Peyronie’s disease represents a significant challenge to male sexual health, affecting not only the anatomy of the penis, with abnormal curvatures, but also the patient’s physical and emotional well-being. After all, in many cases the condition can cause pain during erections and negatively affect sexual life and self-esteem.
Peyronie’s disease may raise questions about its symptoms, progression and options for monitoring or treatment. This guide presents general information about the condition and explains why an individualized clinical assessment is relevant to clarify each case.
Continue reading and understand everything about the topic in the guide below!
Peyronie’s Disease: When Is Penile Curvature a Problem?
Peyronie’s disease is an acquired condition characterized by the formation of fibrous plaques in the tunica albuginea, which may be associated with curvature, shortening or other penile deformities during erection. Its origin is multifactorial and, in some cases, there may be a history of trauma or microtrauma; the intensity and shape of the deformity vary among patients.The disease is characterized by a scar in the tunica albuginea, the tissue that covers the penis’s erectile mechanism, and usually manifests through fibrosis. Thus, over time, this scar leaves the penile tissue with reduced elasticity, which results in a deformity that is only noticeable during erection.
The evolution of the curvature varies among patients. In some cases, there may be pain during erection, increased deformity or impact on sexual activity; in others, the condition may remain stable. The need for monitoring or treatment should be determined after an individualized clinical evaluation.
How did the term Peyronie arise?
Diagnosed and described for the first time in 1743, the disease took the name of the first physician who diagnosed it, François Gigot de La Peyronie, who had famous patients such as King Louis XV of France.
What causes Peyronie’s disease?
Peyronie’s disease may be associated with various factors, including changes in healing, history of penile trauma, certain health conditions and other individual elements. A patient’s observation of changes may justify a consultation, but it does not allow confirmation of the cause or establishment of the diagnosis, which depends on an adequate clinical evaluation.
Advancing age and erectile problems
As years pass, it is common for men to go through natural changes in the body, and this includes sexual health. After all, collagen production decreases, blood circulation may become compromised and hormonal levels also change.
Some factors may be associated with greater vulnerability to penile microtraumas during sexual activity. Repetition of microtraumas is a hypothesis considered in some cases, but the formation of fibrous plaques and progression to Peyronie’s disease depend on multiple factors and require clinical evaluation.
In addition, advancing age is often accompanied by difficulties in erection, which make the penis less rigid and, therefore, more vulnerable to bending or injury during sex. Repetition of these situations can initiate an internal scarring process which, over time, produces curvature and discomfort.
Trauma, fractures and penile fibrosis
The occurrence of trauma and fissures in the penis predisposes to the formation of penile fibrosis. This usually happens during sexual intercourse, especially when the man is in a position that does not allow him to control the situation.
In such moments, attention to movements and the use of artificial lubrication are essential for things to go smoothly during the sexual act, even when there are no problems maintaining an erection.
When accompanied by a Congenital Penile Curvature, however, extra care should be taken. Therefore, observe whether the penis slips out frequently and consult a urologist if this happens. Remember that this is a fairly common situation in men with a pronounced curvature, but the heat of the moment can cause this symptom to go unnoticed.
In addition, fissures caused by trauma or penile fracture tend to initiate or further worsen the penis curvature, and can even aggravate an initially simpler problem into Peyronie’s disease.
In other words, if you experience difficulty in sexual relations or pain during intercourse, consulting a urologist for an in-person evaluation is more than necessary so that further guidance can be given.
Diabetes and Peyronie’s disease
Men with diabetes should take extra care regarding Peyronie’s disease. This is because elevated blood glucose causes damage to the functioning of blood vessels.
As a consequence, it favors the appearance of fibroses without there having been trauma to the penis; it impairs healing; and it is also a major cause of erectile dysfunction. All these factors, together, are linked to the causes of Peyronie.
A quality erection is directly related to blood flow within the penis, so it is important to control the disease so that the blood vessels and the nerves that provide sensitivity in the genital region remain healthy.
Prostate surgeries and Peyronie
Treatment for prostate cancer involves interventions that can have harmful consequences for a man’s health. Some of these are directly associated with the causes of Peyronie’s disease.
Erectile dysfunction and the appearance of fibroses in the penis are examples of this, and they can also cause shortening of the penis. Therefore, it is important to address the consequences caused by prostate cancer, such as loss of rigidity, size and girth of the penis, because they contribute to the emergence of penile deformities and progressive worsening of Peyronie.
Types of penile curvature
Besides Peyronie’s disease, there is another factor that can make the penis crooked, one of genetic origin: Congenital Curvature or young man’s curved penis.
