A curved penis because of Peyronie’s disease can be a little embarrassing or a real roadblock to sex.
You have a few choices to help the problem. If you only have a mild curve and your sex life and erections are good, you probably don't need treatment. If sex is hard or impossible, medicines, injections, and sometimes surgery can help.
Pills
Pentoxifylline (Trental) is often the first medicine doctors prescribe to help straighten the penis. You have to take the pill for a few months to see if it’s going to work.
Some doctors prescribe vitamin E supplements or a form of potassium called para-aminobenzoate, but there is little evidence these work.
In men with Peyronie’s disease who also have some erectile dysfunction, drugs to treat ED may help.
Injections
Your doctor might suggest injecting a drug into the penis to break up the scar tissue.
Some doctors use a drug called verapamil. Studies show it can decrease the curve and pain in many men.
Collagenase clostridium histolyticum (Xiaflex) is another injected drug for treating Peyronie’s. In a clinical study, men who got the injections saw their curves reduced by 34% on average, while men who got placebo shots ("fake" treatment) saw an average 18% improvement. You’ll need up to four rounds of two shots each round, along with a non-surgical procedure, to help straighten the penis.
Surgery
Most doctors consider surgery only when sex is difficult or impossible. They wait until your Peyronie’s has stopped getting worse before operating.
There are three different types of surgery:
1. Plaque excision/incision with grafting. The surgeon either cuts open the scar tissue to release the tightness, or cuts out the scar tissue and removes it. Holes or gaps are filled with a tissue graft.
This can give you back some of the lost length or width of the penis. But it can sometimes cause loss of feeling. It’s most common in men who have scar tissue on the top of the penis. That loss of feeling is usually temporary but can be permanent. It can take 6 to 12 months to get full feeling back.
With this surgery, there’s a 1 in 5 chance that after-surgery erections will be too soft to have sex. If this happens, the man may need a penile implant.
2. Plication. This is a simpler, shorter surgery. The surgeon sews the side of the penis that is not affected so it matches the side that’s been shortened by scar tissue. This makes the penis straight, or at least straighter. You’ll probably end up with a slightly shorter penis, but the surgery is less likely to cause numbness or ED than the first option.
3. Penile prosthesis. The doctor places two cylinders inside the penis and a small pump inside the scrotum. After the surgery, you get an erection by squeezing the pump. The scarred side of the penis is not expanded in this surgery, so you may end up with a slightly shorter penis.
