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Diseases & Conditions

Peyronie's Disease

(Also Called 'Bent Penis Pain', 'Curvature of Penis')

Peyronie’s disease is characterized by a non-cancerous plaque, or hard lump, that forms in the penis. The plaque is not visible, and depending on the severity and location of the plaque, the penis will bend either upward, downward, or to the side. In some cases, the plaque develops on both the top and bottom of the shaft, leading to an indentation and shortening of the penis.

Peyronie’s disease can be accompanied by erectile dysfunction due to restricted blood flow to the penis, or to the stress accompanied by the disease. The decrease in rigidity can make the penis susceptible to bending more during sexual intercourse. In addition, the elastic covering the layer of the two erectile chambers (or cylinders) may become more brittle over time. Together, these changes can lead to an injury within the elastic layer of the erectile chambers during intercourse.

What causes Peyronie’s disease?

The cause of Peyronie’s disease is not entirely clear. Many researchers believe the plaque of Peyronie’s disease can develop following trauma (hitting or bending) that causes localized bleeding inside the penis.

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 have this listing are interferon, which is used to treat multiple sclerosis, and Dilantin, an anti-seizure medicine.

Who gets Peyronie’s disease?

This is a fairly common disorder, occurring in nine to 10 percent of middle-aged men; however, younger and older men can also be affected. In some cases, men who are related tend to develop the disease, suggesting that familial factors 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. 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.

Approximately 30 percent of men will experience some pain during intercourse at the onset of Peyronie’s disease, but the pain resolves in nearly everyone over time. There is often some associated decrease in the length of the erect penis; this change may be permanent.

How is Peyronie’s disease diagnosed?

The physician will gather information about any circumstances, such as an injury, that may have occurred prior to symptoms appearing. The physician will feel the hardened tissue caused by the disease, although sometimes it is necessary to do the examination when the penis is erect.

In some cases where the examination does not confirm Peyronie’s disease, or in cases where the condition develops rapidly, the physician may perform a biopsy. A biopsy involves removing tissue from the affected area for examination in a lab.

Can Peyronie’s disease be treated?

Mild curvatures usually do not require treatment, and since the condition improves on its own in some men, physicians often recommend waiting approximately one year before proceeding with corrective surgery. Surgery is only potentially helpful and considered when there is persistent curvature during erection that is severe and limits or prevents sexual intercourse.

There are two procedures available for men who have a disabling erectile curvature, but are still able to obtain adequate rigidity or firmness. (When erect, the penis can be thought of as having a long side and a short side due to the curvature.)

Plication
  • Involves operating on the side of the penis opposite the scar or plaque, and shortening the long side of the erect penis
  • Done on an outpatient basis and does not actually involve the removal of any tissue
  • Successful in more than 90 percent of men in terms of adequately straightening the erection and maintaining erectile firmness, but will result in some further shortening of the erection
  • Prior to surgery, one can estimate the length of the erection following the plication operation by having the patient lie down and then manually stretching the penis upwards while soft. This provides an appropriate expectation regarding the results.
Plaque/scar tissue removal
  • Most commonly used in men with the most severe erectile curvature (approximately 75-90 degrees in severity)
  • Involves removing plaque or scar tissue to allow expansion of the short side of the penis to achieve straightening.
  • The tissue removal results in a defect in the covering layer of the erectile chambers that must then be filled with a graft, which may be obtained from a commercial source or harvested from somewhere else on the patient’s body.
  • Designed to result in better preservation of remaining penile length, but still will not restore erection length back to what it was before the onset of Peyronie’s disease.
  • This procedure has an increased risk of side effects compared to plication, including weak erection or erectile dysfunction that may then require pills or a penile implant; a temporary change in sensation; and longer postoperative recovery.
  • In approximately 75 percent of cases, the procedure results in correction of curvature and an adequately firm erection for sexual intercourse.

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 is not treated. This pain may only occur with an erection.

References:

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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: 9/5/2013...#10044

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