In this case, the elasticity of the penile tissue is already formed with a difference between them from birth. However, in Congenital Curvature the tortuosity will only be noticed during puberty, due to penile development, more frequent erections and the start of sexual activity.
This can be a perfectly normal characteristic and without risk of future complications.
In some cases, there is no need for treatment. This is because simple follow-up and precautions during sex are essential for the man to continue with a calm and happy life.
It is also important to note that evaluation by a urologist is very important to provide the necessary guidance or define whether some type of treatment will be needed so that the young man’s curved penis does not evolve into Peyronie’s disease.
How to identify the symptoms of Peyronie’s disease?
If your penis used to be straight but is becoming crooked, it is a sign that something is not right with your genital health. Even stronger are the indications that the problem may be Peyronie’s disease.
However, do not worry: Peyronie’s disease can be cured, and it can be alleviated or even prevented when diagnosed early. To understand what is happening with your penis, it is important to know the symptoms.
Thus, upon noticing any of these signs, seek medical help to increase the chances of an effective treatment:
Nodules or lump on the penis
The presence of nodules on the penis may indicate the formation of penile fibrosis, also known as scar tissue.
Superficial plaques can be felt by palpation and usually form on the top side of the penis, but they can also occur on the underside or the sides. Therefore, be alert to their appearance; often it is possible to identify them through self-examination by feeling the penis when flaccid.
On the other hand, situations such as deeper fibroses can form a kind of lump inside the penis. Generally, these are only identified after a detailed examination of the corpora cavernosa, the internal structures of the penis responsible for erection.
Pain in the penis during erection
Frequent pains in the penis during erection may be an indication of a more serious situation, such as the inflammatory phase of Peyronie’s disease.
A consultation with a urologist, in this case, can identify the problem and provide the necessary guidance.
Onset of erectile dysfunction
The difficulty achieving an erection is not only an indicator of Peyronie’s disease, it can also be its cause. When the penis is not rigid enough at the time of penetration, it may suffer traumas or microtraumas that, over time, transform into a nodule and evolve into Acquired Penile Curvature.
In addition, if the patient already has Peyronie’s disease, the erection may also be impaired and the curvature will worsen even more.
Reduction, thinning or constriction of the penis
Penile fibrosis is directly associated with reduced tissue elasticity and, consequently, with symptoms such as reduction in size, thickness or thinning of the member.
If this happens, it is essential to set aside embarrassment and seek medical help. After all, the sooner the problem is diagnosed, the greater the chance of resuming a healthy and satisfactory sexual life.
Pronounced penile curvature
Normally, curvature causes problems when it is above 30 degrees. Thus, if it progresses and makes intercourse impossible, it is time to seek a specialist.
If it causes pain for you or your partner, this is also an indication that penile health is not well.
What are the consequences of Peyronie’s disease?
In Peyronie’s disease, the man has fibrosis in the tunica albuginea or within the corpus cavernosum that brings with it some consequences, such as difficulty in obtaining/maintaining erections, penile thinning, shortened movements and others.
In other words, problems that interfere both with the anatomy and the functionality of the penis. Therefore, it is important to treat Peyronie as soon as possible, since these aspects are directly related to a man’s sexual satisfaction and self-esteem.
Learn about other consequences:
Pronounced penile curvature
The position where the fibrosis is located within the penis will directly impact its anatomy.
This is because it causes a difference in the elasticity of penile tissues, which can cause or accentuate curvature to the sides, downward or upward toward the navel. If this fibrosis is not treated, the penis will continue to bend until it reaches a point that completely prevents penetration.
Reduction, thinning or constriction of the penis
In the same way that fibrosis affects the curvature of the penis, it also causes its reduction, thinning and even constriction. For this reason, it is important to treat not only the fibrosis, but also all the impacts caused on the anatomy of the penis.
In such cases, it is possible to perform relaxing incisions to expand the tissues, enabling recovery of lost dimensions.
Difficulty in achieving and maintaining an erection
With fibrosis disrupting blood circulation, it is quite possible that a man with Peyronie’s disease will also have difficulty maintaining an erection, or even achieving one.
This should be evaluated before performing surgery to treat the fibrosis, because if there is erectile dysfunction linked to the disease, placement of a penile prosthesis will be necessary for the man to recover his sexual life. This also aims to prevent the penis from developing new fibroses and curving again in the future.
Pain or discomfort in the partner
With a bent penis, penetration becomes a less comfortable act both for the patient and for his/her partner.
Pronounced curvature causes the back-and-forth movement to provoke pain or discomfort in the other person, since the penis is not in its natural anatomy suited for sex.
