What is Peyronie's disease?

Peyronie's disease is a condition of the penis characterized by plaque formation due to scar tissue that develops in the penis. By causing curvature of the penis, it prevents a straight and firm erection.

Some men with Peyronie's disease can continue their sexual lives. For many, however, it turns into painful erectile dysfunction.

Many forms of treatment have been defined depending on the symptoms.

What causes Peyronie's disease?

Today, scientists do not know exactly what causes Peyronie's disease. Many researchers believe that these plaques form as a result of bleeding inside the penis after a trauma (a blow or bending). Injuries of this kind may not always be visible to the eye.

In other cases, it can appear over time on a genetic basis. In some men, trauma and genetics occur together.

Although it has not been fully proven, the package information of some medications also lists Peyronie's disease as a possible side effect.

Who gets Peyronie's disease?

Although it is most often seen in middle-aged men, it can also occur in younger and older men.

Its frequency in men increases with age. But it is not a natural part of aging.

What are the symptoms of Peyronie's disease?

Symptoms may develop slowly or appear suddenly. When the penis is soft, no problem is noticeable. In advanced cases, however, the hardened plaque impairs elasticity, causing curvature and pain in the penis during erection.

In most cases, a slight decrease in pain is observed over time, while the curvature gradually gets worse.

In some men with Peyronie's disease, plaque formation similar to that in the penis can also be seen in other parts of the body. It usually occurs in the hands and feet. Peyronie's disease is more common in patients with Dupuytren's contracture — scar tissue in the hands affecting the fingers — than in the rest of the population.

How do doctors diagnose Peyronie's disease?

Tell your doctor your full history from before the symptoms began, as accurately as possible.

During the physical examination, your urologist will identify the hardened tissue that has formed on the penis. Although it is not a commonly used method, in advanced cases the examination may also be performed after an injection that makes the penis erect.

For the patient's further follow-up, a penile Doppler ultrasound may be requested before treatment.

Rarely, in some patients — when the urologist cannot fully diagnose Peyronie's disease during the physical examination, or when the disease progresses much faster than is typical for its character — a biopsy may be taken from the penis. The biopsy is taken as a very small piece from the affected area and sent to pathology.

Can Peyronie's disease be treated?

Yes, but it is very important that you choose, together with your urologist, the form of treatment best suited to the severity of your disease.

What treatments are available for Peyronie's disease?

There are 4 main forms of treatment for Peyronie's disease.

Medication therapy: a treatment modality that can last for years. Many drugs have been tried, and recently the most widely used ones have been banned from use by the world urological association.

Surgical treatment: there are 3 types. While the first two can cause erection problems, the penile prosthesis (penile implant) has comparatively fewer complications.

ESWT treatment + injection combination: this treatment modality using shock waves is currently the newest treatment protocol in the world. It has no side effects at all. With short sessions, daily life can continue as usual. With the support of the collagenase enzyme, success rates increase considerably. After revascularization (new blood vessel formation), which can take up to 6 months, shrinkage of the plaques, reduction of pain and improvement of the curvature are observed.

Do vitamins help?

There are many studies on the combination of vitamin E and colchicine. However, no evidence has been found that they are successful.

Other options

Very rarely, radiation therapy has been applied to the plaques. This method, used mostly for pain, has not been proven either. It is not used routinely today.