Peyronie’s Disease (Curved Penis) – Everything You Need to Know

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What Is Peyronie’s Disease?

Peyronie’s disease is a penis disease that is caused by scar (also called plaque) that forms inside the penis tissue. This scar tissue can make the penis curve in any direction at various angles. The curvature of the penis is due to the fact that scar tissue does not stretch as well as normal tissue.

In some men, Peyronie’s disease can also cause a significant pain. This penis curvature can prevent a man from having sex or might make it difficult to get or maintain an erection. As a conqequence it is also acompanied by by stress and anxiety.

Ofcourse  men’s penises vary in shape and size and having a curved erection is actually common and is not necessarily a cause for concern.  Meaning that not every curved penis is Peyronie’s disease – check this guide about causes and treatment of a curved penis).

A little bit of a history lesson – Peyronie’s disease got it’s name after François Gigot de la Peyronie who was a surgeon to King Louis XV of France. In 1743 he described a disorder characterized and this condition is now referred to as Peyronie’s disease.

Peyronie’s disease stages

The first is the “active” or »acute« phase, which lasts for about first 6 to 24 months. During this phase, the disease progresses, the plaques form and the penis continues to curve and you can feel a pain or discomfort during erection.

After acute phase Peyronie’s disease usually stabilizes. This is called the “chronic” phase when the plaque stops growing and the penis doesn’t curve any more.. If ther was a pain during acute phase it usually subsides in chronic phase.

Erectile Dysfunction and Peyronie’s

Peyronie’s often goes hand in hand with erectile dysfunction.  Check this science based guide on how to naturally enhance your erections.

Other simmilar diseases affecting tissue

• Dupuytren’s contracture – A disease affecting tissue on your palm
• Plantar fascial fibromatosis, also known as Ledderhose’s disease – A disease affecting tissue on your feet

Here is a short video of William O. Brant, M.D, explaining it in a very simple way. He also talks about how common it is, what causes it and some available treatments. But if you are looking for a more comprehensive info than he provides you are on the right page. Skip the video and read this guide to learn all you need to know.

https://youtu.be/7Wc0zjJYVzs

Warning – The video is from 2013 so some of the treatments that available today were not yet available back then. Check the treatments section of the guide for more info.

What Causes Peyronie’s Disease?

Unfortunately at this point nobody is sure what, exactly, causes Peyronie’s disease.

Most experts in the field believe it is a form of a wound healing disorder. But there are many possible reasons for onset of Peyronie’s that could be caused by any of the reasons bellow or a combination of those.

Injury: As already stated – the most popular theory today is that Peyronie’s disease is induced by some kind of trauma to the penis hitting or bending) that causes bleeding inside the penis..A man may injure his erect penis, such as through vigorous sex or even during night erections. You might not notice the injury or trauma.,. However, for some reason the injury does not heal as it should – it can be connected to other reasons for Peyronie’s listed below..

Heredity: It’s also possible that some cases of Peyronie’s disease are inherited. There is certain evidence that it may have a genetic basis.Meaning If one of your family members has a Peyronie’s disease, you have an increased risk.

Connective tissue disorders.Men who have a connective tissue disorder have an increased risk of developing Peyronie’s disease. It is connected to the Dupuytren’s contracture — disease of the palm that causes the fingers to pull inward.

Side effect of certain medications: Someprescription medications list Peyronie’s disease as a possible side effect. There is also a lot of people complaining on a forums that certain medication caused them Peyronie’s. Among them are some of the very well known and widely used products for men – check this post to learn more.

Low testosterone and DHT – There is also a strong connection between low levels of the male hormone testosterone and androgen DHT and Peyronies’ disease. If your are out of shape and an older guy you probably have suboptimal testosterone levels – check this post.

Diabetes: Having a diabetes makes you suceptible to a whole range of other issues – also Peyronie’s.

Congenital: This is when a baby is born with the condition but this is not recognised until he sexualy develops and matures.

Age: The prevalence of Peyronie’s disease increases with age. The older you are the more likely it is that something in your body is not working properly anymore. Thosea age-related changes in tissues might cause them to be more easily injured and less likely to heal well.

What Are the Signs and Symptoms of Peyronie’s Disease?

Penis curvature: This is by far the most common symptom. Besides curvature up or down, left of right there is also possibility of hourglass deformities – penis is thinner in some point.

Pain: With curvature also comes the pain mostly experienced during erections. It is thought to be due to active inflammation in the plaque and usually disappears on its own with time.

Lump/scar: The plaque or scar that you can actually feel on your penis benith the skin is the scar tissue that has been deposited on the spot where erection curves. It is present in the majority but not all patients with Peyronie’s disease.

