Peyronie's disease is caused by scar tissue, called plaque, which forms along the length of the penis. This plaque is not visible, and depending on the severity of the condition, the plaque can cause the penis to bend making sexual intercourse difficult.
What causes Peyronie’s disease?
The cause of Peyronie’s disease is unclear. Many researchers believe the plaque of Peyronie's disease can develop following trauma (hitting or bending) that causes localized bleeding inside the penis. Other cases, which develop over time, may be genetically linked or inherited.
In addition, a number of medications list Peyronie's disease as a possible side effect. Most are a type of drug called beta-blockers that are often prescribed for people with heart conditions or high blood pressure. Other drugs that may cause Peyronie's disease are interferon, which is used to treat multiple sclerosis, and Dilantin, an anti-seizure medicine. However, the chances of developing Peyronie's disease from any of these medicines are very low and there is no evidence that Peyronie’s disease is related to taking these drugs.
Who gets Peyronie's disease?
One study found Peyronie's disease occurring in 1% of men. Although the disease occurs mostly in middle-aged men, younger and older men can get it. In some cases, men who are related tend to develop Peyronie's disease, suggesting that familial factors might make a man vulnerable to the disease.
What are the symptoms of Peyronie's disease?
Symptoms may develop slowly or appear overnight. When the penis is soft, no problem can be seen. But, in severe cases, the hardened plaque reduces flexibility, causing pain and forcing the penis to bend or arc during erection. In most cases, the pain decreases over time, but the bend in the penis can remain a problem. Occasionally, milder forms of the disease will resolve without causing significant pain or permanent bending.
The plaque itself is benign, or noncancerous. A plaque on the top of the shaft (most common) causes the penis to bend upward; a plaque on the underside causes it to bend downward. In some cases, the plaque develops on both the top and bottom, leading to indentation and shortening of the penis. Some men with Peyronie's disease develop scar tissue elsewhere in the body, such as on the hand or foot.
How is Peyronie’s disease diagnosed?
First your doctor will talk to you and ask you about any circumstances, such as injury, that may have occurred prior to symptoms appearing. Your doctor can feel the hardened tissue caused by the disease on examination, although sometimes it is necessary to do the examination with the penis erect. In some cases where the doctor's examination does not confirm Peyronie’s disease, or in cases where the condition develops rapidly, your doctor may perform a biopsy. A biopsy involves removing tissue from the affected area for examination in a lab.
Can Peyronie’s disease be treated?
Yes. But, since some people's condition improves without treatment, doctors often suggest waiting 1 to 2 years or longer before attempting to correct it. Mild cases of the condition rarely require treatment.
If treatment is needed, surgery can be performed. The two most common surgeries used to treat Peyronie's disease are:
- Removal of the plaque followed by placement of a tissue patch.
- Removal or pinching of tissue from the side of the penis opposite the plaque, which counters the disease’s bending effect. This procedure is known as plication.
Unfortunately, the surgeries do not guarantee normal penis function. The first method can involve partial loss of erectile function, especially rigidity. The second method, known as the Nesbit procedure, causes a shortening of the erect penis.
Most types of surgery produce positive results. But because complications can occur, and because many of the complications associated with Peyronie's disease (for example, shortening of the penis) cannot be corrected by surgery, most doctors prefer to perform surgery only on the small number of men with curvature so severe that it prevents sexual intercourse.
If surgery is not right for you, there are other options. Some studies have shown that vitamin E pills improved Peyronie’s disease. Similar inconclusive studies have been done on para-aminobenzoate, a substance related to B-complex vitamins. In certain instances, the calcium channel blocker verapamil may be effective in decreasing the pain related to Peyronie’s disease when injected directly into the penile scar or plaque.
Other approaches to treating Peyronie’s disease that have yet to be confirmed as effective include the injection of chemical agents directly into the plaque or radiation therapy. But, radiation therapy can only relieve pain associated with Peyronie’s disease; it cannot cure it.
Since the severity of the condition varies from person to person, talk to your doctor about what treatment strategy is right for you. The pain associated with Peyronie’s disease is usually mild and thus not treated. This pain occurs only with an erection.
What is the outlook?
Peyronie’s disease is a self-limiting condition. Pain disappears with time, plaque formation stops and the erection deformity stabilizes. Most men with Peyronie’s disease are able to have sexual intercourse and for these men surgical treatment is usually not necessary.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 9/14/2006
