Last Updated – February 20, 2023
If you’re reading this to answer the question, “Do I have Peyronie’s disease?” We wrote this article for you.
First, we’ll explain what Peyronie’s disease is, then discuss its symptoms and causes, how it’s diagnosed, and treatment options.
What is Peyronie’s Disease?
Peyronie’s disease is a condition causing a man’s penis to curve. Because the shape and size of a penis can vary from man to man, the curvature caused by Peyronie’s disease may appear slight or more significant.
Severe cases of Peyronie’s disease are very painful and may make sex impossible.
What Causes Peyronie’s Disease?
The curvature due to Peyronie’s disease is caused by scar tissue buildup in the penis. This scar tissue is called plaque, but it’s not like plaque on your teeth or the plaque that can clog blood vessels.
The Mayo Clinic is an excellent resource for learning about Peyronie’s disease symptoms. Here’s what to look for:
- Scar tissue (Plaque)
You can feel the plaque building under the skin of the penis like a hard band or flat lumps.
- A significant bend to the penis
Peyronie’s disease causes the penis to curve upward, downward, or to one side.
- A problem maintaining erections
Peyronie’s disease might cause ED (erectile dysfunction). However, men often already have ED before the onset of any Peyronie’s disease symptoms.
- A shortened penis
Peyronie’s disease may cause the penis to get shorter.
- Varying amounts of pain
Peyronie’s disease may cause pain in an erect or flaccid penis.
- Other penile deformities
Peyronie’s disease symptoms may include a penis that narrows when erect. In addition, there may be indentations to the penis, or the penis may appear to be hourglass-shaped due to a tight band of plaque around the shaft.
Peyronie’s Disease Causes
Other health conditions or lifestyle choices may cause Peyronie’s disease. While Peyronie’s disease happens more often in older men, the following risk factors can increase the chances of developing the condition:
- Heart problems and Cardiovascular issues
High blood pressure and high cholesterol can contribute to Peyronie’s disease.
- Diabetes
Studies show that diabetes is a risk factor.
- Lifestyle risks
Heavy smoking and drinking are risk factors. There’s also a concern with unprotected sex leading to an STD (sexually transmitted disease) causing inflammation.
- Injuries during sex
Specifically, rough sexual activities may cause Peyronie’s disease, especially if the penis gets bent or stretched. Another risk factor is sexual penetration before the penis is fully erect.
- Erectile dysfunction
The likelihood of Peyronie’s disease symptoms seems to increase in men who already experience ED.
Peyronie’s Disease Diagnosis:
It’s always best to seek a medical diagnosis if you’re concerned that you have Peyronie’s disease.
This Self-Check questionnaire will assist you in the process:
- Are erections painful for you?
- Do you have problems getting a firm erection now?
- Does your penis curve when erect?
- If so, has the curve gotten more apparent over time?
- Do you think your erect penis is shorter than before?
- Does your erect penis appear to be indented or have an hourglass shape?
- Do you feel any new bumps or nodules in your penis?
- Is sexual penetration hard now because your penis buckles or bends?
You may not experience every symptom on this questionnaire. Still, if you have one or more of these Peyronie’s disease symptoms, you should talk to your primary care provider or urologist.
Medical Tests for Peyronie’s Disease
Your healthcare provider or urologist will order the following kinds of tests to determine if you have Peyronie’s disease:
Palpation
This is generally the first test you will undergo, where the specialist palpitates the flaccid penis. Next, the specialist will locate indentations, bumps, or hard tissue on the penis.
Peyronie’s disease Questionnaire (PDQ)
Your specialist also uses a medical questionnaire called the Peyronie’s disease Questionnaire (PDQ), a 15-item list with psychological and physical questions you will answer.
A PDQ can help your specialist learn what caused your Peyronie’s disease and its seriousness. It will also help your specialist know what treatment to prescribe and how well it will improve your condition.
Measurement of Curvature
This test requires the penis to be erect, and the specialist may inject your penis with medication to produce an erection. Next, the specialist measures the curve in your erection with a goniometer device. The measurement can also be done manually.
Blood Tests
Low testosterone levels in the blood may cause some men not to have firm erections. This increases Peyronie’s disease risk, so a blood test may be ordered to determine your testosterone levels.
Imaging
A high-resolution ultrasound may be ordered to identify plaque (scar tissue) in the penis, a Peyronie’s disease symptom.
Imaging tests (X-rays, CT, MRI) are rarely ordered to investigate or confirm a diagnosis of Peyronie’s. An ultra und is the most commonly requested imaging modality to examine the soft tissue and identify any scar or plaque formation.
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Peyronie’s Disease Treatment Options
The good news is effective treatments exist for Peyronie’s disease. Here are some treatments currently offered.
