Most men with Peyronie's disease can still have sex. But for some, it can be painful and cause erectile dysfunction.
Depending on the symptoms, you may opt for observation, medical or surgical treatments.
What Causes Peyronie's Disease?
Doctors don’t know exactly why Peyronie's disease happens. Many researchers believe the fibrous plaque can start after trauma (hitting or bending) that causes bleeding inside the penis. You might not notice the injury or trauma.
Other cases, which develop over time, may be linked to genes. In some men, injury and genes could both be involved.
Some medications list Peyronie's disease as a possible side effect. But there is no proof that these drugs cause the condition.
Who Gets Peyronie's Disease?
Although it mostly happens in middle-aged men, younger and older men can get it.
It becomes more common as a man gets older. But it’s not a normal part of aging.
What Are the Symptoms of Peyronie's Disease?
Symptoms may develop slowly or appear overnight. When the penis is soft, you can’t see a problem. But in severe cases, the hardened plaque hampers flexibility, causing pain and forcing the penis to bend or arc when erect.
In most cases, the pain eases over time, but the bend in the penis can worsen.
Some men with the condition develop scar tissue elsewhere in the body, such as on the hand or foot. Men with Dupuytren's contractures -- scarring in the hand that affects fingers -- seem to be more likely to get Peyronie's.
How Do Doctors Diagnose Peyronie's Disease?
Tell your doctor about anything, such as an injury, that happened before the symptoms started.
You’ll get an exam in which your doctor will feel the hardened tissue caused by the disease during an exam. It’s not always necessary, but if the penis has to be erect for the exam, the doctor would inject a medicine to make that happen.
There’s a chance you may need to get an X-ray or ultrasound of the penis.
It’s rare, but in some cases where the doctor's exam does not confirm Peyronie's disease, or if the condition develops rapidly, your doctor may do a biopsy. That involves removing a little bit of tissue from the affected area for lab tests.
Can Peyronie's Disease Be Treated?
Yes, but you might not need it.
Since the condition improves without treatment in some men, doctors often suggest waiting 1 to 2 years or longer before they try to correct it.
Mild cases of the condition rarely need treatment. Also, the pain that comes from Peyronie's disease happens only with an erection and is usually mild. If it’s not causing a problem with your sex life, treatment may not be necessary.
What Treatments Are Available?
If you need treatment, your doctor will consider surgery or medicine.
If those don’t work, you may get a shot of verapamil or collagenase (Xiaflex) into the scar tissue of the penis. If nothing else works, your doctor may consider surgery, but usually only for men who can’t have sex because of their Peyronie’s disease.
The two most common operations are:
- Remove the plaque and get a tissue graft in its place.
- Remove or alter the tissue on the side of the penis opposite the plaque, which counters the disease's bending effect.
Unfortunately, these procedures aren’t a sure solution. With the first method, you could have some erection problems. The second method, which doctors call the Nesbit procedure, shortens the erect penis.
In some cases, it may be an option to get a penile prosthesis implanted. This treatment is only for men who have both Peyronie's disease and ED (erectile dysfunction).
Most types of surgery help. But because of the possibility of complications that can’t be corrected, most doctors prefer to operate only on the small number of men with curvature so severe that it prevents sex.
Do Vitamins Help?
Other ways to treat Peyronie's disease that are unproven include injecting chemicals directly into the plaque and radiation therapy. But because radiation therapy can only relieve pain associated with Peyronie's disease and pain often stops without treatment, it’s rarely done.
In most men who have penile pain due to Peyronie's disease, the discomfort usually will fade on its own as the penile inflammation subsides. This process may take as long as 6 to 18 months.