Peyronie's Disease: Causes and Treatment of Curved Penis

10 min read
Peyronie's Disease: Causes and Treatment of Curved Penis

It’s understandable that men who notice penile curvature may be alarmed, especially if the curving has suddenly appeared. A slight bend in the penis may be nothing to worry about. Unfortunately, for men with Peyronie’s disease (PD) the curvature of their penis can be a major cause for concern. 

At first, men suffering from PD may just find the curving of their penis a source of embarrassment. However, one of the most challenging difficulties of the disease is the insufferable pain it can cause whilst the penis is erect. So much so, that Peyronie’s disease can make having sex impossible to tolerate.

The good news is that the disease is treatable through both surgical and non-surgical procedures. This article will explain everything you need to know about Peyronie’s disease, including what it is, how it’s caused, and what you can do about it.

What is Peyronie’s Disease

Peyronie’s disease is an issue that causes the penis to be curved while erect. PD can lead to pain during sexual intercourse and may even cause erectile dysfunction (ED).

While some penile curvature may not be a problem, Peyronie’s disease can cause drastic bending and intense pain.

PD can occur as a result of scar tissue (known as plaque) forming on the penis. The plaque develops under the skin and can appear anywhere along the penis. It’s said that doctors can’t give an exact reason why Peyronie’s disease occurs however, it’s widely believed that the development of plaque can be a result of penile injury.

How common is Peyronie’s Disease

It’s reported that around 1 in 100 men have been diagnosed with Peyronie's disease in the United States. With that said, estimating the true prevalence of PD may prove challenging. Given the sensitive nature of the condition, individuals may be hesitant to discuss their symptoms with a health professional. It’s possible that the actual number of men with Peyronie’s disease is significantly higher than 1 in 100.

A study estimated that in the US, definitive cases of PD are at around 0.7%, while probable cases of the disease are as high as 11%. The difference between definitive and probable cases suggests that PD may be under or misdiagnosed. This could be due to patients who are hesitant to visit a medical professional, inadequate screening tools for PD or physicians being unfamiliar with the condition.

 

The Stages of Peyronie’s Disease

Peyronie’s disease can be broken down into 2 different stages, these are known as the acute stage and the chronic stage. We’ve explained each of these below.

Acute Stage

Typically the acute phase will last approximately 6 months but can last up to 18 months in rare circumstances. Within this timeframe, the penis has plaque forming inside it and the curvature of the penis is increasing.

The acute phase may lead to pain when the penis becomes erect, but it’s also possible for pain to present itself when the penis is in a flaccid state.

Chronic Stage

This stage begins when plaque has stopped growing and the penis doesn’t experience a further increase in curvature.

This stage will usually begin around 12 to 18 months after the initial symptoms of Peyronie’s disease occur.The pain which was present during the acute phase may lessen or dissipate. In the chronic phase, erectile dysfunction may occur or worsen if it’s already present.

What causes Peyronie’s Disease?

Although the exact cause of Peyronie’s disease is not fully understood yet, there are some factors to consider in the development of the disease. These are highlighted below:

Trauma (Penile injury)

It’s believed that Peyronie’s disease can be the result of injury to the penis. Penile injury can occur in a variety of settings, including during sexual activity, sports environments, or any physical collision. When the penis is healing, the formation of scar tissue takes place (also known as plaque).

When a male becomes sexually aroused, blood flow to the penis increases and it expands. For men with Peyronie’s disease, the region with scar tissue doesn’t expand, which creates a bend in the penis and potentially causes penile pain.

Genetics

The link between genetics and Peyronie’s disease is not yet fully understood.
However, existing research suggests that genetics do play a part in determining whether an individual will get Peyronie’s disease.

One study highlights race as a contributing factor and found that PD is more prevalent in Caucasian men. Other research concludes (although based on limited data) that PD is likely to represent a heterogenous condition. It states that the development of PD is likely contributed to by both heritable and environmentally-driven factors.

Aging

Although age itself can’t be considered a cause for Peyronie’s disease, research suggests that there is a positive correlation between getting older and being susceptible to PD.
Although it typically affects men of all ages, those in their 20s and 30s are less likely to suffer from Peyronie’s disease compared to someone in their 50s.

