Understanding ED: Peyronie’s Disease

Written by The Healthline Editorial Team | Published on February 25, 2015
Medically Reviewed by The Healthline Medical Team on February 25, 2015

Do You Have Erectile Dysfunction?

Erectile dysfunction (ED) is a condition in which a man has difficulty getting or maintaining an erection. It can cause problems in the bedroom for men of all ages. One form of ED called Peyronie’s disease causes a bend in the penis that can make an erection painful. 

While a curved erection doesn’t always indicate a problem, men who have Peyronie’s disease may have trouble having sex. This can cause anxiety and discomfort.

Keep reading to understand more about Peyronie’s disease.

What Causes Peyronie’s Disease?

According to the Mayo Clinic, the cause of Peyronie’s disease is largely unknown. However, research suggests that the condition may develop after trauma to the penis, such as bending or hitting. This can cause bleeding and subsequent scar tissue buildup.

While injury may be the cause of Peyronie’s disease in some cases, the National Kidney and Urologic Diseases Clearinghouse (NKUDC) notes that often the condition arises without a traumatic event. 

How to Know if You’re at Risk

Genetics and age both appear to play a role in Peyronie’s disease. Tissue changes can lead to easier injury and slower healing as men get older, putting them at greater risk for developing Peyronie’s disease.

Men with a connective tissue disorder called Dupuytren’s contracture have a higher chance of developing Peyronie’s disease. Dupuytren’s contracture is a thickening in the hand that makes your fingers pull inward.

Scar Tissue and Curvature Symptoms

The main symptom of Peyronie’s disease is the formation of flat scar tissue, also called plaque. This scar tissue can generally be felt through the skin. Plaque normally forms on the upper side of the penis, but may also occur on the bottom or side. 

Sometimes extensive plaque goes all the way around the penis, causing a "waisting" or "bottleneck" deformity. Plaque can gather calcium and become very hard. Scar tissue can cause painful erections, soft erections, or severe curvature.

Scar tissue on a certain part of the penis reduces elasticity in that area. Plaque on the top of the penis can cause it to bend upward during an erection. Plaque on the side can cause curvature toward that side. More than one plaque can cause complex curvatures.

Curvature also can make sexual penetration more difficult. Scar tissue may cause shrinkage or shortening of the penis.

Tests to Take

If you think you may have Peyronie’s disease, the first step is to visit your doctor. A physical exam can help your doctor determine if you have the condition. This exam may involve taking an initial measurement of your penis.

This can help identify the location and amount of scar tissue, and determine whether your penis has shortened over time. Based on this information, your doctor may suggest an ultrasound or X-rays to reveal the presence of scar tissue.

Treatments to Try

Though it may be tempting to request medicine right away to solve this problem, many doctors prefer the ‘watchful waiting’ approach if your symptoms aren’t severe or worsening.

Your doctor may recommend medications — often drugs injected into the penis — or even surgery if you’re experiencing more pain or penis curvature over time. Two types of medicines that may be prescribed are:

  • verapamil (usually used to treat high blood pressure)
  • interferon (helps break down fibrous tissue)

Research is inconclusive on whether penile injections are effective.

Surgery is saved as a last course of action in the case of severe penis deformity. According to the NKUDC, you should wait at least a year before turning to surgery for Peyronie’s disease.

Types of Surgery

Surgical solutions include shortening the unaffected side, lengthening the scar tissue side, or penile implants. Lengthening runs a greater risk of erectile dysfunction.

Shortening the unaffected side is used when curvature is less severe. One type of shortening is a procedure called the Nesbit plication. In this procedure, doctors remove or cinch excess tissue on the longer side. This creates a straighter, shorter penis.

Facing Your Anxiety

Sex-related problems are stressful. Any form of ED can make you feel embarrassed or ashamed. This type of anxiety can lead to problems with your sexual partner.

Take steps to nip stress in the bud. Talk to your partner about Peyronie’s disease and how it may affect your performance in bed. If necessary, enlist the support of your doctor or a therapist to help you cope with your condition. 

When It Gets Complicated

In addition to the anxiety or stress that the condition may cause you — and perhaps also your partner — some other complications may arise from Peyronie’s disease. Difficulty achieving or keeping an erection can make it tough to have sexual intercourse at all. If intercourse isn’t possible, you may also find yourself dealing with difficulty fathering a child.

Seek support from your healthcare team, which may include your doctor and a psychological counselor, to help you face these complex issues.

Hope and Progress

Research is underway to help scientists better understand what causes Peyronie’s disease. Researchers are hopeful that their investigation into the process will help lead them to an effective therapy to help men with Peyronie’s disease.

In the meantime, do what you can to understand the condition and take the necessary steps to improve your quality of life — both in and outside of the bedroom.

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