What is Peyronie’s disease? Symptoms, causes, and treatment options for men
April 29, 2026
Quick links: Causes | Symptoms | Treatments
One health issue we often see in the urology clinic is one that many men have never heard of. It’s also something that some may find difficult to talk about, likely due to perceived stigma surrounding sexual health.
Peyronie’s disease occurs when scar tissue forms in the elastic sheath of the penis that helps maintain rigidity during an erection. As scar tissue builds up, it can cause the penis to bend, curve, shorten, or narrow when erect.
The curvature may angle upward, downward, or to the side; some men notice an indentation or “hourglass” shape. Peyronie’s disease can cause painful erections, contribute to erectile dysfunction, or interfere with sexual function.
Some studies say 1 out of 10 adult men in the U.S. are affected. However, Peyronie’s disease is significantly underdiagnosed – one estimate suggests up to 18% of men have the condition.
When curvature, pain, or erectile dysfunction get in the way of intimacy, it can affect confidence, relationships, and mental health. Embarrassment or perceived lack of options may cause many men to avoid seeking care. Helping men regain their sexual health is a vital part of what we do at UT Southwestern.
The good news: Peyronie’s disease is treatable. And in many cases, early evaluation opens the door to more options and better outcomes.
What are the symptoms of Peyronie’s disease?
If you notice any of these symptoms, it’s time to talk to your doctor:
- New bend or curve during erection
- Palpable lump or hardened area along the shaft
- Pain with erections, particularly in the early phase
- Avoidance of sex due to discomfort
- Shortening of the penis
- Erectile dysfunction
Up to half of men with Peyronie’s disease experience erectile dysfunction. The curvature can make intercourse difficult or uncomfortable. In addition, the scar tissue may interfere with blood flow and rigidity. Beyond physical symptoms, Peyronie’s disease can take a psychological toll. Many men experience anxiety, depression, or strained intimate relationships.
What causes penile curvature?
We don’t always know why Peyronie’s disease develops, but it is generally thought to result from abnormal wound healing after repeated micro‑injury to the penis. Instead of healing normally, the body forms excess scar tissue.
For example, if erections are not as firm as they once were, the penis can bend during penetration, leading to microtears in the tissue.
In most men, these minor injuries heal normally. In some men, scar tissue forms, gradually accumulating until it alters the shape of the penis and oftentimes triggers other symptoms.
Other contributing factors include:
- Diabetes: Men with diabetes-related erectile dysfunction are significantly more likely to develop Peyronie’s.
- Prostate cancer treatment: Certain therapies, particularly prostate surgery, can increase the risk.
- Genetics: There can be a hereditary component; if a family member has Peyronie’s disease, your risk is higher.
- Connective tissue disorders: Conditions such as Dupuytren’s contracture, which causes a similar scarring and pulling of tissue in the palm of the hand, has been associated with an increased risk.
Peyronie’s disease is different from congenital penile curvature, which starts in adolescence, does not involve scar tissue, and does not get worse over time. Peyronie’s disease develops in adulthood and becomes more common between ages 40-60. It is not a normal part of aging, and it can worsen if left untreated.
Two phases of Peyronie’s disease
Peyronie’s disease progresses through two distinct phases, which play an important role in treatment decisions:
Acute
This early phase can last from three to 18 months. During this time, scar tissue forms, curvature worsens, and pain with erections is common. The penis may begin to shorten or develop indentations. Treatment during this phase focuses on reducing discomfort and preserving function. Because the changes are still ongoing, we typically avoid surgery during this period.
Chronic
Once the pain subsides and the curvature stops changing for three to six months, Peyronie’s disease enters the chronic phase. At this point, the scar tissue becomes firmer. Although symptoms may feel more stable, spontaneous improvement is uncommon at this stage. This is when we discuss definitive treatments, such as surgery or corrective procedures.
I cannot emphasize enough the importance of seeking medical help early. When the penis doesn't get regular blood flow or is not used frequently, the curvature can worsen, and shortening can become permanent. Delaying a visit to a specialist can make the condition more challenging to treat.
Diagnosis is usually straightforward. We start with a detailed medical and sexual history, followed by a focused physical examination. We’ll evaluate the location and size of the scar tissue and assess how curvature affects sexual function. In some cases, we use imaging such as penile ultrasound to evaluate blood flow, tissue characteristics, and erectile function. This data helps guide personalized treatment planning.
How is Peyronie’s disease treated?
There is no one-size-fits-all treatment. The right approach depends on:
- Degree of curvature
- Disease phase
- Presence of erectile dysfunction
- Penile length
- The patient’s goals
Nonsurgical therapies
During the acute phase, treatment may focus on symptom control and stabilization. This can include medications for pain, strategies to improve erectile quality, and close monitoring for progression.
For men with stable curvature that interferes with sexual activity, we can inject a medication approved by the Food and Drug Administration called Collagenase Clostridium histolyticum directly into the scar tissue. The enzyme in this medication helps break down the collagen in the scar tissue to reduce the bend. This is an office-based treatment, combining a series of injections with penile modeling to reshape the tissue.
Another approach is called traction therapy. This option involves a specialized mechanical device that gently stretches the penis over time. This helps limit the progression of the curve and prevent shortening.
Surgical options
If the curvature is severe and prevents comfortable or successful intercourse, surgery may be the best path forward.
- Plication: For mild to moderate curves, we can suture the unaffected side of the penis to straighten it.
- Grafting: For more complex deformities, we can remove the scar tissue and replace it with a graft to restore a natural appearance.
- Penile implants: For men who have both Peyronie’s disease and significant erectile dysfunction, an inflatable penile prosthesis can be an excellent treatment option. It simultaneously straightens the penis and provides a reliable solution for erectile dysfunction.
Each procedure has trade-offs, including potential effects on length and sensation. A detailed evaluation and discussion of goals are essential to selecting the right procedure.
It’s time to break the stigma
One of the biggest barriers to care is silence. Many patients assume they are alone or that nothing can be done. In reality, Peyronie’s disease is common and treatable and a routine part of specialized urologic care.
Addressing sexual health is not a cosmetic pursuit – it is central to overall health and quality of life. While penile curvature can be difficult to talk about, it is not something you have to face alone. If you have changes in curvature, pain, or erectile function, make an appointment to see a doctor. Effective therapies are available. Early evaluation can expand your options, protect function, and help restore your confidence.
To talk with an expert about Peyronie’s disease, make an appointment by calling 214-645-8765 or request an appointment online.
