Peyronie's (pa-ro-NEEZ) disease causes a bent penis during erection. A hard, fibrous layer of scar tissue (plaque) develops under the skin on the upper or lower side of the penis. When the penis is erect, the scar tissue pulls the affected area off at an angle, causing a curved penis. The plaque, formed by thickened layers of soft tissue in the penis is noncancerous (benign). The condition can cause pain and make sexual intercourse difficult.
Sometimes Peyronie's disease improves without treatment, so your doctor may initially recommend a wait-and-see approach. Treatments of Peyronie's disease involve nonsurgical and surgical approaches.
The signs and symptoms of Peyronie's disease may appear overnight or develop more slowly. These may include:
- Painful erection
- A bend or curve in your penis during erection
- A thick band of hard tissue on one or more sides of your penis
- Indentation, or an "hourglass-shaped" penis during erection
- Impaired ability to obtain an erection (erectile dysfunction, or ED)
- Shrinking or shortening of your penis
- Scar tissue that develops on the top of the penis will cause the penis to bend upward. Plaque on the underside of your penis will cause it to bend downward. Sometimes scar tissue occurs on both sides of the penis, causing an indentation or "bottleneck."
In many cases, pain caused by Peyronie's disease may decrease after a short period of time. However, the curvature may persist even if the pain subsides. In some men with a milder form of the disease, inflammation may improve without causing a lot of pain or permanent bending.
Doctors and researchers don't completely understand what causes Peyronie's disease. A number of theories exist, including:
- Injury to the penis. Trauma to the penis may cause small tears in the tissue, and small blood vessels in the penis can rupture and bleed internally. Penile injuries can be caused by vigorous sexual intercourse or an accident. Abnormal healing can result in the development of hard, thickened scar tissue (plaque) under the skin of the penis. With repetitive trauma, the plaque may develop tough fibrous tissue (fibrosis) or calcium deposits (calcification) and result in the deformity.
- Autoimmune disorder. Some studies suggest that Peyronie's disease may be an autoimmune disorder. A man's immune system may respond abnormally and cause plaque to form in the penis. However, Peyronie's disease isn't related to other autoimmune diseases, such as rheumatoid arthritis or lupus.
- Inherited collagen abnormality. Peyronie's disease may be caused by an inherited abnormality in the genes that regulate the growth fibrous connective tissue proteins (collagen).
- Medications. Some drugs may cause Peyronie's disease as a possible side effect. Most of these drugs belong to a class of blood pressure and heart medications called beta blockers. These drugs are also used to treat glaucoma, multiple sclerosis and seizures. Developing Peyronie's disease as a side effect of these drugs is rare. Check with your doctor before stopping or changing any prescribed drug.
Although injury to the penis may explain sudden (acute) cases of Peyronie's disease, cases that develop slowly or disappear quickly with no apparent trauma to the penis remain unexplained.
Doctors can usually diagnose Peyronie's disease with a physical examination. Hard plaque can be felt in your penis with or without an erection. It may be necessary to inject medication into your penis to induce an erection for proper evaluation. In some cases, ultrasound of the penis is used to help diagnose Peyronie's disease.
Treatments can be discussed in detail with your medical provider.