Alternate Names: Peyronie's disease

Causes and Risks:

The vascular pathway that runs the length of the penis (corpora cavernosa) normally fills with blood during an erection. In Peyronie’s disease (curvature of the penis) fibrous tissue develops within and obstructs the corpora cavernosa of the penis. Why the fibrous tissue occurs is not known. The obstruction causes a bend to develop during erection that is painful and can make intercourse difficult or impossible. The condition is relatively uncommon and affects men between 40 and 60 years and older. An association has been noted with Dupuytren’s contracture, a cord-like thickening across the palm of one or both palms causing the 4th and 5th fingers to pull in toward the palm, a fairly common disorder of white men over 50 years old. However, only 1 to 2% of individuals with Dupuytren’s contracture develop curvature of the penis. Other risk factors have not been identified.

Prevention:

There is no known prevention for this condition.

Symptoms:

• Painful erection
• Observable bend in the penis with erection
• Observable narrowing of the diameter of the penis with erection
• Thick band of hard tissue within the penis

Signs and Tests:

Physical examination is sufficient to diagnose curvature of the penis.The hard plaques can be felt with or without erection.It may be necessary to use injectable medications to induce an erection for proper evaluation of the penile curvature.The patient may also provide pictures of the erect penis for evaluation by the physician.Ultrasound of the penis may demonstrate the lesions in the penis but is not necessary.

Treatment:

Symptoms may be decreased somewhat with radiation therapy or corticosteroid injections into the fibrous band of tissue.Topical verapamil, an oral medication used for high blood pressure, has recently been shown to improve the disease and has been approved for use in treating Peyronie’s.

If medical therapy fails and intercourse is not possible secondary to the curvature of the penis, surgery may be utilized to correct the curvature.Surgery is reserved for severe cases where intercourse is not possible due to the high risk of the surgery causing impotence.

Prognosis:

The condition is typically progressive and leads to inability to have intercourse. The disease is also associated with development of impotence.

Complications:

The condition may make intercourse difficult, painful, or impossible.Surgical correction may also lead to impotence.

Call for an appointment with your health care provider if symptoms occur, particularly if erections are painful.