Penile Curvature (Peyronie's Disease)

Penile curvature, also known as Peyronie’s disease, is a condition that occurs when fibrous scar tissue develops on the penis, causing curved, painful erections. Penile curvature can be caused by injury or trauma to the penis, or it can be the result of genetic factors.

Physicians at The University of Kansas Health System provide leading-edge treatments for Peyronie's disease. Those with recent disease onset may only need an in-office treatment, while men who have a long history of penile curvature often require surgical intervention. Whatever your needs, The University of Kansas Health System provides all available options for penile curve correction.

It is normal for penis size and shape to vary among men, so a curved erection doesn’t necessarily indicate the presence of Peyronie’s disease. However, penile curvature that results from Peyronie’s disease causes significantly curved erections that are also painful.

Peyronie’s disease results from fibrous scar tissue that develops on the penis, possibly due to a previous injury. This results in penile curvature that can be severe enough to interfere with a man’s ability to achieve or maintain an erection (erectile dysfunction). Penile shortening can also occur. Without treatment, Peyronie’s disease tends to worsen with time.

The primary symptom of Peyronie’s disease is an abnormal curvature of the penis during erections. Other common symptoms and complications may include:

• Erection problems
• Penile pain, with or without an erection
• Penile shortening or other deformity, such as narrowing or developing an hourglass shape
• Scar tissue that can be felt as lumps or tight bands under the skin of the penis
• Stress or anxiety due to concerns over sexual abilities

In many cases, the symptoms of Peyronie’s disease worsen initially, then stabilize between 3 and 12 months after the initial onset. Typically, the pain associated with erections improves within 1 to 2 years, although the penile curvature and shortening remain unchanged.

It’s currently believed that Peyronie’s disease develops due to a former injury that leads to unusual scar tissue development. However, not every injury to the penis will result in painful penile curvature.

• Age: The incidence of penile curvature increases for men in their 50s and 60s.
• Connective tissue disorders: In men with certain connective tissue disorders, such as Dupuytren's contracture, penile curvature seems more likely to occur.
• Heredity: Having a family member with Peyronie’s disease increases your risk of penile curvature..

Doctors can often correctly diagnose Peyronie’s disease during a normal physical exam. A urologist will examine your penis for the presence of fibrous plaques, curvature or any other physical abnormalities. They may also assess the degree of curvature and any pain you experience during an erection.

In some cases, ultrasound or other imaging devices may be used to look for scar tissue or evaluate blood flow to the penis.

The course of treatment your doctor recommends for penile curvature correction will depend on how long you’ve been having symptoms. Men in the earliest stages of Peyronie’s disease may benefit from a different approach compared to men with more advanced penile curvature.

In the beginning stages (acute phase) of Peyronie’s disease, early treatment may help slow the symptoms from worsening. Corrective penile curvature surgery is only recommended after the disease has stabilized (chronic phase) and symptoms are no longer worsening. This is to prevent the need for additional surgeries.

Rarely, some men may see improvement in their Peyronie’s disease symptoms without any treatment.

Common treatment options for penile curvature include:

• Medications: Your doctor may prescribe oral medications, such as pentoxifylline or potassium para-aminobenzoate (Potaba), to help reduce pain and potentially slow the progression of the disease.
• Injection therapies: In some cases, a healthcare provider may recommend injecting medications directly into the plaques to soften and break down the scar tissue. This can include the use of verapamil, collagenase (Xiaflex), or other agents.
• Physical therapy: Some men benefit from physical therapy techniques that aim to stretch and straighten the penis. This is often done under the guidance of a specialist.
• Penile traction devices: These devices apply gentle stretching to the penis over time, which can help reduce curvature. They are typically used in combination with other treatments.
• Surgery: Surgery may be considered if the curvature is severe or if other treatments have not been effective. Surgical options can include plaque incision or excision, penile implants or penile reconstruction procedures.