • A bent or curved appearance of the penis that is most noticeable when the penis is erect
  • A painful erection or tenderness when the lump on the penis is touched
  • An inability to maintain an erection
  • An inability to achieve penetration during intercourse

Peyronie’s disease can be a serious quality-of-life issue that causes much stress and embarrassment.

Diagnosis

Peyronie’s disease is usually diagnosed using a medical history and physical examination. The hard plaques can usually be felt with or without erection, but an injection that causes penile erection may be used to examine the problem further. Other tests may include:

  • An X-ray to view structures within the penis
  • Doppler flow studies to determine if blood flow is reaching the end of your penis uninterrupted
  • An ultrasound

Treatment

Treatment is not always necessary if Peyronie’s disease does not cause pain or interfere with sexual activity. Other treatments include:

  • Medicines and oral vitamin E to improve sexual function and reduce pain
  • Penile injections
  • In severe cases, surgery may be considered to remove the scar tissue, shorten the affected side of the penis or insert a penile prosthesis

Sometimes, the condition goes away without treatment, which is why most physicians encourage waiting at least a year before pursuing surgical treatment options.

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