Peyronie’s Disease
What is Peyronie’s Disease?
Peyronie’s disease is a disorder in which fibrous plaques develop within the penis, causing curvature and painful erections. Peyronie’s disease can be so severe that it could inhibit the ability to have sex. Peyronie’s disease affects up to 10% of men and becomes more common with age.
Symptoms of Peyronie’s Disease
A painful erection is often the first sign for some men with Peyronie’s disease. The pain is a sign of inflammation, which can lead to a hard, fibrotic plaque and penile curvature. Usually, the plaques develop on the upper surface of the penis, although in some cases it can occur on the bottom surface or the sides. Signs and symptoms include the following:
- The plaques can often be felt at the site of the curvature in the penis
- A narrowing of the penis (also known as an “hourglass” deformity)
- Erectile dysfunction
- Pain with erection and/or sex
There are 2 phases of Peyronie’s disease. During the acute phase, which can last up to 2 years, plaques form, curvature develops, and patients often experience pain. During the stable (chronic) phase, pain is diminished, but the curvature is usually permanent.
How is Peyronie’s Disease Treated?
In about 10% of men with Peyronie’s, the fibrosis/curvature will improve without any treatment. For the majority of men, the plaques will stabilize and remain permanent. There are several treatment options, depending on the severity of the condition.
Oral Medication: Several different oral medications have been used to help inhibit inflammation and the development of scar tissue, but these are likely ineffective.
Penile Traction Therapy: Penile stretching with a penile traction device can help reduce curvature of the penis.
Verapamil Injection: Verapamil injected directly into the plaque may help soften the plaque and reduce pain during the acute phase.
Xiaflex Injection: Collagenase clostridium histolyticum (Xiaflex) is the only FDA-approved medication for Peyronie’s disease. These injections improve penile curvature by breaking down the plaques/scar tissue.
Penile Plication Surgery: Surgery may be necessary to correct curvature in severe cases of Peyronie’s disease or in cases in which a patient is not a candidate for injection therapy.
Penile Implant: A penile implant can treat men with both erectile dysfunction and Peyronie’s disease. The penile prosthesis will help straighten the penis.
