Table of ContentsView AllTable of ContentsSymptomsWhat Causes PD?Is PD Permanent?Talking With a ProviderTreatment OptionsEmotional ImpactManaging PainLiving and CopingNext in Peyronie’s Disease GuidePeyronie’s Disease Symptoms
Table of ContentsView All
View All
Table of Contents
Symptoms
What Causes PD?
Is PD Permanent?
Talking With a Provider
Treatment Options
Emotional Impact
Managing Pain
Living and Coping
Next in Peyronie’s Disease Guide
Peyronie’s disease(PD) is a condition in which thepenisdevelops an abnormal curve. The bend is due to the buildup of scar tissue, called plaques, on the membrane surrounding the inner shaft of the penis. PD tends to affect older people and can cause painfulerections,pain with intercourse, anderectile dysfunction (ED). Treatment includes medical-grade penile injections, penile traction therapy, and surgical correction.
PD is abenign(noncancerous) condition but one that can cause considerable stress and a loss of sexual function, affecting a person’s self-esteem and relationships.
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This article describes the symptoms and causes of Peyronie’s disease and what can be done to diagnose, treat, and cope with a condition that affects up to 11% of people with penises in the United States.
Peyronie’s Disease Symptoms
Penises can have some degree of curvature that you are born with and that is perfectly normal. Peyronie’s disease refers to a change in the curvature of the penis that can either evolve over time or occur spontaneously.
Common symptoms of PD include:
Complications
Beyond the deformity of the penis itself, PD is associated with an increasedrisk of erectile dysfunction (ED). The loss of erectile function may occur with the onset of PD symptoms, develop months or years later, or make existing ED symptoms worse.
The penile plaques can stem the flow of blood needed to engorge the penis during an erection. It can also disrupt the function ofsmooth musclesaround the penis that stiffen during an erection.
Risks of Erectile DysfunctionStudies suggest that anywhere from 40% to 60% of people with Peyronie’s disease have some degree of erectile dysfunction.However, as PD tends to affect older people who are already at risk of ED, it may be a contributing rather than the sole cause of ED.
Risks of Erectile Dysfunction
Studies suggest that anywhere from 40% to 60% of people with Peyronie’s disease have some degree of erectile dysfunction.However, as PD tends to affect older people who are already at risk of ED, it may be a contributing rather than the sole cause of ED.
While PD doesn’t directly interfere withmale fertility, erectile dysfunction associated with the physical and psychological effects of PD can. As an independent risk factor, ED can lead to infertility in 1 out of 6 people with the condition.
The Facts About Age and Male Fertility
What Causes Peyronie’s Disease?
The tunica albuginea surrounds and encases three spongy columns that make up the shaft of the penis, called thecorpus cavernosaand thecorpus spongiosum. It maintains an erection after the corpus cavernosa and corpus spongiosum engorge with blood.
The plaques compromise the stability of the tunica albuginea, causing it to collapse at the junction of weakness either spontaneously or over time.
After that, PD will progress into the following two stages:
Risk Factors
Older age is considered the primary factor contributing to Peyronie’s disease Most people with PD develop symptoms after the age of 50.
While study results vary, other conditions may increase the risk of PD, including heart disease,hypogonadism(low testosterone), and family genetics. PD is also more common in people with other connective tissue disorders, likeDuputyren’s contracture.
Facts and Statistics About Peyronie’s Disease
Is Peyronie’s Disease Permanent?
Peyronie’s disease is usually a permanent condition, but that doesn’t mean the severity of symptoms or complications won’t improve. For some, the curvature and pain may resolve over time. In others, the curvature and shortening of the penis may persist. Pain during erections may improve within one to two years.
Can a Bent Penis Unbend?According to a 2020 review inF1000 Research,around 12% to 13% of people with PD will experience an improvement in the curvature of their penises. Of the remaining 87% to 88%, around 40% to 47% will have stable penile curvature, and 40% to 48% will have worsening penile curvature. The reasons for these differences are not clear.
Can a Bent Penis Unbend?
According to a 2020 review inF1000 Research,around 12% to 13% of people with PD will experience an improvement in the curvature of their penises. Of the remaining 87% to 88%, around 40% to 47% will have stable penile curvature, and 40% to 48% will have worsening penile curvature. The reasons for these differences are not clear.
It is also unclear how frequently erectile dysfunction improves in people with PD, although there is evidence that smaller plaque volumes and less severe penile curvature may play a role.
Talking With a Healthcare Provider About Peyronie’s Disease
Talking with a healthcare provider about Peyronie’s disease may seem awkward and embarrassing, but avoiding the conversation may cause more harm than good.
For one thing, early diagnosis and treatment may help to halt the progressive curvature of the penis with nonsurgical means. The diagnosis may also reveal a more serious condition entirely unrelated to PD, such as apenile fractureorpenile cancer.
If you feel uncomfortable speaking with your primary care provider, you can schedule an appointment with aurologist. These doctors are specialists in diseases of the male reproductive organs and urinary tract. They are trained to deal with conditions like PD and may be best suited to dispense advice and treatment.