Erectile dysfunction: As if you already don’t have enough problems with curve there is another major problem that may come with it – erectile dysfunction. But It is unclear whether erectile dysfunction causes Peyronie’s disease or vice versa. It something of an chicken and egg situation. If you have problem with erection you shoud check this post where I write about scientifically proven ways to improve you erections.

Who Gets Peyronie’s Disease and How Common is it?

How common it really is, is hard to tell as many man suffering may be too embarrassed to see their doctor about it. So the condition is under reported.

However, experts on the field say that it affects between 3-9 men out of a 100.

Who can get Peyronie’s? It is most common in older men (in their fifties and upward) but any man can get it regardless of age – check the causes section again.

How is Peyronie’s Disease Diagnosed?

The most common test to diagnose Peyronie’s disease is actually through physical examination. You doctor will check your penis for any palpable scar tissue with his hands.

He will most probably ask you if there were any injuries to your groin area that may caused it.

Then he may take a measurement to determine any possible length loss and degree of penis curvature.

You may also want to take a picture of your erect penis at home to show a doctor or he may induce erection with medication or injections if necesarry.

To examine the plaque more closely and measure its dimenasion an ultrasound can be used. Other methods like MRIs are less likely since they cost too much.

Should Peyronie’s Disease Be Treated?

In a pretty small percentage of men, Peyronie’s disease actually goes away on its own (in about 10% of cases it resolves on its own). But in most cases you are not so lucky – it will remain stable or worsen. So yes, it should be treated in most cases.

»When a patient presents with active disease, the chance of spontaneous improvement is approximately 20%, stabilization is 40% and further progression is 40%.«

But if you have a small plaque and not to severe curve and no pain then you may possibly not be treated by your doctor – but dont worry, there are plenty of natural treatments for peyronie’s that you can try at home.

What Treatments Are Available? (5 Proven Ways)

The treatment chosen depends on the current state of disease and severity of the curve and pain. There are many treatment option with surgery being reserved for most extreme cases (if they have been stable for at least 6 months).

1. Oral Drugs

Here are some oral drugs that are often used in the treatment of Peyronie’s:

Potassium amino-benzoate (“Potaba”): Some studies show that this vitamin B-complex helps reduce plaque size, but not the curve. Downside is that It is very  costly since you need to take 24 pills per day for 3 to 6 months.

Tamoxifen: This drug has been used to treat desmoid tumors, which are similary to  the plaques in Peyronie’s disease but the studies are showing that it is not more effective than placebo.

Colchicine: Another drug that has not been proven to work more than placebo. Colchicine is an anti-swelling agent that is sometimes used in treatment of Peyronie’s.

Pentoxifylline (Trental): Pentoxifylline is medicine that improves blood flow by decreaseing the viscosity (thickness / stickiness) of the blood. There are some positive results using this drug by reducing the calcification of plaques.

(PDE5) inhibitors: Think Viagra and Cialis…

2. Penile Injections

Injection treatment is often used for men with acute phase disease who aren’t sure they want to have surgery. Injections are usually followed up with penile modeling.

Collagenaseclostridium histolyticum injections (Xiaflex): Collagenases are enzymes made by the body that breakthe peptide bonds in collagen. This is the first treatment for Peyronie’s that is approved by the FDA! (It was approved 6th December 2013). It does not cure Peyronie’s disease but they have been shown to be effective treatment for some Peyronie’s patients. XIAFLEX is approved for two uses – both Dupuytren’s contracture and Peyronie’s disease.

Verapamil injections: Unlike Xiaflex Verapamil is not approved for Peyronie’s as it is mostly used to treat high blood pressure but there are indications that it works for penile pain and curving but more studies are needed.  It could be a good, low-cost treatment which makes it one of the most popular today.

Interferon injections: Interferon is a protein made in the body that helps control swelling. The present study confirmed the good analgesic effects of interferon-a – meaning it reduces pain very effectively but it doesnt improve curvature or reduce plaque. » the penile deviation diminished quantifiably in only one patient and remained unchanged in all the others; the plaque size remained unchanged in all patients.« The outcome of the study was that »the drug cannot be recommended for the conservative treatment of Peyronie’s disease«

Corticosteroids injections: Also known only as steroids, are an anti-inflammatory medicine prescribed for a wide range of conditions. Initialy thought as effective but the Follow-up studies demonstrated that corticosteroid injections had no therapeutic benefit and are not currently recommended as an intralesional therapy for PD.

Here’s a short video of dr. Neil Baum explaining the treatment using Xiaflex:

3. Supplements

Natural Treatments

For those who cant afford or for some reason don’t want conventional treatment there is a whole range of natural treatments that are proven to be effective.

Warning – In this guide you are reading right now I have listed all available treatments that are commonly used no matter the effectiveness. If you are into natural treatment you should definitely check my guide on 7 natural and effective ways to treat Peyronie’s.

