Peyronie's Disease

Signs and Symptoms

Peyronie's disease is a disorder affecting about 3 percent of men middle-age and older. The condition is caused by the formation of dense, fibrous scar tissue, or plaque, in the penis' tunica albuginea -- the sheath that surrounds the erectile tissue.

Due to the formation of scar tissue in the penis, patients with Peyronie's disease may experience pain and a curvature or distortion, such as a shortening or narrowing of the penis during an erection. In severe cases, these symptoms may lead to erectile dysfunction. The cause of Peyronie's disease is not completely known. However, factors such as genetics and trauma to the penis, which may occur due to injury or invasive penile procedures, may contribute to the disease.

Diagnosis

A diagnosis of Peyronie's disease usually can be made by a detailed medical history and conducting a thorough physical examination. Your doctor will check for and discuss any symptoms you may experience that are related to the disease. In some instances, an ultrasound scan may be used to identify the hardened plaque in the penis. It also is recommended that, if possible, the patient bring photographs from a digital or polaroid camera of the erect penis taken from above and both sides, which can be very helpful in making a diagnosis.

In rare cases where a diagnosis of Peyronie's disease cannot be made through a physical examination, a biopsy may be recommended. During a biopsy, a small amount of plaque cells are removed from the penis and then examined under a microscope to help diagnose the condition and rule out other diseases, such as cancer.

Treatment

In about 15 percent of cases, Peyronie's disease spontaneously resolves itself without treatment. However, more than 40 percent of the cases may worsen. If treatment is necessary, oral therapies, injections and surgery may be used. Therapy for the condition aims to relieve symptoms and preserve erectile function.

• Oral Therapies -- Taking a drug known as para-aminobenzoate or vitamin E tablets may be recommended for several months. Unfortunately, in most cases, these medications have limited success. At UCSF Medical Center, our experts pioneered new treatments, such as colchicine and pentoxifylline, that have better success.

• Injections -- The injection of verapamil into the plaque in the penis may be recommended. This treatment typically requires about six to 12 injections over six months duration.

• Iontophoresis -- This is a technique in which a painless current of electricity is used to deliver verapamil or some other agent under the skin into the plaque.

Surgery

Surgery has been shown to be the most effective treatment for Peyronie's disease to correct the curvature of the penis. However, it is usually only recommended in severe cases for patients who fail to respond to non-surgical therapy and have curvature for longer than 12 months.

The two most common surgical methods are the cutting of the plaque followed by placement of a patch of vein or artificial material, or stitching of tissue from the side of the penis opposite the plaque, which corrects the penile curvature.

Read more about surgical treatment in Patient Education.

Other Options

Some men choose to receive an implanted device, or penile prosthesis, that increases the rigidity of the penis. In some cases, a penile implant alone will adequately straighten the penis.

For more detailed information on the three surgical procedures offered at UCSF Medical Center, please see Surgical Treatment for Peyronie's Disease.