Restricted positions and short movements
When Peyronie’s disease does not completely prevent sexual intercourse, it can greatly restrict the possible positions and movements. This is because the man must constantly take care to find a way in which penetration is possible, and also take extra care not to cause further penile trauma, which could worsen the penile curvature.
Treatment for Peyronie’s disease: medicines, injections or surgery?
As mentioned, Peyronie’s disease, although it may be frightening, can be treated. But how can this actually be done? See below:
Clinical treatments for Peyronie’s disease
There are several reasons why patients with Peyronie’s disease should see a urologist. The fact that the condition can be eased or even avoided with appropriate medical follow-up is among the main ones.
To begin with, it is important that a man understands the need to have regular appointments with a urologist from adolescence. After all, this habit helps provide good guidance about the start of sexual life, since it aids in identifying hormonal imbalances and possible erectile problems, one of the main causes of Peyronie’s disease.
For cultural reasons, however, this does not usually happen. For this reason it is common for a patient to arrive at a urologist’s office with serious complaints, and often the diagnosis is Peyronie’s disease.
And since there was no professional advice on how to treat the early stage of the condition, some inappropriate habits and attitudes contribute to worsening the case, causing greater physical discomfort and also affecting the patient’s psychological state and self-esteem.
When diagnosed early, control of Peyronie’s disease can be achieved with the use of medications and monitoring of results over an average period of 6 months. During this process, the man will receive specific guidance to prevent the condition from worsening and, if surgery to correct the penile curvature is necessary, he will already be prepared for the procedure and the physician will have full detail of the condition for an assertive treatment.
Surgical treatments to straighten the penis
When Peyronie’s disease reaches the second stage, also known as the scarring phase, clinical treatment will probably no longer be effective. In that case, a surgical procedure is indicated.
Surgery can address the marked curvature and the shortening of the penis caused by Peyronie’s disease. It can also correct narrowing and erectile dysfunction problems. Typically, the procedure is performed under local anesthesia and the patient is discharged the same day.
The surgical method using multiple incisions involves expanding penile tissues to restore length and girth. There are various methods capable of providing a straight, functional penis. However, for this it is essential to speak with a specialist to decide which treatment is most appropriate for your case.
Doppler ultrasound
The first step in seeking treatment is performing a Doppler ultrasound of the corpora cavernosa.
This is an exam that will measure penile function with an induced erection and high-definition color ultrasound. This ultrasound will provide images of the inside of the penis so the specialist can check for the presence of fibrosis, whether it is superficial or deep, whether there is any associated erectile problem, as well as measure the penile vascularization, that is, how blood circulation within it is functioning.
With this result in hand, it will be possible to identify the stage of Peyronie’s disease to decide whether treatment should begin with medications, or whether it is more appropriate to proceed directly to surgery.
The exam also provides the exact degree of curvature and identifies the region that will need to be expanded for correction, as well as whether there are other associated factors, such as erectile dysfunction, shortening and thinning of the penis.
Surgery for Peyronie’s disease: how does the pre- and postoperative care work?
The pre- and postoperative care for surgery for Peyronie’s disease requires certain precautions to enable full recovery. However, it is important to clarify that not every man with a crooked penis needs treatment. In other words, if a patient is diagnosed with Peyronie’s disease, treatment does not necessarily have to be surgical; surgery is usually indicated for patients whose curvature makes intercourse difficult and/or impossible.
As with any surgical procedure, there are questions about preparation and concerns about hospitalization and anesthesia, so it is important to know the preparations for the procedure, how it is performed and the care that should be taken in the postoperative period. See below:
Before surgery
Once diagnosed, the patient is referred for a Doppler ultrasound of the corpora cavernosa, which assesses penile function with an induced erection and also checks the condition of the fibroses, the blood circulation inside the penis and the degree of curvature.
If an accompanying case of erectile dysfunction associated with Peyronie’s disease is identified, placement of a penile implant may be indicated to resolve the situation in the same procedure. Of course this option will only be considered for patients who have already tried medications to stimulate erection but without satisfactory results.
All this assessment is necessary so the physician has a detailed overview of the penile curvature and can plan the step‑by‑step of the surgery. After that, you simply schedule the date and wait.
The procedure does not require extensive preparations. As with any surgery, blood and urine tests and a cardiology evaluation will be required to avoid any complications.
It is also important that glucose levels are controlled to avoid healing difficulties and the risk of infection. In addition, the physician instructs the patient on cleaning the pubic area with an antibacterial soap, which should be done for two days before the surgery.
