Peyronie’s Disease

Peyronie’s disease is the development of fibrous scar tissue inside the penis that causes curved, painful erections. Penises vary in shape and size, and having a curved erection isn’t necessarily a cause for concern. But Peyronie’s disease causes a significant bend or pain in some men.

This can prevent you from having sex or might make it difficult to get or maintain an erection (erectile dysfunction). For many men, Peyronie’s disease also causes stress and anxiety.

Peyronie’s disease sometimes goes away on its own. But in most cases, it will remain stable or worsen. Treatment might be needed if the curvature is severe enough that it prevents successful sexual intercourse.

Symptoms

Peyronie’s disease signs and symptoms might appear suddenly or develop gradually. The most common signs and symptoms include:

• Scar tissue. The scar tissue (plaques) associated with Peyronie’s disease can be felt under the skin of the penis as flat lumps or a band of hard tissue.
• A significant bend to the penis. Your penis might be curved upward, downward or bent to one side. In some cases, the erect penis might have narrowing, indentations or an hourglass appearance, with a tight, narrow band around the shaft.
• Erection problems. Peyronie’s disease might cause problems getting or maintaining an erection (erectile dysfunction).
• Shortening of the penis. Your penis might become shorter as a result of Peyronie’s disease.
• Pain. You might have penile pain, with or without an erection.

The curvature associated with Peyronie’s disease might gradually worsen. At some point, however, it typically stabilizes. Pain during erections usually improves within one to two years, but the scar tissue and curvature often remain. In some cases, both the curvature and pain associated with Peyronie’s disease improve without treatment.

The only FDA-approved medication for Peyronie’s disease is collagenase clostridium histolyticum (Xiaflex). This medicine has been approved for use in adult men with moderate to severe curvatures and a palpable nodule. The treatment works by breaking down the buildup of collagen that causes penile curvature.

Although Xiaflex is not uncomfortable to receive, some patients have significant pain for up to 48 hours after the injection, with rare patients having discomfort beyond this period.