Peyronie's disease

Peyronie’s disease is a disorder of the connective tissue that surrounds the erectile tissue in the penis. This results in a curve or bend in the penis when it’s erect.

Peyronie’s disease is different from congenital curvature of the penis, which occurs due to slight differences in growth between different sides of the penis during development. It occurs in around 3% of men, becoming more common with increasing age.

Peyronie’s disease has two phases: the active phase and the stable phase.

During the active phase, you’ll usually experience pain, often (but not always) after some type of injury to the penis (but not always), and your symptoms may change as curving or bending occurs.

During the stable phase (after three months without changing symptoms), you might not have any pain, but you can usually feel the scar tissue in your penis, and the bend or curve in your penis does not get worse.

The most likely cause of Peyronie’s disease is repeated damage to the penis during sexual activity, although many men do not recall any event before noticing the disease.

There are probably some genetic differences in healing processes that contribute to Peyronie’s disease in at least some affected men.

Surgery is the best way to treat Peyronie’s disease.

Collagenase clostridium histolyticum (CCH) is the only approved injected medication for Peyronie’s disease, but it is no longer available in Australia.

Oral medications such as vitamin E, colchicine and phosphodiesterase type-5 (PDE5) inhibitors have minimal benefit. Shock wave therapy is still being assessed as a suitable treatment for Peyronie’s disease. Traction devices have some benefit in straightening the curvature of the penis in Peyronie’s disease.

Peyronie’s disease is often accompanied by pain and commonly results in problems having intercourse. It has a negative impact on the mental health and sexual relationships of most men with the disease.

If your penis has always had a bit of a curve that doesn’t bother you and is not painful, there’s no need to do anything.

Dupuytren’s contracture, a medical condition that affects the hands, is linked to Peyronie’s disease. Diabetes and high blood pressure are associated with Peyronie’s disease, but neither of these is likely to have a direct cause-and-effect relationship.

If you injure your penis and are in pain, you should see your doctor to make sure there’s no severe damage.

Even if you don’t remember injuring yourself, if you have penis pain (either with or without an erection), you should see your doctor. You should also see your doctor if you notice any changes to the shape of your penis (not just bends and curves, but lumps and bumps too).

Your doctor will probably refer you to a urologist, who will have experience in treating Peyronie’s disease. The urologist will perform an examination, might order an ultrasound scan, and will talk to you about treatment options.