To make the conversation easier, open with general statements like:
A urologist can pick up on these cues and start asking questions to get closer to what you are actually experiencing. Come prepared with relevant information, such as when symptoms first started, when the pain occurs, and whether you had erectile dysfunction before or after the bend.
The more the healthcare provider knows, the better able they will be to prescribe the appropriate treatment.
How Peyronie’s Disease Is Diagnosed
Peyronie’s Disease Treatment
The treatment of Peyronie’s disease has evolved, with more tools, medications, and procedures at a healthcare provider’s disposal. The treatment will be individualized based on the characteristics and severity of your symptoms as well as the impact of PD on your well-being and quality of life.
PD is treated conservatively during the acute stage, delaying surgery until the condition stabilizes to avoid repeat surgery. During the chronic stage, a combination of treatments may be considered, with surgery most often reserved for cases in which the penile deformity is severe or impacts your ability to have sex.
Penile Traction
Penile tractionis a form of physical therapy in which a device is applied to the penis to improve the curvature and length of the penis. The device places opposing pressure against the bend to straighten it gradually and has an extender to maintain or improve the length of the penis.
Depending on the severity of the curve and the device used, penile traction may be prescribed anywhere from 30 minutes to eight hours per day for at least six months.
Penile traction is thought to be most effective during the acute phase but also has its place in the treatment of chronic PD when used in combination with locally injected medicines.
Do Penis Exercises Help?Penile vacuum pumps,penile massage,and penile exercises (such asjelging)have all been proposed as treatments for Peyronie’s disease, but the evidence supporting their use is lacking.
Do Penis Exercises Help?
Penile vacuum pumps,penile massage,and penile exercises (such asjelging)have all been proposed as treatments for Peyronie’s disease, but the evidence supporting their use is lacking.
How to Prevent Peyronie’s Disease
Medications
One of the mainstays of PD treatment is intralesional injections, This is when medications are injected into plaques to gradually break up and loosen scar tissues. Depending on the drug used, injections may be given in cycles every two to six weeks, with or without penile traction.
Medications that can be used include:
Other topical, oral, and injectable drugs and supplements have been studied, but none has proven to be consistently effective in treating PD.
Can Viagra and Cialis Help?PDE5 inhibitorsare oral medications used to treat erectile dysfunction. With Peyronie’s disease, drugs likeViagra (sildenafil)andCialis (tadalafil)improve the quality and duration of erections and also reduce the inflammatory stress that promotes the progression of PD symptoms.
Can Viagra and Cialis Help?
PDE5 inhibitorsare oral medications used to treat erectile dysfunction. With Peyronie’s disease, drugs likeViagra (sildenafil)andCialis (tadalafil)improve the quality and duration of erections and also reduce the inflammatory stress that promotes the progression of PD symptoms.
Extracorporeal Shockwave Therapy
Despite evidence that ESWT can help ease PD pain, there is limited evidence that it can either decrease or prevent the worsening of the penile curve.
Surgery
Surgery may be considered if the penile curve is severe or interfering with your ability to have sex or conceive children.
Surgical options include:
Emotional Impact of Peyronie’s Disease
Mental Health
Many people with PD experience depression, low self-esteem, and emotional distress as a result of their condition. These can lead to social isolation (to avoid anyone noticing or hearing about your symptoms) and feelings of stigmatization (both real and perceived).
A 2013 analysis published in theJournal of Sexual Medicinerevealed that these emotions are far more common than many people think.According to the investigators, among people living with PD:
Moreover, these emotions did not appear to improve with time.
Treatment with a therapist or counselor is commonly advised for people faced with clinically significant Peyronie’s disease. Options include education along withcognitive behavioral therapy (CBT)to identify and adjust negative thought patterns related to self-esteem and sexual self-identity.
Intimacy
The same study in theJournal of Sexual Medicinereported that no less than 54% of people with PD report relationship difficulties due to their condition.
Not only are people with PD more likely to express dissatisfaction with sex and their relationships, but so will their partners. A 2016 study from McGill University reported that among the female partners of males with Peyronie’s, the loss of intimacy and changes in their partner’s mood accounted for these negative thoughts and feelings.
Improving Intimacy in Couples With PDBecause PD affects couples as well as individuals, education and counseling are advised early on in treatment. This may involvecouple sex therapy,emotionally focused therapy (EFT)to strengthen emotional bonds in couples, andsensate focusto increase a couple’s responsiveness to touch irrespective of sexual intercourse.
Improving Intimacy in Couples With PD
Because PD affects couples as well as individuals, education and counseling are advised early on in treatment. This may involvecouple sex therapy,emotionally focused therapy (EFT)to strengthen emotional bonds in couples, andsensate focusto increase a couple’s responsiveness to touch irrespective of sexual intercourse.
How to Cope With Erectile Dysfunction
How to Deal With Pain From Peyronie’s Disease
During the first year or two of developing Peyronie’s disease, it is not uncommon to experience pain with an erection and even without one. In some cases, the pain may be persistent and require strategies to cope better.
