Some degree of penile curvature can be completely normal. However, when a new or increasing curve develops — particularly when accompanied by pain, a noticeable lump or difficulty with sexual intercourse — it may be caused by a condition known as Peyronie’s disease.

Peyronie’s disease is a urological condition caused by the development of fibrous scar tissue, known as plaque, within the penis. This can affect the shape, length and function of the penis during an erection.

For some men the condition causes relatively minor symptoms. For others, the curvature can become significant enough to affect sexual function and quality of life.

What Is Peyronie’s Disease?

Peyronie’s disease occurs when an area of fibrous scar tissue develops within the tissue surrounding the erectile chambers of the penis.

Because this scar tissue does not stretch normally during an erection, one area of the penis may expand less than the surrounding tissue. This can result in the penis bending towards the affected side.

Changes may include:

• Penile curvature during an erection
• A hard lump or area of thickened tissue
• Pain during erections
• Shortening or narrowing of the penis
• An indentation or hourglass appearance
• Difficulty with sexual intercourse
• Erectile dysfunction

The degree of curvature varies considerably between individuals.

What Causes Peyronie’s Disease?

The exact cause is not always clear.

In some cases, Peyronie’s disease is thought to develop following injury or repeated minor trauma to the penis. Healing following these injuries may result in abnormal scar tissue formation.

However, many men diagnosed with Peyronie’s disease do not remember experiencing a specific injury.

Certain factors may increase the likelihood of developing the condition, including age, family history and some connective tissue disorders.

Is a Curved Penis Always Peyronie’s Disease?

No.

Some men naturally have a degree of penile curvature that has been present since adolescence or early adulthood. This is known as congenital penile curvature and is different from Peyronie’s disease.

A curve is more suggestive of Peyronie’s disease when it develops later in life or changes progressively over time, particularly if there is associated pain or a palpable area of hardened tissue.

A urologist can help determine the cause.

Does Peyronie’s Disease Cause Erectile Dysfunction?

Peyronie’s disease and erectile dysfunction can occur together.

The physical changes caused by Peyronie’s disease may make maintaining an erection more difficult in some men. Significant curvature can also interfere mechanically with sexual intercourse.

There can also be a psychological component. Concern about pain, appearance or sexual performance may contribute to difficulties with erections.

For this reason, assessment often considers both the physical curvature and overall erectile function.

Does Peyronie’s Disease Get Worse?

Peyronie’s disease commonly develops in stages.

During the earlier or active phase, curvature may continue to change and pain may be present during erections.

Eventually, the condition may enter a more stable phase in which the curvature stops progressing and pain often improves.

Not every patient follows exactly the same pattern, which is why treatment recommendations depend on the individual’s symptoms and stage of disease.

How Is Peyronie’s Disease Diagnosed?

Diagnosis usually begins with a medical history and physical examination.

A urologist may assess the location and size of the plaque and the degree of penile curvature.

In some circumstances, photographs of the erect penis or specialised ultrasound imaging may be useful to assess the curvature, blood flow and erectile tissue.

How Is Peyronie’s Disease Treated?

Treatment depends on several factors, including:

• Severity of the curvature
• Whether the condition is stable or progressing
• Presence of pain
• Erectile function
• Whether sexual intercourse is affected
• How much the condition is affecting quality of life

Not every patient requires active treatment.

Observation

Mild Peyronie’s disease that does not cause significant pain or interfere with sexual function may sometimes be monitored.

Penile Traction Therapy

Specialised traction devices may be recommended for selected patients.

These devices apply controlled stretching over time and may help improve curvature or preserve penile length in appropriate cases.

Medications and Other Treatments

Various medical treatments have been investigated for Peyronie’s disease. Their suitability and effectiveness depend on the individual patient and stage of the condition.

A urologist can discuss which evidence-based options may be appropriate.

Surgery

Surgery may be considered when curvature is significant, the condition has stabilised and sexual intercourse is difficult or impossible.

Different surgical techniques are available depending on the degree of curvature, penile length and erectile function.

These can include procedures that straighten the penis, grafting procedures and, in selected patients who also have significant erectile dysfunction, penile prosthesis surgery.

When Should You See a Urologist?

Consider seeking a urological assessment if you notice:

• A new curve developing during erections
• Increasing penile curvature
• Pain during erections
• A hard lump or plaque within the penis
• Penile shortening or narrowing
• Difficulty having sexual intercourse because of curvature
• Erectile dysfunction occurring alongside these changes

Early assessment can help establish whether the changes are caused by Peyronie’s disease or another condition and determine whether treatment or monitoring is appropriate.

Peyronie’s Disease Is a Treatable Urological Condition

Men can be reluctant to discuss changes involving the penis, even with their doctor.

However, Peyronie’s disease is a recognised medical condition and something urologists routinely assess and treat.

Treatment is not necessary for every patient, but when penile curvature causes pain, erectile difficulties or problems with sexual intercourse, several treatment approaches may be available.

If you have noticed a new or worsening penile curvature, speaking with a urologist can help determine the cause and the most appropriate next step.

This information is general in nature and does not replace individual medical advice.

Come chat with your local Brisbane based Urologist, Dr Jo, to discuss Rezum with you. Jo and one other Urologist in QLD were the first to start this technique in QLD.