With Peyronie’s disease most commonly seen in the fifth decade of a man's life, it’s worth noting that the onset of PD is clinically more “noisy and acute” in patients under the age of 40. This may lead to physicians subjecting them to more vigorous treatment.

Erectile Dysfunction

Erectile dysfunction is when men struggle to get or maintain an erection. ED is closely linked with Peyronie’s disease as the condition itself can cause erectile issues.

It’s common for men with PD to report symptoms of erectile dysfunction prior to their symptoms of Peyronie’s disease.

It’s said  that men who have diabetes-associated erectile dysfunction are up to five times more likely to develop Peyronie’s disease.

Connective Tissue Disorders

Connective tissue disease refers to disorders that involve protein-rich tissue that supports organs and other body parts. Connective tissues include fat, bone, and cartilage. Some men with connective tissue disorders may be at higher risk of developing Peyronie’s disease.

This was found in a study that examined the prevalence of PD symptoms in men with Dupuytren Contractures (DC), a connective tissue disorder that causes the fingers to pull towards the palm. It found that many men with DC also presented with bothersome symptoms consistent with Peyronie's disease.

Prostate Cancer Surgery

Radical Prostatectomy (RP) is a common operation performed to treat prostate cancer. The procedure involves removing the prostate gland and its surrounding tissue and this type of operation can cause inflammation and swelling. This leads to a buildup of scar tissue and fibrous plaque.

A study found that men presenting with sexual dysfunctions after RP have a higher incidence of Peyronie’s disease when compared to the general population. The study made the recommendation that men who have undergone RP procedures should be routinely evaluated for PD.

Symptoms of Peyronie’s Disease

Peyronie’s disease has a range of symptoms, some of which can appear quickly or develop gradually over time. Some of the most common symptoms are detailed below.

Notable bend on the penis

Bending is one of the main symptoms of Peyronie’s disease and may present itself with upwards, downwards, or sideways curvature.

Plaques / Lumps in the penis

Scar tissue development called plaque can be felt under the skin. This may feel like thickened areas or hard lumps. It’s considered rare for there to be more than one area of plaque buildup.

Pain when you get an erection

One of the most prevalent symptoms is experiencing pain when the penis is erect. In rare cases, pain may even be present when there is no erection.

Other erection problems may occur such as difficulty maintaining or getting an erection. In some cases, erectile dysfunction symptoms occur before the symptoms of PD start to show.

Loss of penis size

One of the easier symptoms to spot is a reduction in the size of the penis. For men suffering from PD, their penis can be susceptible to a reduction in length as well as girth.

Change in penis shape

Peyronie’s disease can cause the penis to change shape and appear almost like an hourglass. The penis may appear thinner in places with narrow banding presenting itself around the shaft.

Getting medical treatment for Peyronie’s Disease

If you’re worried that you have Peyronie’s disease or unusual symptoms such as penile pain you should consult a medical professional. Give your doctor as much information as you can, including injuries that took place prior to PD symptoms, or mentioning other penile conditions such as erectile dysfunction.

A doctor can give you an examination to see if your symptoms are consistent with Peyronie’s disease. They will be able to familiarize you with the treatment options available for your symptoms and advise on which option they believe is best for you.

Best treatments for Peyronie’s Disease?

Peyronie’s disease can be handled with surgical and non-surgical treatments. For many men, the thought of undergoing penile surgery can be intimidating. However, in many cases of Peyronie’s disease, non-surgical treatment is an effective option. Both surgical and non-surgical treatment options are highlighted below.

Surgical treatments

In extreme cases surgery is an option for treating Peyronie’s disease however, many people suffering from PD won’t need to undergo surgical treatment (depending on the severity of symptoms).

Medical professionals may only consider surgical treatment if sex has become impossible due to the pain caused by PD. Doctors will also need to wait until the disease has stabilized before operating. Surgery can involve a few different techniques which are explained below.

1.  Removing the plaque by cutting it and attaching skin or a vein to remove the curvature of the penis. It’s worth noting that some men can experience a loss of feeling which usually lasts 6 to 12 months but in some cases, it can be permanent.

2.  Removal of the area opposite the plaque. This is done in order to neutralize the bending but may result in a slight reduction in penis size. This type of treatment is less likely to cause numbness or ED in comparison to the first method.

