How Is Peyronie's disease treated?
Peyronie's disease is a lifelong connective tissue disorder. While there isn't a cure, treatments can help.
Who treats Peyronie's disease?
A urologist is a medical doctor who specializes in the diagnosis and treatment of conditions like Peyronie's disease. These conditions affect the urinary tract and reproductive system.
Who needs treatment for Peyronie's disease?
Not everyone who has Peyronie's disease requires treatment. In approximately 13 out of 100 men, the condition improves on its own. For this reason, your doctor may recommend holding off on more invasive (surgical) treatments for 12 months after the initial diagnosis of Peyronie's disease. While you're in this early (acute) stage of the disease, you may try nonsurgical treatments.
You might not need treatment if you have:
minimal (slight) penile curvature
no pain
no problem with sexual function
small plaque deposits
Peyronie's disease treatment goals
Treatments for Peyronie's disease vary depending on your symptoms. This includes the degree of penile curvature, disease stage (acute or chronic), and pain level.
The plaque deposits of scar tissue that cause Peyronie's disease are permanent. There isn't a treatment to make the deposits go away and completely eliminate the penile curvature. But there are nonsurgical and surgical treatments that can help.
The goals of treatments are to:
minimize the penile curvature as much as possible
reduce pain
restore the ability to have sexual intercourse
treat erectile dysfunction (ED), if needed
What are the nonsurgical treatments for Peyronie's disease?
Nonsurgical treatments tend to be most effective when you're in the early (acute) stage of the disease. This stage typically lasts for 5 to 7 months while the curvature is developing. The acute stage can last for up to 18 months.
Nonsurgical treatments for Peyronie's disease include:
oral medications
penile injections
traction therapy
other nonmedicinal therapies
Oral medications
Some oral medications may slow the progression of the curvature, although the outcomes usually aren't as good as other treatments. Medications include:
carnitine, an antioxidant that reduces inflammation and speeds wound healing
colchicine to reduce swelling
nonsteroidal anti-inflammatory drugs (NSAIDs) to ease pain and inflammation
potassium aminobenzoate, a B-complex vitamin that may reduce plaque size
tadalafil (Cialis®) to treat erectile dysfunction, improve blood flow to the penis, and minimize the buildup of scar tissue
tamoxifen, a selective estrogen receptor modulator (SERM) that minimizes plaque buildup
vitamin E to reduce plaque size
Penile injections
Injections directly into the plaque deposit are often more effective than oral medications. Your doctor will apply a topical anesthetic to the skin to numb the area before the injection.
The Xiaflex® collagenase penile injection is currently the only medication specifically approved by the U.S. Food and Drug Administration (FDA) to treat Peyronie's disease. Collagenase enzymes break down the scar tissue that causes the penis to curve. Xiaflex is approved for men who have penile curvatures greater than 30 degrees. You receive two shots every week for eight weeks.
Other penile injection treatments include:
interferon alfa-2b to slow scar tissue buildup, and reduce pain and swelling
verapamil, a medication for high blood pressure that minimizes pain and curving
From the community: "I saw a urologist about two months after mine started. His answer to me was to wait two years for the peyronies to stabilize before doing treatment. That's what I did then did the xiaflex injections. I know that's hard to hear, at least it was for me. My doctor never recommended any other treatment until the two years were up. After I was finished with the xiaflex and still have a slight upward curve I asked him a extender and he said some guys have some success with them. I used one for several months. I'm not a big fan. All I think the extender did for me was stretch the skin." – Inspire member
Traction therapy
Traction therapy uses a device to stretch and straighten the penis. A small number of studies suggest that performing traction therapy for at least six months may restore penile length and straighten the curve. You may use this device along with oral or injectable medications, or after surgical treatment.
Other nonmedicinal therapies
Some men try alternative therapies like shock wave treatments, platelet-rich plasma (PRP) injections, and stem cell injections. Studies haven't shown these treatments to be effective.
What are the surgical treatments for Peyronie's disease?
If the penile curvature makes it difficult to have sex, your doctor may recommend surgery. You would need to be in the chronic stage of Peyronie's disease, which means the penile curvature hasn't worsened for at least 9 to 12 months.
Surgical treatments for Peyronie's disease include:
grafting
penile implants
plication
Grafting
This surgery works best for men who have severe curvatures or indentations that create a narrowing in the shaft (the penis may have an hourglass shape). Your doctor:
makes a few cuts in the scar tissue
removes some of the scar tissue
patches the excised area with a graft of tissue taken from another part of the body or a donor
Penile implants
Penile implants, also called penile prostheses, work best for men who have Peyronie's disease and moderate to severe erectile dysfunction. Your doctor surgically places an inflatable device into the penis. You squeeze a pump hidden inside the scrotum to make the penis erect. After sex, you use the pump to deflate the device. Your doctor may also need to do grafting or a procedure called modeling to help straighten the penis.
Plication
This procedure shortens the outside of the curve to match the inside of the curve, resulting in a straighter penis. This surgery works best for men who don't have erectile dysfunction (or who have mild cases) and who have slight curvatures.
During this surgery, your doctor removes small pieces of tissue on the outside of the curve. Or your doctor may close (pinch) the tissue together with sutures. Because your doctor removes some tissue, this procedure may make the penis slightly shorter.
From the community: “I had my plication surgery about 5 weeks ago. The plaque was removed and the graft was inserted. It seems to be healing well. I'm diligently following my rehab and will begin the Penimaster traction later this week. The hope is to resume my normal sex life with a very understanding and wonderful wife. I'm looking for some feedback on how your recovery and resumption went.” - Inspire member
“Had to wear a compression bandage for a week which was an absolute nightmare and I must admit at times the pain was almost unbearable. Wind on a very long week and bandage removed with a visit to [the doctor] who was very pleased with the outcome so far. He has advised very light stretching and has also prescribed daily Cialis. Wind on almost another week (2 weeks after surgery) things are healing well, bruising almost completely gone and already I am getting erections during the day and night (night time ones very painful). I will continue with very light stretching and will then start vacuum in another 2 weeks. Considering buying a penis master pro to gain some of the length that I have lost, however will not likely start using this until start of post op week 8.” - Inspire member
Sources
Peyronie's disease. American Urological Foundation. September 2020.
Peyronie's disease: Management and treatment. Cleveland Clinic. August 2020.
Peyronie's disease: Diagnosis and treatment. Mayo Clinic. April 2020.
Penile Implants. Mayo Clinic. December 2019.
Penile curvature (Peyronie's disease). National Institute of Diabetes and Digestive and Kidney Diseases. August 2019.
Disclaimer
Member comments are lightly edited for length and to remove identifying information but are otherwise reproduced as they appear in the community as part of public posts.
This content is for general informational purposes only and does not necessarily reflect the views and opinions of any organization or individual. The content should not be used as a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider about any questions you may have regarding a medical condition.
