Peyronies Disease

Peyronie's Disease

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How do I know if I have Peyronie’s Disease?

Peyronie's disease is the curvature of the penis that can be physically uncomfortable and emotionally distressing on a man, especially if shortening or “hour glass” deformity of the penis occurs.

Filopuius described the first curvature in a patient in 1561. Surgeon Peyronie himself described 5 cases. They were treated by bathing in the waters of Berege in France in 1743 (water unavailable in our offices).

A trip to the urologist can confirm diagnosis. Some signs and symptoms include the following:
  • Noticeable knot or scar on the inside the penile shaft
  • Pronounced curve during erection
  • Noticeably shorter penis
  • Pain with intercourse or erection
There are various causes to explain why Peyronie's may occur that include but are not limited to testosterone levels (even if ED is not present), genetics, and underlying conditions. There have been studies that show a link between Peyronie's and Dupuytren's Contracture which is a disease affecting the tendons in the fingers and other joints. Studies have shown that there are also a few inflammatory disorders that hold an influence on gene mutation for chromosome 11. 

What causes a bent or curved penis?

Some men can have a very mild curve, which is natural. If a curve worsens or is more dramatic, this is possibly PD. Bent penis occurs when fibrous tissue forms a plaque underneath the skin of the penis and acts as a scar, preventing the natural stretch of the penis during erection. While the exact cause differs, many men report an injury to the penis that occurred during sex. A snap is heard or felt, and sometimes men notice bruising on the penis. The injury heals over time, but a plaque is formed. 

Is penile injury common?

Penile injury is, in fact, pretty common. Although the development of plaque in the penis after injury, called Peyronie’s Disease, it not as common – it can affect as many as 1 out 10 men. Unfortunately, this common condition is often hidden due to embarrassment. We have the spectrum of treatments to fight PD.

Are there alternatives to surgery?
We use multiple approaches to help fix the curved penis and we try to reduce the pain associated with Peyronie's.

  • Surgery is considered the gold standard. Unfortunately, patients may decide against surgery because it will shorten the length of the penis.
  • Xiaflex is FDA approved. It is an injection directly into the scar tissue. Studies show a 30% improvement in curvature. Not all cases are candidates for xiaflex. The medication can be expensive depending on insurance coverage. Side-effects may be severe sometimes. Penile rupture is a possibility.
  • Verapamil injection is less effective and relatively unproven compared to xiaflex.
  • Verapamil gel is also available.
  • Penile extension devices are options. We encourage this treatment and have them in stock.
  • Research on platelet rich plasma and biologics have shown promise for reducing inflammation and promoting healing. We have experience with these agents and can counsel you to see if it is an option.

Can I Just Take Pills for My Bent Penis?

Unfortunately, many pills are not 100% reliable. However, we have seen that the combination of Tadalafil and Pentoxyfiline has been effective for Peyronies. A recent randomized study has shown a 10% improvement in plaque and reduction of pain with the use of Tadalafil. In regards to Pentoxyfiline, a randomized and controlled trial had shown the reduction of curvature with this medication.

Does GAINSWave Help with Peyronie's?

GAINSWave or low Intensity shockwave therapy helps stimulate the growth of small blood vessels and nerve tissue. The shockwaves are able to break up microplaque as well. The American Urology Association considers shockwaves effective for any pain with Peyronie’s. The effect of soundwaves for treating the penis curve is mixed. However, a recent study had noted improvement when the soundwaves were directly targeting into the plaque. Luckily, the treatment does not have any downtime or side-effects associated.

Does Testosterone Help with Peyronies?

This is still a topic of discussion that is being researched. However, studies have shown that low testosterone levels are associated with Peyronie's disease.
If you have symptoms of low T such as low energy or sleeplessness, we can check your levels and start a safe program to optimize your levels into a normal range. 
Read more about hormone replacement therapy here.

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