Non-Surgical Treatments
Depending on your symptoms and how long you’ve been experiencing Peyronie’s disease, these non-surgical treatments are currently available.
Intralesional Therapies
Intralesional therapies are treatments for Peyronie’s Disease that involve injecting substances directly into the plaque that causes the curvature of the penis.
There are several types of intralesional therapies, including Collagenase Clostridium Histolyticum (CCH), Calcium Channel Blockers (verapamil and nicardipine), Hyaluronic Acid (HA) and Platelet Rich Plasma (PRP) therapy.
According to research, Platelet Rich Plasma (PRP) therapy has shown promising results in treating Peyronie’s Disease. In PRP, a patient’s blood creates a concentrated solution of platelets injected into the plaque area. Some preliminary studies have shown improvement in penile curvature and reduction in pain, but further research is needed.
Other treatments, such as Hyaluronic Acid or Calcium Channel Blockers, have also shown positive results in improving curvature, but their effectiveness varies.
Topical Therapies
Topical therapies are treatments applied directly to the skin to treat Peyronie’s Disease.
Different topical therapies include extracorporeal shockwave therapy (ESWT), traction devices, laser therapy, and various topical medications.
ESWT, known as Acoustic Shockwave Therapy, is a promising treatment option for Peyronie’s Disease due to its non-invasive nature and potential benefits. Several studies have shown it to effectively improve penile curvature, reduce pain, and improve sexual function.
It is important to note that further research is necessary to fully understand the long-term effects of ESWT on Peyronie’s Disease. Still, currently, it is considered a favourable option for those seeking treatment.
Oral Therapies
Vitamin E, Tamoxifen, Potassium Paraaminobenozate (POTABA), Phosphodiesterase type 5 inhibitors (PDE5-I), Colchicine, Acetyl-L-carnitine, and Co-enzyme Q10 are some of the oral therapies used for treating Peyronie’s Disease.
According to research, Vitamin E improves plaque size and penile curvature, while POTABA improves curvature and plaque size. PDE5-I improves pain, and co-enzyme Q10 shows some positive improvements. However, tamoxifen and colchicine show no significant progress.
More research is needed to determine the efficacy and safety of these oral therapies for Peyronie’s Disease.
Surgical Treatments
Surgical options are available to treat Peyronie’s disease, depending on the seriousness of your condition and what your specialist believes is the most effective treatment. Surgical options include:
- Suturing
- Incision/Excision and grafting
- Penile prosthesis
When Should You See a Doctor?
Peyronie’s disease symptoms can worsen with time, so please see our specialists at Oakwood Health Network as soon as possible when you notice signs or symptoms. Early treatment is the most effective way to improve and prevent Peyronie’s disease from worsening.
You can also schedule a free consultation online right now!
Boskey, E., 2021. How Peyronie’s Disease Is Diagnosed. [online] verywell Health. Available at: <https://www.verywellhealth.com/peyronies-disease-diagnosis-4688592> [Accessed 10 October 2021]. Urologyhealth.org. 2020. Peyronie’s Disease: Symptoms, Diagnosis & Treatment – Urology Care Foundation. [online] available at: <https://www.urologyhealth.org/urology-a-z/p/peyronies-disease> [Accessed 12 October 2021]. Pruthi, S., 2021. Peyronie’s disease – Symptoms and causes. [online] ayo Clinic. Available at: <https://www.mayoclinic.org/diseases-conditions/peyronies-disease/symptoms-causes/syc-20353468> [Accessed 8 October 2021]. Arafa M, Eid H, El-Badry A, Ezz-Eldine K, Shamloul R. The prevalence of Peyronie’s disease in diabetic patients with erectile dysfunction. Int J Impot Res. 2007 Mar-Apr;19(2):213-7. doi: 10.1038/sj.ijir.3901518. Epub 2006 Aug 17. PMID: 169 5304. Casabé A, Bechara A, Cheliz G, De Bonis W, Rey H. Risk factors of Peyronie’s disease. What does our clinical experience show? J Sex Med. 2011 Feb;8(2):518-23. doi: 10.1111/j.1743-6109.2010.02072.x. Epub 2010 Oct 18. PMID: 209 5309. Al-thakafi S, Al-hathal N. Peyronie’s disease: a literature review on epidemiology, genetics, pathophysiology, diagnosis and work-up. Transl Androl Urol. 2016;5(3):280-9. doi:10.21037/tau.2016.04.05 Hayat, S., Brunckhorst, O., Alnajjar, H.M. et al. A systematic review of non-surgical management in Peyronieʼs disease. Int J Impot Res (2022). https://doi.org/10.1038/s41443-022-00633-w
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