3. Penile prosthesis involves the doctor placing two cylinders inside the penis and a pump into the scrotum. Post-surgery the patient will achieve erections by squeezing the pump. It’s important to note that this method may also lead to a slightly smaller penis as the scarred tissue is not expanded during surgery.

    Non-surgical treatments

    There are plenty of men who have Peyronie’s disease but don’t require treatment due to the fact that their sexual function has not been affected.

    In some cases, it’s possible to see improvements in the disease without undergoing any treatment. There’s a variety of options available for non-surgical treatments, these include vacuum devices, medicines, and injections.

    Vacuum Devices

    In some cases, using vacuum erection devices (VED) also known as penis pumps can be an effective option for men seeking out non-surgical treatment for PE. A study found that for patients opting to try non-invasive management of Peyronie’s disease, VED therapy improved curvature resolution when compared to people who didn’t use this type of device.

    The study concluded that men with large initial penile curvatures saw the biggest improvement in both curve and PD duration, with the patient's age not affecting the magnitude of curvature improvement. It’s important to note that penis pumps aren’t an effective treatment for every case of PD.

    Medicine

    A medicine called Pentoxifylline (Trental) is usually the initial drug prescribed in an attempt to straighten the penis. The pill is usually taken for a number of months to assess its effectiveness. As PD and erectile dysfunction can exist simultaneously, if ED is also present doctors can prescribe a separate medicine to treat the condition.

    Injections

    Doctors may suggest injecting a drug into the penis in order to break up scar tissue. A common drug found to be effective for this is Verapamil which is used to decrease pain as well as curvature.

    Another drug that can be injected for treating PD is Collagenase Clostridium Histolycticum (Xiaflex). Studies have shown the effectiveness of this drug with men seeing a 34% reduction in curvature on average. This is administered in up to four rounds of treatment consisting of two injections each time.

    Peyronie’s Disease FAQs

    Can certain sex positions cause Peyronie’s Disease?

    It’s unknown whether certain sex positions can cause Peyronie’s disease. However, with penile trauma being a cause of PD, if the penis hurts or feels strained during sex, try changing position and finding one that doesn’t cause discomfort.

    Can Masturbation cause Peyronie’s Disease?

    Although little research exists on the impact of masturbation on Peyronie’s disease, masturbation can cause penile trauma. With Peyronie’s disease forming as a result of trauma to the penis if you feel pain during masturbation stop immediately and reconsider your technique.

    Does Peyronie’s Disease Hurt?

    Yes, one of the main symptoms of Peyronie’s disease is pain. The pain can be so significant that it makes engaging in any form of sexual activity impossible for the individual. The pain usually occurs while the penis is erect however, in some rare cases pain can also occur when the penis is flaccid.

    How long does Peyronie’s disease last?

    Peyronie’s disease is permanent in most cases. If it’s not causing severe pain or limiting sexual function the condition can go untreated. However, symptoms may worsen over time in response to additional injuries. Severe cases may warrant surgical or non-surgical treatment to correct the issues.

    Can Peyronie’s disease make the penis smaller?

    Yes, Peyronie’s disease can lead to a decrease in penis size. This may appear as an initial symptom with it being possible for Peyronie’s disease to result in a loss of length or girth of the penis. Some surgical treatments can also lead to a slight decrease in the size of an individual's penis due to the removal of tissue.

    Can CBD oil help with Peyronie’s Disease?

    No, there is currently no research stating CBD oil is an effective treatment for Peyronie’s disease.

    Is Tumeric good for Peyronie’s Disease?

    No, there is no evidence that suggests Tumeric is effective in treating Peyronie’s disease.

    Summary

    Peyronie’s disease is a condition that leads to a bending of the penis and can cause enough pain that it prevents sexual activity. The disease usually occurs due to trauma resulting in the formation of scar tissue known as plaque. When the penis is erect, the plaque does not stretch as the other skin does and the penis appears to be curved.

    The symptoms of the disease include pain during erections, a curved penis, a loss of penis size or a change of shape. Treatment can be carried out surgically via an operation or non-surgically with the use of a penis pump, medicine, or injections. If you’re concerned that you may have Peyronie’s disease or other unusual symptoms consult your medical professional.

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