Peyronie's disease is when you have a curved or bent penis. It is caused by scar tissue forming along the shaft of the penis. This causes painful erections and a bend or curve, usually about halfway along the penis. The change in shape is usually only obvious when the penis is erect.
The disease was named after the French surgeon François Gigot de la Peyronie who described it in 1743, but there have even been mentions of it in the 13th century. There are now lots of treatments for Peyronie's disease/bent penis which range from devices fitted to your penis for an hour or two a day to straighten it out, to medications injected into the scar tissue, to surgery.
Peyronie's disease is more common than you might think. It is found in about 1 in 20 men. It most often affects middle-aged men but it can also occur in teenage boys.
- The first thing that's noticed is painful erections.
- Then over a few months the penis gets curved or bent: this can be bent upwards (the most common form of Peyronie's), or bent downwards, or bent to the side.
- After about a year the curving or bending of the penis will stop and stay the same. At this point the pain usually goes away.
- Occasionally the curved penis goes back to normal without any treatment.
- Usually the penis looks normal when soft, and the curve or bend is only visible in an erection.
Peyronie's disease images
By Peyronie (Own work), via Wikimedia Commons
By Kentkalell (Own work), CC BY-SA 4.0, via Wikimedia Commons
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Generally the cause is thought to be some damage to the penis, either during sex or masturbation. For some people this heals up normally, but in other people there is a genetic predisposition to scar tissue forming.
This scar tissue gathers up on one side of your penis, making it curved.
Peyronie's disease is seen more frequently in people who:
- Have diabetes.
- Have high blood pressure.
- Have high cholesterol.
- Have Dupuytren's contracture (a thickened band across the palm).
- Drink too much alcohol.
How is Peyronie's disease diagnosed?
The typical symptoms of painful erections and a curved or bent penis are usually enough for the doctor to make the diagnosis. The doctor will usually want to measure the bend or distortion of the penis whilst it is erect. This can be assessed by either of two methods:
- Photographs you have taken at home.
- More accurately, by use of a vacuum pump or injection into the shaft, in the surgery, to stimulate an erection.
Your doctor may ask you to complete a short questionnaire to assess how much the condition is impacting on your life.
In most cases it is not necessary to do any other tests but, occasionally, you may be asked to undergo a type of scan called a duplex ultrasound which shows up the blood circulation of the penis.
You may decide that you do not want any treatment if:
- You have a mild version of the disease which does not cause much pain.
- You are not sexually active.
- You have few or no difficulties with sexual intercourse.
As you can imagine there a lots of treatments offered online for a bent penis and Peyronie's disease but most of them don't work! Speak with your doctor before spending money on something online.
- A traction device: this is worn for about two hours a day and gradually straightens out the curved penis. It has been shown to help, in studies. A specialist doctor will provide you with one: don't buy one online!
- A vacuum device: this is similar to the traction device and is worn at home. It gradually straightens out the penis.
- Shock wave therapy: this uses sound waves produced by a large machine. It is done in hospital or in a clinic.
Unfortunately most tablets promised to work for Peyronie's disease have been found in studies to not do anything. Vitamin E was one of them: avoid it.
Medicines injected into the scar tissue
A specialist doctor can inject your penis, just where the bend is, with medication that can relax or dissolve the scar tissue.
- An example is verapamil, which can dampen down the scar tissue and can help it flatten out.
- Interferon alfa-2b has been shown to work well when injected into the curved bit of the penis.
- Another treatment is something called collagenase: it dissolves the scar tissue. This comes under the tradename Xiaflex®, so you might come across it online. It's not a new treatment: the first study of it was in 1993, but it was authorised for treatment in 2013 in the USA.
Surgical treatments for Peyronie's disease
- There are a number of surgical procedures for Peyronie's. They generally work well but involve an anaesthetic and long recovery time. A surgeon will be able to advise you on whether surgery will work for you.
What is the outlook for Peyronie's disease?
- With many treatments being properly tested now for Peyronie's disease/bent penis there is a lot that can be done.
- If you have a curved or bent penis, don't be embarrassed: it's a common problem. See your doctor.
Further reading and references
Hellstrom WJ; Medical management of Peyronie's disease. J Androl. 2009 Jul-Aug30(4):397-405. Epub 2008 Oct 30.
Tal R, Hall MS, Alex B, et al; Peyronie's disease in teenagers. J Sex Med. 2012 Jan9(1):302-8. doi: 10.1111/j.1743-6109.2011.02502.x. Epub 2011 Oct 7.
Bilgutay AN, Pastuszak AW; Peyronie's Disease: a Review of Etiology, Diagnosis and Management. Curr Sex Health Rep. 2015 Jun 17(2):117-131. doi: 10.1007/s11930-015-0045-y.
Kalokairinou K, Konstantinidis C, Domazou M, et al; US Imaging in Peyronie's Disease. J Clin Imaging Sci. 20122:63. doi: 10.4103/2156-7514.103053. Epub 2012 Oct 31.
Ostrowski KA, Gannon JR, Walsh TJ; A review of the epidemiology and treatment of Peyronie's disease. Res Rep Urol. 2016 Apr 298:61-70. doi: 10.2147/RRU.S65620. eCollection 2016.
Capece M, Cocci A, Russo G, et al; Collagenase clostridium histolyticum for the treatment of Peyronie's disease: a prospective Italian multicentric study. Andrology. 2018 Jul6(4):564-567. doi: 10.1111/andr.12497. Epub 2018 May 7.
Jordan GH; Peyronie's disease: update on medical management and surgical tips. Can J Urol. 2007 Dec14 Suppl 1:69-74.