Finally, an eight‑hour fast is requested, both from solid foods and liquids. With that done, just get a good night’s sleep and relax, as everything will be under control.
The day of surgery
The procedure to correct Peyronie’s curvature is not long. After all, the surgery lasts between 2 and 3 hours and is performed only with sedation and local anesthesia. Usually the patient is admitted to the hospital early in the morning and it is possible that by early afternoon they are already cleared to go home.
Shaving of pubic hair is done in the operating room by the physician and team. Therefore, there is no need to worry about this, as they will take the greatest care to prevent any risk of infection.
After surgery
The postoperative period for Peyronie’s disease is also not complicated. The follow‑up visit takes place on the same day of the surgery, in the afternoon. At this appointment, the physician will assess the surgical result and give final instructions so that healing occurs as well as possible.
The penis will be bandaged and it will not be necessary to remove the dressing for the first five days. After this period, the bandage should be changed daily for a further five days. Due to the simplicity of the change, it is not necessary for the patient to return to the physician to have it done: it can be done at home in a few minutes.
There are three stages for the patient to return to normal life: between 7 and 10 days it is possible to return to work (if it does not require physical exertion), from 30 days one can resume physical activities, and from 45 to 60 days sexual activity may be resumed after medical assessment.
* This estimate may vary case by case, depending on each patient’s recovery.
The recovery process is further simplified because the surgical sutures are absorbable, preventing the patient from having any discomfort in the future or during sexual intercourse. In about two months, all of them will have fallen away naturally.
Cure of Peyronie’s disease: with or without a penile prosthesis?
A penile prosthesis is a solution indicated in cases where Peyronie’s disease causes fibrosis, marked penile curvature and erectile dysfunction. After all, it helps restore the axial rigidity of the penis after correction of the curvature, preventing further trauma.
Although there is still some resistance due to lack of information or stigma, the implant can be instrumental in restoring sexual function and quality of life. Normally, placement of the prosthesis is performed in the same surgical procedure to correct the curvature, without requiring additional stages for the patient.
There are different types of prostheses, such as the malleable (or semirigid) and the inflatable, each with its own characteristics. The malleable prosthesis is composed of two flexible rods that keep the penis in an adjustable position, offering practicality and low maintenance. The inflatable prosthesis allows inflation and deflation of the penis via a pump in the scrotum, providing more discretion, although it requires a bit more care in handling. The choice of the ideal model depends on factors such as patient preference, lifestyle, medical condition and cost.
In some initial or milder cases, treatment may be performed with anti‑inflammatory medications or drugs to improve penile circulation, but these methods are palliative. When there is no satisfactory improvement with clinical treatments, surgery with penile implant — often combined with penile reconstruction — becomes the most effective alternative to restore sexual function and the patient’s well‑being.
Care with self-diagnosis
Be careful when self-diagnosing, as it is not possible to know the true state of penile health without performing specific exams first. After all, Peyronie’s disease may be linked to other problems and a urologist experienced in the area will know how to indicate the ideal treatment.
Therefore, if you notice any symptom suggestive of Peyronie’s disease, such as the presence of nodules or lumps on the penis, its shortening and thinning, pain during erection, erectile dysfunction or an increase in curvature, it is advised that you seek medical help.
Remember: self-examination is welcome and necessary, but it does not replace an in-person consultation.
Reasons to visit a urologist
There are several reasons why patients with Peyronie’s disease should consult a urologist, and the fact that the condition can be eased or even avoided with appropriate medical follow-up is among the main ones.
To begin with, it is important that a man understands the need to have regular appointments with a urologist from adolescence. After all, this habit contributes to good guidance about the start of sexual life, as it helps identify hormonal imbalances and possible erectile problems, one of the main causes of Peyronie’s disease.
For cultural reasons, however, this usually does not happen.
It is common for a patient to arrive at a urologist’s office with serious complaints, and often the diagnosis is Peyronie’s disease. And since there was no professional counseling on how to treat the early stage of the condition, some incorrect habits and attitudes contribute to worsening the case, causing greater physical discomfort and also affecting the patient’s psychological state and self-esteem.
Treatment for Peyronie’s disease
Learn about some of the main questions on the topic:
When should a penis that has become crooked from Peyronie’s be treated?
It is important to seek a physician who specializes in Peyronie’s disease as soon as possible. This is because the curvature has implications for the anatomy of the penis that can cause pain and lower self-esteem, since, in addition to physical effects, there are also psychological symptoms associated with the condition.
What is the importance of caring for a crooked penis from a young age?
