10044 Peyronies Disease

Overview

Peyronie's disease is a condition in which scar tissue (called a plaque) forms inside the penis. This scar tissue can make the penis bend or curve when it is erect (hard), which can cause pain and make sex difficult.

It is not rare, although many men do not talk about it. Doctors think it affects about 1 in 100 men, though some studies suggest it could be more common.

It usually affects men between 40 and 60 years old, but it can happen at any age. It is uncommon in children and teenagers.

Symptoms

Common symptoms

• A curve or bend in the penis during an erection
• A hard lump or band of tissue under the skin of the penis
• Pain during an erection, especially in the early stages
• The penis becoming shorter or narrower
• Erection problems, like trouble getting or keeping an erection

Symptoms in children

• This condition is very rare in children. If a child has penile pain, a lump, or an unusual curve, a doctor should check for other causes.

Symptoms in older adults

• In older men, Peyronie's can be linked with weaker erections, so the bend may be noticed less. It can also be harder to treat if the scar tissue has been there for a long time.

Causes

Main causes

• Injury or minor trauma to the penis that tears the tissue and causes bleeding
• The body then forms scar tissue (a plaque) as it heals
• Sometimes there is no clear cause; it may be related to a family tendency or an immune system problem

Risk factors

• Being aged 40–60
• Diabetes
• High blood pressure
• High cholesterol
• Smoking
• A past injury to the penis
• Having a family member with the condition
• Certain connective tissue disorders, like Dupuytren's contracture

When to see a doctor

See a doctor urgently if:

• You have sudden, severe pain or swelling after an injury
• You cannot pass urine
• You have signs of infection (fever, redness, swelling, or discharge)

Book a routine appointment if:

• You notice a curve or bend in your penis that seems new
• You feel a hard lump or band of tissue in your penis
• You have pain during erections
• You are worried about a change in your penis

Diagnosis

A doctor can usually diagnose Peyronie's disease by asking about your symptoms and examining your penis. They will look for a plaque and feel how big it is. They may also measure the curve, often by asking you to provide photos or by using a special medicine to create an erection during the visit.

Tests that may be done

• Medical history (questions about your symptoms and health)
• Physical exam of the penis and testicles
• Sometimes an ultrasound scan to look at the plaque and check blood flow
• In some cases, a small injection (given by the doctor) to create an erection so the curve can be measured

What to expect at your appointment

The visit is usually quick. You do not need to do anything to prepare. The doctor may ask you to bring a photo of your erection if you are comfortable. They may also do a blood test to check for other health issues.

Treatment

Treatment depends on how bad the curve is and how much it affects your sex life or wellbeing. If symptoms are mild, the doctor may suggest watching and waiting, because many men get better on their own within the first year. For more bothersome symptoms, there are several options, including medications, devices, shockwave therapy, and surgery.

Self-care at home

• Do not try to 'straighten' your penis with home-made devices. Only use devices your doctor recommends.
• If sex is painful, take a break from penetrative sex until the pain settles.
• Talk to your partner about what is happening – it can reduce stress.
• Stop smoking, as it can make tissue health worse.

Medical treatments

A doctor may offer injectable treatments that help break down the scar tissue (some are given directly into the plaque). Oral medicines (pills) may also be used, but they are not very effective and are not usually prescribed. Other options include shockwave therapy (using sound waves to try to soften the plaque) or a traction device (a gentle stretching tool) for some men. The choice depends on how long you have had the condition and how fixed the scar is.

When is surgery considered?

Surgery is usually only considered if the curve is severe, stable, and makes sex impossible or very difficult. Types of surgery include straightening the penis (by stitching the opposite side) or placing an implant that helps you get an erection. Surgery is not needed for most men.

Living with this condition

Living with Peyronie's can be upsetting, but many men adjust. The pain usually goes away after the first few months, even if the curve remains. During that time, avoid activities that cause pain, and focus on ways of intimacy that do not involve penetrative sex if that hurts.

Lifestyle tips

• Keep physically active – regular walking or exercise can help your overall health.
• Manage conditions like diabetes and high blood pressure.
• Stay engaged socially; isolation can make worry worse.
• If you are in a relationship, keep communicating with your partner.

Diet and exercise

Eating a healthy, balanced diet and staying active are good for circulation and may help with tissue health. There is no special diet that cures Peyronie's, but a heart-healthy diet can support erections.

Mental health and emotional wellbeing

Peyronie's can cause anxiety, depression, and low self-esteem. It is normal to feel upset or embarrassed. If these feelings last, or if you are avoiding sex or relationships, ask your doctor about talking to a counselor or sexual health therapist.

Prevention

There is no guaranteed way to prevent Peyronie's, but you can reduce your chances by avoiding injury to the penis, not smoking, keeping your blood pressure and blood sugar healthy, and using caution during vigorous sexual activity.

Vaccines

There is no vaccine for Peyronie's disease.

Screening programmes

There is no routine screening test for Peyronie's. It is usually found when a man notices symptoms and talks to a doctor.

Complications

If left untreated

• Persistent pain during erections (though this often settles on its own)
• A more severe curve that makes sexual intercourse difficult or impossible
• Shortening or narrowing of the penis
• Erectile dysfunction (trouble getting or keeping an erection)
• Anxiety, stress, or relationship problems

Long-term outlook

For most men, Peyronie's is a benign (not dangerous) condition. The pain usually improves, and many men find their curve stays the same or gets somewhat better. Treatments can help when needed. Even though it can be emotionally difficult, most men live normal, active sex lives with the right support.

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