Greater Boston Urology Blog

Your Peyronie's Disease Questions, Answered

Peyronie's disease is the development of scar tissue along the tunica albuginea, which is the fiber sheath that surrounds the erectile tissue of the male penis. This scar tissue can cause a penis to bend or curve during an erection, making sexual activity or the erection itself difficult.

The development of the scar tissue isn't necessarily painful. But it can affect a patient's self-image and quality of life. The good news: Peyronie's disease is a very treatable condition. The bad news is there's a lack of public awareness even though Johns Hopkins Medicine reports that the disease affects as many as one in 11 men.

Back in 2017, we took a deep dive into what Peyronie's disease is. But to help increase public awareness further, we thought it might make sense to answer common questions we see online (and that can often lead to myths and misinformation). 

As with all content on our blog, the following is meant to be educational in nature, not medical advice. Always consult your physician regarding your unique healthcare needs.

How do you get Peyronie's disease?

GBU: The exact cause of Peyronie's disease is still unknown, but most agree that penile trauma in the erect or flaccid state in a susceptible individual often contributes to the disease. Patients who have penile trauma who are at higher risk include those over 50 years old with erectile dysfunction, diabetes, and those with scarring disorders, such as Dupuytren's disease, plantar fasciitis, and tympanosclerosis. 

At what age can you get Peyronie's disease?

GBU: Peyronie's disease is most commonly diagnosed after the age of 50, but certainly can be diagnosed in younger men. Curvature of the penis in a younger man or infant could be another condition called congenital curvature of the penis, or chordee, which is where the inner corporal cylinders of the penis do not develop proportionately, which causes bending of the penis.

How do you prevent Peyronie's disease?

GBU: While it is very difficult to prevent Peyronie's disease specifically, preventing risk factors for erectile dysfunction and diabetes never hurts. Engaging in regular cardiovascular exercise (walking, running, biking, weightlifting) and maintaining a healthy overall weight is certainly beneficial. 

How do you treat Peyronie's disease?

GBU:  Peyronie's disease exists in two phases: acute and stable/chronic phase. In the acute phase, patients have a lot of pain with erections and the degree of curvature is changing (getting better or worse with time). In this case, we recommend treating with NSAIDs like ibuprofen or naproxen. The acute phase can last for about 12-18 months.

Once the penile curvature is stable (not changing) for more than 3 to 6 months and less painful with erections, there are several other treatment options available.

•    Exercises: Controlled penile stretching (penile traction devices)

•    Office injections: Verapamil, interferon a-2b, and collagenase (Xiaflex) are doctor-administered injections in the office that break up the plaque of scar tissue that causes the penis to bend. These injections are done every 6 weeks for about 6 months total. 

  • Surgery: Several surgical options exist:

    • Plication, which involves bending the penis in the opposite direction to straighten it out with sutures

    • Incision/excision and grafting, which involves surgical removal of the scarred plaque

    • Inflatable penile prosthesis with modeling for patients with both Peyronie's curvature and erectile dysfunction

What happens if you leave Peyronie's disease untreated?

GBU: The curvature can improve or can worsen, but eventually will stabilize usually after 12-18 months. This is not a life-threatening disease and does not pose any increased risk of cancer, and thus untreated Peyronie's disease is completely fine if the patient is not bothered by the curvature.

Is there a Peyronie's disease medication?

GBU: Unfortunately, no oral medications have ever been proven to significantly reduce Peyronie's curvature in any randomized controlled trial. Vitamin E, colchicine, tamoxifen, carnitine, and pentoxifylline have all been trialed without any evidence to support their use. The most recent American Urological Association guidelines do not recommend any of these medications for Peyronie's disease.

What are the best supplements for Peyronie's disease?

GBU: There are no known supplements that actually improve Peyronie's curvature. Vitamin E is the most commonly recommended supplement via advertising, although randomized controlled trials show that Vitamin E is no better than taking a placebo medication in reducing Peyronie's curvature.

Can masturbation cause Peyronie's disease?

GBU: Micro-trauma to the penis can certainly lead to Peyronie's disease in a susceptible individual, as detailed above, but there is no direct link between masturbation and Peyronie's curvature. 

Can Viagra cause Peyronie's disease? What about other meds?

GBU: No; medications like Viagra, Cialis, or other similar medications for erectile dysfunction do not contribute to Peyronie's or curvature problems. Because these medications are more likely to improve erections, disease states such as Peyronie's curvature may be more apparent after taking them, but there is no direct link between the medications and Peyronie's disease. 

Are there exercises for Peyronie's disease?

GBU: Patients can perform controlled penile stretching using a penile traction device at home. There are several commercially available traction devices that can be purchased online. The penis is stretched for about 4.5-5 hours per day for approximately 6 months. This can improve penile curvature by 15 degrees over a 6-month period. In general, we find this to be an underutilized method of treating Peyronie's disease, as it can provide significant benefit.

Can massage help Peyronie's disease?

GBU: No, penile massage has not been shown to reduce Peyronie's curvature. 

Do vacuum pumps work for Peyronie's disease?

GBU: Vacuum erection devices are useful for erectile dysfunction, particularly in those with venous leak causing difficulty maintaining erections, but the data to support their use in Peyronie's disease is not so clear.

At the present time, observational studies have shown that vacuum pumps can reduce penile curvature in some men, but there is not enough data to encourage their use routinely. For this reason, they are not recommended by the American Urological Association guidelines for Peyronie's disease. They can be used as an adjunct with other treatments for Peyronie's disease, particularly in men who also have erectile dysfunction.

I've heard about using Vick's Vapor Rub for Peyronie's disease. Does that work?

GBU: No supplements have ever been proven to be useful for Peyronie's disease, so we do not routinely recommend Vick's Vapor Rub for this disease process. We have several other options which are beneficial.

Can Peyronie's disease cause cancer?

GBU: No, this is not a direct cause of penile or any other type of cancer.

I think I have Peyronie's disease. What should I do?

GBU: You are not alone. 10-30% of men have Peyronie's disease, and this can understandably be very frustrating and embarrassing for patients. If this is causing bother or difficulty with sexual activity, we recommend seeing a urologist. We will evaluate you in the office, often measuring the degree of curvature, examining for penile scar tissue, and offering proven and effective treatments that are supported by the American Urological Association guidelines. 

Remember, your quality of life matters. Let us help.

Don't leave your healthcare to searches in Google. Our physicians can diagnose and treat Peyronie's disease. Make an appointment with one of our world-class urologists today. 


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