Caring for a crooked penis from a young age is important to determine whether the curvature is natural or a sign of a more serious condition, such as Peyronie’s disease. After all, in many cases the tortuosity does not cause pain or interfere with sexual life, but it is still essential to maintain good habits, such as using lubrication, avoiding sudden movements and choosing safe positions during sex. Evaluation by a urologist helps guide the patient, clarify doubts and prevent possible complications in the future, as well as indicate appropriate treatment when necessary.
Can Peyronie’s disease affect fertility?
Peyronie’s disease does not directly affect sperm production or fertility, but it can make sexual intercourse more difficult, which indirectly impacts the ability to conceive a partner. In more severe cases, pain and deformity may prevent penetration, making treatment necessary to restore sexual function.
The main presentations of Peyronie’s disease
The deformities of the penis caused by Peyronie’s disease can be upward, downward or to the sides. Sometimes they occur in more than one plane, also causing shortening and thinning of the penis.
For this reason it is essential to perform a detailed evaluation of the penis before determining treatment. A functional exam, with an artificially induced erection, will provide specific information to help the healthcare professional adopt an appropriate treatment approach for your case.
Cases of unsuccessful surgeries without penile reconstruction
If the professional corrects tissue size without using the geometric principle, relying on the shorter side to correct the curvature, this may result in a smaller penis. It is common to hear reports from patients who lost penile girth after Peyronie’s surgery.
To avoid this type of situation it is important to ask the healthcare professional which surgical method they will use to correct the deformity and what consequences this procedure will have regarding penile measurements.
Surgery for Peyronie’s: how does the pre- and postoperative care work?
The pre- and postoperative care for surgery for Peyronie’s disease requires certain precautions so the patient’s recovery can occur fully.
However, it is important to clarify that not every man with a crooked penis needs treatment. If a patient is diagnosed with Peyronie’s disease, treatment does not necessarily have to be surgical. Surgical treatment is generally indicated for patients whose curvature makes intercourse difficult and/or impossible.
As with any surgical process, there are questions about preparation and concerns about hospitalization and anesthesia, so it is important to know the preparations for the procedure, how it is performed and the care that should be taken in the postoperative period.
Before surgery
Once diagnosed, the patient is referred for a Doppler ultrasound of the corpora cavernosa, which assesses penile function with an induced erection and also checks the condition of the fibroses, the blood circulation inside the penis and the degree of curvature.
If an accompanying case of erectile dysfunction associated with Peyronie’s disease is identified, placement of a penile implant may be indicated to resolve the situation in the same procedure. Of course this option will only be considered for patients who have already tried medications to stimulate erection but without satisfactory results.
All this assessment is necessary so the physician has a detailed overview of the penile curvature and can plan the step‑by‑step of the surgery. After that, it is just a matter of setting the date and waiting.
See also: Learn about the 04 main penile surgeries and the function of each
The procedure does not require extensive preparations. As with any surgery, blood and urine tests and a cardiology evaluation will be required to avoid any complications.
It is important that glucose levels are controlled to avoid healing difficulties and the risk of infection. The physician also instructs the patient on cleansing the pubic area with antibacterial soap, which should be done for two days before surgery. In addition, an eight‑hour fast is requested, both from solid foods and liquids.
With that done, just get a good night’s sleep and relax, as everything will be under control.
The day of surgery
The procedure to correct Peyronie’s curvature is not long. The surgery lasts between 2 and 3 hours and is performed only with sedation and local anesthesia. Generally the patient is admitted to the hospital early in the morning and it is possible that by early afternoon they are already cleared to go home.
Shaving of the pubic hair is done in the operating room by the physician and their team. Therefore, there is no need to worry about this, as they will take the greatest care to ensure there is no risk of infection.
After surgery
The postoperative period for Peyronie’s disease is also not complicated. The follow-up with the doctor takes place on the same day as the surgery, in the afternoon. At this appointment the doctor will assess the result of the surgery and provide the final instructions so that healing can occur as favorably as possible.
The penis will have a bandaged dressing and it will not be necessary to remove it during the first five days. After this period, the bandage should be changed daily for a further five days. Because the change is simple, it is not necessary for the patient to return to the doctor to have it performed. It can be done by the patient alone in a few minutes.
There are three stages for the patient to return to normal life: between 7 and 10 days it may be possible to return to work (if it does not require physical effort), from 30 days physical activities may be resumed, and from 45 to 60 days sexual activity may be resumed after medical evaluation.
* This estimate may vary from case to case, according to each patient’s recovery.
The recovery process is further simplified because the surgical sutures are absorbable, which may avoid the need for later removal and may reduce the likelihood of discomfort in the future or during sexual activity. In about two months, they are expected to have fallen out naturally.
