Peyronie’s Disease

Every man’s anatomy is different from size and shape to possibly having a slight curve. But if you notice a significant bend has formed when your penis is erect, or if you notice narrowing of the penile shaft, it’s time to discuss the possibility of Peyronie’s disease with your urologist.

What Is Peyronie’s Disease?

A curved erection caused by Peyronie’s disease may happen because of a problem in the way the body heals after an injury (a connective tissue disorder). Often the injury is not even noticed by patients, and the curve simply develops over time. When this happens, the body doesn’t properly control how much scar tissue develops and too much builds up gradually. A bump of scar tissue forms under the skin of the penis. This bump is called a Peyronie’s plaque.

Symptoms of Peyronie’s Disease

Symptoms can range from mild to severe and may change over time. Common symptoms include penile curvature, painful erections, a lump or hardened area beneath the skin, shortening of the penis, and difficulty achieving or maintaining an erection. In some cases, the curvature or discomfort can interfere with sexual activity.

Causes of Peyronie’s Disease

The exact cause of Peyronie’s disease is not fully understood. It is believed to develop when scar tissue forms during the healing process following injury or repeated minor trauma to the penis. This scar tissue does not stretch normally during an erection, causing the penis to bend or curve. However, many men develop Peyronie’s disease without recalling a specific injury. The condition is not contagious and is not caused by a sexually transmitted infection.

Risk factors for Peyronie’s Disease

Several factors may increase the likelihood of developing Peyronie’s disease. These include aging, a family history of the condition, certain connective tissue disorders, and a history of penile injury or repeated trauma. The condition is more common in middle-aged and older men, although it can occur at any age. Men with erectile dysfunction may also be more likely to experience penile injury that contributes to plaque formation.

Treatment for Peyronie’s Disease

Rarely, men who present with the symptoms of Peyronie’s disease experience improvement without treatment, while other men have lived with the condition for months or longer and require more interventional treatment. Treatment for Peyronie’s disease depends on the severity of the curvature, the presence of pain, changes in sexual function, and whether the condition is stable or progressing. Some men with mild symptoms may not require treatment, while others benefit from medical intervention.

Surgery remains the gold standard treatment for Peyronie’s disease.

There are several surgical options including:

Excision – This procedure involves removing or cutting of the plaque and attaching a graft. This method will straighten the penis and restore some lost length. Risks of the procedure include numbness of the tip of the penis and decreased rigidity of erections in a small number of patients.

Plication – This procedure involves removing or pinching a piece of the tunica albuginea from the side of the penis opposite the plaque, to straighten out the penis. This method is less likely to cause numbness or erectile dysfunction, but it is associated with a decrease in penile length.

Penile Prosthesis – For patients with Peyronie’s disease and erectile dysfunction, placement of an inflatable penile prosthesis (penile implant) is used to increase the rigidity and straighten the penis adequately. Penile prosthesis remains the gold-standard treatment for patients with ED and Peyronie’s disease.

Xiaflex® treatment for Peyronie’s Disease

Nonsurgical injections for penile curvature

Medical or injection therapy may help reduce pain and inflammation, soften plaque, and decrease penile curvature. Medications injected directly into the plaque are designed to reduce the plaque and improve symptoms.

Xiaflex is the first FDA-approved nonsurgical treatment for Peyronie’s disease, Xiaflex is approved for men with a palpable penile plaque causing a curvature of at least 30 degrees during erection. The medication works by breaking down the plaque and is given as a series of injections in your doctor’s office. Most men receive up to four treatments, with each treatment consisting of two injections. Potential side effects should be discussed with your urologist.

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