Peyronie's Disease
Scar tissue causing a curved, sometimes painful erection
Quick Facts
- Type: Connective tissue condition of the penis
- Main feature: Curved erection from internal scar tissue
- Phases: Active (changing) and stable
- Treatment: Medication, injections, or surgery
Overview
Peyronie's disease is a condition in which flat areas of scar tissue, called plaques, form under the skin of the penis within the tough sheath that surrounds the spongy erectile tissue. Because scar tissue does not stretch the way normal tissue does, the plaque causes the penis to bend or curve when erect, and it can also cause pain, narrowing, shortening, or a dent or hourglass appearance.
The condition often develops in two phases. During the active phase, which can last many months, the curve and any pain may change as the scar forms. In the following stable phase, the curve usually settles and pain often improves. Peyronie's disease is more common in middle-aged and older men. It is a recognized medical condition, not a reflection of personal health habits, and a range of treatments can help with the curve, pain, and any difficulty with erections or intimacy.
Symptoms
Symptoms may come on gradually or appear more suddenly and can vary in severity.
- A noticeable bend or curve of the penis, usually most apparent during an erection
- A firm lump or area of hard tissue (plaque) felt under the skin
- Pain, which is more common during erections and often eases over time
- Shortening or narrowing of the penis, or a dent or hourglass shape
- Difficulty getting or keeping an erection
- Difficulty or discomfort with sexual intercourse
For many men the curve stabilizes after the active phase, and pain frequently improves or resolves even without treatment. The condition can also cause stress, anxiety, or relationship strain, which are worth discussing with a doctor.
Causes
The exact cause is not always clear, but Peyronie's disease is thought to involve abnormal wound healing.
- Injury or microtrauma: Repeated minor injury to the penis, including during vigorous activity or intercourse, may trigger scar tissue to form as the area heals abnormally.
- Individual healing tendencies: Some men are more prone to forming excess scar tissue, and the condition is linked to other scarring disorders of connective tissue.
- Genetic and connective tissue factors: A family history or related conditions, such as a hand condition that draws the fingers inward, can increase risk.
In many cases no specific injury is recalled, and the condition develops gradually.
Risk Factors
- Middle and older age
- A family history of Peyronie's disease
- Connective tissue disorders such as Dupuytren's contracture of the hand
- Injury to the penis
- Some pelvic surgeries or procedures
- Diabetes and certain other health conditions
Diagnosis
A doctor, often a urologist, can usually diagnose Peyronie's disease from the history and examination.
- Physical examination: Feeling for the plaque and assessing the penis, sometimes measuring it.
- History: Asking about the curve, pain, timeline, and effect on erections and intimacy.
- Imaging: An ultrasound, sometimes performed during a medication-induced erection, can locate the plaque, check blood flow, and measure the curve to guide treatment.
Treatment
Treatment depends on the phase, the degree of curvature, pain, and whether erections and intercourse are affected. Mild cases that do not interfere with function may simply be monitored.
- Watchful waiting: Because some cases improve or stabilize on their own, observation is reasonable for mild symptoms, especially in the active phase.
- Medications: Oral medicines, injections of medication directly into the plaque to soften it, and pain relievers may be used.
- Mechanical therapy: Traction or vacuum devices may help with curvature and length in selected men.
- Surgery: For stable, significant curves that prevent intercourse, surgical options can straighten the penis or, when erections are also impaired, place a penile implant.
- Support: Counseling can help with the emotional and relationship effects.
Treatment is usually delayed until the disease is stable, except for medications or therapies aimed at the active phase.
Prevention
- There is no proven way to prevent Peyronie's disease
- Avoiding injury to the penis may reduce risk
- Managing conditions such as diabetes supports overall tissue health
- Seeking early evaluation for a new curve or pain allows timely treatment
- Open discussion with a doctor can address both physical and emotional effects
When to See a Doctor
See a doctor, ideally a urologist, if you notice a new curve, lump, pain, or change in the shape of the penis, or if these symptoms make erections or intercourse difficult. Early evaluation can guide treatment during the active phase and help with pain. Seek urgent care if a sudden, severe penile injury occurs with significant pain, swelling, bruising, or a popping sensation during an erection, as this may indicate a penile fracture that needs emergency treatment.
Frequently Asked Questions
What causes Peyronie's disease?
It is thought to result from abnormal healing after injury or repeated minor trauma to the penis, which leads to scar tissue (plaque) forming inside the erectile sheath. Some men are more prone to scarring, and there are links to family history and connective tissue conditions. Often no specific injury is recalled.
Does Peyronie's disease go away on its own?
Sometimes the curve and pain stabilize or even improve without treatment, especially after the active phase ends. Pain in particular often eases over time. However, the scar tissue itself usually does not disappear, and significant curvature that affects intercourse may need treatment.
What treatments are available?
Options include watchful waiting for mild cases, oral medicines, injections that soften the plaque, traction or vacuum devices, and surgery for stable, significant curves. When erections are also affected, a penile implant may be considered. A urologist can recommend the best approach for the situation.
Is Peyronie's disease the same as erectile dysfunction?
No, but they can occur together. Peyronie's disease is about scar tissue causing a curve, while erectile dysfunction is difficulty getting or keeping an erection. The curve or associated changes can contribute to erection problems, and treatment may address both.
When is penile pain an emergency?
Most pain from Peyronie's disease is not an emergency and improves over time. However, sudden severe pain, swelling, bruising, or a popping sound during an erection may signal a penile fracture, which is a medical emergency. Seek urgent care if this happens.
References
- Urology Care Foundation, American Urological Association. Peyronie's Disease.
- Mayo Clinic. Peyronie disease — Symptoms and causes.
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Peyronie's Disease.
- MedlinePlus, U.S. National Library of Medicine. Peyronie disease.