Peyronie’s disease is a penile disorder in which scar tissue, or plaque, forms under the skin of the penis. The plaque forms in the penis within a layer called the tunica albuginea, making it less flexible. This can cause the penis to bend or curve when erect, which can be painful and make intercourse difficult or even impossible.

Symptoms

The most noticeable symptom of Peyronie’s disease is a curvature of the penis. The plaque most often forms on the top, or dorsal side of the penis, but may form on the bottom or all around the penis. The plaque can usually be felt whether the penis is erect or not. 

Causes

Most cases are linked to injuries to the penis causing damage. These injuries can occur during sexual intercourse, athletic activities, or in another type of accident. The injury itself may be very minor, but the resulting scar / plaque is the central problem. 

Some medical experts have suggested that autoimmune disease may contribute to Peyronie’s disease. In an autoimmune disease, the body’s immune system may mistakenly attack cells in the penis, causing inflammation. This inflammation can lead to increased scarring.

Diagnosis

The plaque caused by the disease can usually be felt whether the penis is erect or not. The doctor may want to examine how the erect penis curves, so drugs may be injected to make it stiff for imaging studies. Dynamic ultrasound may also be needed to examine the location of the plaque, check for calcium buildup, and examine the blood flow to the penis.

If a diagnosis of Peyronie’s disease is confirmed, there are two stages of the disease patients experience:

• Active Phase: During this phase, the plaques are forming in the penis and the bending of the penis is getting worse. This is the stage where most men will feel pain with erections. The active phase typically lasts between 6 and 18 months. During this time procedural treatment is not appropriate or effective.
• Stable Phase: The plaque has stopped growing and the curvature of the penis has stopped progressing. The pain usually subsides. Procedural treatment can be effective during this time. 

Treatment

Treatment for this disease varies depending on how severe the case is. In cases where the disease and its symptoms are not interfering with sexual functions, then the doctor may not recommend treatment and take a watchful waiting approach.

However, if the condition is affecting the patient’s quality of life, the doctor may recommend treatments with medications, or in more serious cases, surgery.

• Oral Medication: During the acute phase of the disease, a doctor may prescribe oral medications. There have not been many studies on the effectiveness of the drugs, but some oral medications a doctor may try include:
  • Oral vitamin E
  • Pentoxifylline
  • Potassium amino-benzoate
  • Carnitine
  • Colchicine
• Injectable Medication: Injections of drugs directly into the plaque tissue of the penis. These medications tend to help with curvature, but rarely make the penis completely straight. Injectable medications include:
  • Verapamil
  • Interferon
  • Collagenase (Xiaflex) 
• Surgery: Surgical therapy is the most definitive and can achieve complete straightening. It is only appropriate during the stable phase. Like all penile surgery, they do NOT increase penile length. Different types of surgeries include:
  • Plication. Permanent sutures are carefully placed into the deep penile layers on the opposite side of the scar.  This takes less than an hour and is same day surgery. 
  • Penile Prosthesis. A permanent mechanical device is placed into the penis which allows for straightening. This is best for men who also have severe problems obtaining erection in addition to penile curvature. This is a more invasive surgery and sometimes requires overnight hospital stay.  

Schedule an Appointment

At Alliance Urology Specialists, our goal is to provide the highest level of specialized urology care. Our board-certified physicians specialize in the diagnosis and treatment of a variety of urological conditions, including Peyronie’s disease. To schedule an appointment, call Alliance Urology Specialists in Greensboro at (336) 274-1114.