Peyronie's disease is a condition where penile scar tissue causes curvature of the penis during an erection. The etiology of this condition is unknown but may be related to a history of unperceived repetitive penile trauma resulting in the deposition of scar tissue in the penile erectile tissues. The area where the scar tissue deposits generally corresponds to where the erect penis curves. These areas are often palpable in the flaccid penis and feel like a hard lump (plaque). Many patients are often concerned about the presence of this hard lesion in the penis and may be concerned about cancer. This, however, is very unusual.

The degree of penile curvature can vary from mild to severe enough to prevent intercourse. Patients with Peyronie's disease may also have difficulty achieving a full erection.

Peyronie's disease can present in two different ways. In most patients, the curvature may appear acutely, with one erection being straight and the next being bent with little or no further progression. In the remainder of the patients, the disease is slowly progressive with the degree of curvature eventually reaching an end point. Peyronie's disease is generally self limiting, and in most cases the active process does not last longer than a year. At the time the active process stops, the plaque may sometimes recede.

The recommended treatment for Peyronie's disease varies on the degree of penile curvature and whether or not the patient can achieve a firm enough erection for penetration. For the patient who can still achieve satisfactory intercourse despite having penile curvature, the treatment options include observation, nonsteroidal anti-inflammatory agents ( Motrin or ibuprofen); vitamin E and Potaba. None of these treatments have been found to be superior to any other treatments. As mentioned previously, it is important to know that most patients who initially present with Peyronie's disease will generally not have significant progression of their condition and often will get better spontaneously. Only a few will continue to have worsening of their condition but even these patients will eventually stabilize.

Patients often ask about penile straightening procedures. Generally, surgery is reserved for those patients with penile curvature that is so severe that it prevents satisfactory intercourse. Patients need to be aware that penile straightening procedures, while generally successful, may result in shortening and distortion of the penis when erect. Furthermore, new scarring in the penis may develop secondary to the surgical procedure. Lastly, penile surgery can also potentially result in impotence. Prior to any surgery being performed, your urologist may recommend waiting at least six months to one year to be sure that the disease has reached its end point.

For those patients with severe penile curvature and impotence, two treatment options exist. One option is a penile straightening procedure, as state above, which would have to be combined with the patient having to rely on either a vacuum erection device, penile injections, or a urethral suppository to stimulate his erections. The other option is the placement of a penile prosthesis which results in penile straightening and provides another means to achieve an erection.