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Peyronie's (pay-roe-NEEZ) disease is the development of fibrous scar tissue inside the penis that causes curved, painful erections.
Men's penises vary in shape and size. Having a curved erection is common and isn't necessarily a cause for concern. However, in some men, Peyronie's disease causes a significant bend or pain.
This can prevent a man 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.
In a small percentage of men, Peyronie's disease 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.
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Symptoms By Mayo Clinic Staff
Peyronie's disease signs and symptoms might appear suddenly or develop gradually. The most common signs and symptoms include:
The curvature associated with Peyronie's disease might gradually worsen. At some point, however, it stabilizes in the majority of men.
In most men, pain during erections improves within one to two years, but the scar tissue and curvature often remain. For a few men, both the curvature and pain associated with Peyronie's disease improve without treatment.
See your doctor if pain or curvature of your penis prevents you from having sex or causes you anxiety.
The cause of Peyronie's disease isn't completely understood, but a number of factors appear to be involved.
It's thought Peyronie's disease generally results from repeated injury to the penis. For example, the penis might be damaged during sex, athletic activity or as the result of an accident. However, most often, men do not recall specific trauma to the penis.
During the healing process, scar tissue forms in a disorganized manner, which might then lead to a nodule that you can feel or development of curvature.
Each side of the penis contains a sponge-like tube (corpus cavernosum) that contains many tiny blood vessels. Each of the corpus cavernosa are encased in a sheath of elastic tissue called the tunica albuginea (TOO-nih-kuh al-BYOO-JIN-e-uh), which stretches during an erection.
When you become sexually aroused, blood flow to these chambers increases. As the chambers fill with blood, the penis expands, straightens and stiffens into an erection.
In Peyronie's disease, when the penis becomes erect, the region with the scar tissue doesn't stretch, and the penis bends or becomes disfigured and possibly painful.
In some men, Peyronie's disease comes on gradually and doesn't seem to be related to an injury. Researchers are investigating whether Peyronie's disease might be linked to an inherited trait or certain health conditions.
Risk factors By Mayo Clinic StaffMinor injury to the penis doesn't always lead to Peyronie's disease. However, various factors can contribute to poor wound healing and scar tissue buildup that might play a role in Peyronie's disease. These include:
Other factors — including certain health conditions, smoking and some types of prostate surgery — might be linked to Peyronie's disease.
Complications By Mayo Clinic StaffComplications of Peyronie's disease might include:
A physical exam is often sufficient to identify the presence of scar tissue in the penis and diagnose Peyronie's disease. Rarely, other conditions cause similar symptoms and need to be ruled out.
Tests to diagnose Peyronie's disease and understand exactly what's causing your symptoms might include the following:
Physical exam. Your doctor will feel (palpate) your penis when it's not erect, to identify the location and amount of scar tissue. He or she might also measure the length of your penis. If the condition continues to worsen, this initial measurement helps determine whether the penis has shortened.
Your doctor might also ask you to bring in photos of your erect penis taken at home. This can determine the degree of curvature, location of scar tissue or other details that might help identify the best treatment approach.
Other tests. Your doctor might order an ultrasound or other tests to examine your penis when it's erect. Before taking images of your penis, you'll likely receive an injection directly into the penis that causes it to become erect.
Ultrasound is the most commonly used test for penis abnormalities. Ultrasound tests use sound waves to produce images of soft tissues. These tests can show the presence of scar tissue, blood flow to the penis and any other abnormalities.
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Your doctor might recommend a wait-and-see (watchful waiting) approach if:
If your symptoms are severe or are worsening over time, your doctor might recommend medication or surgery.
The goals of treatment with medication include reducing plaque formation and pain, as well as minimizing curvature of the penis.
There is one medication approved by the Food and Drug Administration for the treatment of Peyronie's disease. It's called collagenase Clostridium histolyticum (Xiaflex). This medicine is approved for use in men with a palpable lump from plaque in the penis that causes a curvature of at least degrees during erection.
The treatment works by breaking down the buildup of collagen that causes penile curvature. It involves a series of in-office injections, directly into the penile lump, as well as penile modeling — brief exercises to gently stretch and straighten the penis.
In clinical trials, this collagenase therapy significantly reduced curvature and bothersome symptoms associated with Peyronie's disease in many participants. Discuss potential side effects of this medication with your doctor, as some of them can be serious.
Examples of off-label use of medications for Peyronie's disease include an oral medication called pentoxifylline (Trental), verapamil (injections or topical gel) and interferon (injections).
Most experts recommend against surgery during the early inflammatory phase of Peyronie's disease. Your doctor might suggest surgery if the deformity of your penis is severe, especially bothersome, or prevents you from having sex. Surgery usually isn't recommended until the curvature of your penis stops increasing.
Surgical methods include:
The type of surgery will depend on your condition. Your doctor will consider the location of scar tissue, the severity of your symptoms and other factors.
A technique known as iontophoresis uses a weak electrical current to deliver a combination of verapamil and dexamethasone noninvasively through the skin. Research shows conflicting results.
Several nondrug treatments for Peyronie's are being investigated, but evidence is limited on how well they work and possible side effects. These include using intense sound waves to break up scar tissue (shock wave therapy), devices to stretch the penis (penile traction therapy) and vacuum devices.
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