The important thing to remember is that the pain associated with acute PD tends to improve over time and may eventually resolve altogether.
Things you can do include:
Living With Peyronie’s Disease
It can take time before you see or feel any changes from Peyronie’s disease treatment. In some cases, the results may fall short of your expectations. Even so, it is important to remain positive and not make any assumptions while undergoing treatment.
By educating yourself, working with your partner, and communicating openly, you can reduce stress and focus on living well on a day-to-day basis. By doing so, you’ll improve both your physical and mental health, which, in turn, can improve your sexual health.
To better cope with Peyronie’s disease:
If you are unable to cope, do not hesitate to seek a referral to a sex therapist orpsychiatrist. This is especially true if you have persistent feelings of despair, hopelessness, or sadness. Medications can be prescribed if needed to help you better manage your moods.
20 Sources
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Teloken P, Katz D.Medical management of Peyronie’s disease: review of the clinical evidence,Med Sci (Basel).2019;7(9):96. doi:10.3390/medsci7090096
Stuntz M, Perlaky A, des Vignes F, Kyriakides T, Glass D.The prevalence of Peyronie’s disease in the United States: a population-based study.PLoS One.2016;11(2):e0150157. doi:10.1371/journal.pone.0150157
Hussein AA, Alwaal A, Lue TF.All about Peyronie’s disease.Asian J Urol.2015;2(2):70–78. doi:10.1016/j.ajur.2015.04.019
Segundo A, Glina S.Prevalence, risk factors, and erectile dysfunction associated with Peyronie’s disease among men seeking urological care.Sex Med.2020;8(2):230–236. doi:10.1016/j.esxm.2019.11.002
Campbell J, Alzubaidi R.Understanding the cellular basis and pathophysiology of Peyronie’s disease to optimize treatment for erectile dysfunction.Transl Androl Urol.2017;6(1):46–59. doi:10.21037/tau.2016.11.01
Bilgutay AN, Pastuszak AW.Peyronie’s disease. a review of the etiology, diagnosis, and management.Curr Sex Health Rep. 2015;7(2):117–131. doi:10.1007/s11930-015-0045-y
Lotti S, Maggi M.Sexual dysfunction and male infertility.Nat Rev Urol.2018 May;15(5):287-307. doi:10.1038/nrurol.2018.20
Babu A, Kayes O.Recent advances in managing Peyronie’s disease.F1000Res.2020;9:F1000 Faculty Rev-381. doi:10.12688/f1000research.20557.1
Da Silva GVM, Davila FJ, Rosito TE, Martins FE.Global perspective on the management of Peyronie’s disease.Front Reprod Health.2022;4:863844. doi:10.3389/frph.2022.863844
Yoo HS, Satti S, Matrana M.Primary undifferentiated pleomorphic sarcoma of the penis.Ochsner J.2017;17(4):434–437.
Nehra A, Alterowitz R, Culkin DJ, et al.Peyronie’s disease: AUA guideline.J Urol.2015;194(3):745–753. doi:10.1016/j.juro.2015.05.098
Chung E.Penile traction therapy and Peyronie’s disease: a state of art review of the current literature.Ther Advances Urol. 2013;5(1):59–65. doi:10.1177/1756287212454932
MacDonald LP, Armstrong ML, Lehmann KJ, Acker MR, Langille GM.Outcome analysis of patients with Peyronie’s disease who elect for vacuum erection device therapy.Can Urol Assoc J. 2020;14(9):E428-E431. doi:10.5489/cuaj.6205
Gokce A, Wang JC, Powers MK, Hellstrom WJG.Current and emerging treatment options for Peyronie’s disease.Res Rep Urol.2013;5:17–27. doi:10.2147/RRU.S24609
Sun J, Gao F, Wang Y, Sun W, Jiang B, Li Z.Extracorporeal shock wave therapy is effective in treating chronic plantar fasciitis: a meta-analysis of RCTs.Medicine. 2017;96(15):e6621. doi:10.1097/MD.0000000000006621
Nelson CJ, Mulhall JP.Psychological impact of Peyronie’s disease: a review.J Sex Med.2013;10(3):653-660. doi:10.1111/j.1743-6109.2012.02999.x
Hartzell R.Psychosexual symptoms and treatment of Peyronie’s disease within a collaborative care model.Sex Med.2014;2(4):168–177. doi:10.1002/sm2.45
Davis SNP, Ferrar S, Sadikaj D, Gerard M, Binik YM, Carrier S.Female partners of men with Peyronie’s disease have impaired sexual function, satisfaction, and mood, while degree of sexual interference is associated with worse outcomes.J Sex Med. 2016 Jul;13(7):1095-1103. doi:10.1016/j.jsxm.2016.04.074
Talib RA, Ibrahim MA, Canguven O.Nonsurgical treatment options in Peyronie’s disease: 2016 update.Turk J Urol.2016;42(4):217–223. doi:10.5152/tud.2016.4099
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