Vitamin E: Vitamin E was for a long time one of the most used supplements regarding to Peyronie’s disease. It is an antioxidant that’s popular because of its mild side effects and low cost. But the research does not approve wide usage of this vitamin –  the studies showing no significant improvement in Peyronie’s. But it may be beneficial when combined with other treatments!

Acetyl-l-Carnitine: It is an amino acid.  It also helps the body with energy production and functions as an antioxidant.

L-Arginine: It is most known for  his role as a precursor of nitric oxide (NO). Nitric oxide is most known for being vasodilator – improving the blood flow.

Coenzyme Q10: It has also a role as an antioxidant, protecting the cells from harmful free radicals. As an antioxidant it occurs naturally in some foods. It is beneficial in early stages of disease – it leads to plaque size and penile curvature reduction and improves erectile function.

Omega 3: Your fish oil. It came to the conclusion that the data did not support a beneficial effect of omega-3 supplementation.

4. Penile Traction Devices

Also known as penis extenders. Traction devices have been used for treatment of Peyronie’s for a long time and more and more studies are supporting their use. Many experts are proponents of ‘combination therapy’, with traction therapy being a potential component. (source)

When you apply the penile traction device to your penis, it supplies constant stretch along the penis tissue and this causes the cells within the Corpora Cavernosa and tunica albuginea to pull away and split and therefore increase the shorter side of the penis.

Here are some scientific sources stating that those devices can help with curvature:

• »…device indicate that significant (10-45 degrees) improvement in curvatures are achievable« (study)
• “seems that penile traction therapy, in combination with intralesional plaque therapy, represents a good nonsurgical therapeutic option for men with PD.” (source)
• penile traction therapy is “reasonable alternative for men who are not candidates for surgery or refuse surgery, and who are wishing to seek modest improvements in recovery of length and penile curvature.” (source)
• And also almost every other study I found shows “increased penile length and reduction of penile curvature”.

They are one of the best options but the downside is that It is generally required to wear it for at least few months for good results and many people do not have enough patience.

Here is an instructional video on how to use this device. There is a german patent on the market that is very comfortable and you can wear during sleep. According to their studies one patient with incurvate penis was able to reduce the angle of curvature from 60 to 40 degrees within three months. 

For more info on their study and product visit their official website here or check their page about curved penis here.

Penis vacuum pump or vacuum erection device (VED) is another device that is commonly used. 

5. Surgery for Peyronie’s Disease

Surgery is usually reserved for men with severe deformities that make it hard or even impossible to have sex.

It is generally not performed or recommended until the plaque and curving have stopped getting worse, and the patient has been pain-free and stable for at least 9 to 12 months.

Type of surgery is dependent on:

• location of the plaque,
• degree of curvature,
• erectile function status

Some patients think that the curvature can be corrected simply by the removing of plaque. This is not the case as the plaque is actually a scar within the tunica albugines itself and if you just cut it out you would create a hole in you penis. 

Plication or tunical shortening.  The most common surgery for the Peyronie’s disease. One of the most known procedures is called Nesbit. It basicaly means that the penis (tunica albuginea part) is cut out on the side opposite of plaque (the longer side) to match the shorter side. Obvious side effect is that the penis is shorter after the procedure so it length matter to you this is not the best option.

Grafting or tunical lengthening. This is the opposite of the plication and it means adding tissue to the shorter side where the plaque is located. It is performed by completely removing/cutting out the plaque and replacing it with the graft. A graft can be a tissue either from you own body or it can be from animal sources.

Penile prosthesis implantation. Most commonly used on the Peyroni’e patients that also have a severe erectile dysfunction. A penile “pump” prosthesis is inserted into penis that can be used to artificiality induce erections.

Here is the animated video on grafting procedure:

https://youtu.be/j69WmNH_CcU

Most other videos are very graphical and if you are interested check them on YouTube.

Peyronies’s Surgery Complications

There are potential complications of penile straightening surgery:

– penile shortening (in plication techniques)

– numbness of the penis (damage of the nerves)

– residual curvature (penis still not completely straight)

– erectile dysfunction (inability to get an erection)

Conclusion

Sadly there are no 100% effective treatment for peyronies’s diease right now.

The most effective procedure has been a combininatin of presription medication and natural supplements and traction devices.

»Once again, multimodal therapy has been proven to be the best approach for conservative management of PD, as it makes it possible to achieve better results than those obtained with any single drug.« https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4706125/

Most Peyronie’s specialists and experts on the field recommend combined treatment:

• oral treatments(Pentoxifylline),
• Injection: Xiafles or Verapamil
• Supplements- L-Arginine
• penis traction device.

Talk with your doctor about conventional treatment and read this post to learn about most effective and scientifically proven natural treamtents.