Peyronie’s Disease

Peyronie's disease is the formation of a hard scar, called a plaque, in the sheath around the erectile tissue of the penis. The scar does not stretch, so the erect penis bends, narrows or shortens. It affects several in every 100 men, mostly after the age of 40.

It has an active phase of roughly 6 to 18 months with pain and a changing curve, followed by a stable phase in which pain settles and the shape stays fixed. It is not cancer and not an infection. It rarely resolves completely, and definitive treatment waits until the shape is stable.

Symptoms

• A new bend or curve of the erect penis
• A firm lump or band felt under the skin
• Pain with erection in the early months
• Shortening, narrowing or an hourglass shape
• Erections that are softer beyond the plaque
• Difficult or impossible intercourse
• Distress, embarrassment and strain on the relationship

Causes and risk factors

The plaque is thought to result from abnormal wound healing after small injuries to the erect penis, often unnoticed, in men who are prone to it. It is associated with Dupuytren's contracture of the hand, diabetes, smoking, previous pelvic or prostate surgery and erectile dysfunction, and it can run in families.

How it is diagnosed

• History and examination: The plaque can usually be felt. Bringing photographs of the erect penis from above and from the side is very helpful.
• Measurement of curvature: After an injection in the clinic that produces an erection, the angle is measured accurately.
• Penile Doppler ultrasound: Shows plaque size and calcification and measures blood flow, which helps in choosing the operation.
• Erectile function assessment: Questionnaires and a review of general health, because poor erections change the recommendation.

Treatment options

• Observation and tablets: Anti-inflammatory pain relief and daily tadalafil in the active phase. Oral vitamin E and similar supplements have not been shown to correct the curve.
• Traction or vacuum devices: Daily use over months can modestly reduce curvature and help preserve length.
• Injections into the plaque: Collagenase for stable curves of roughly 30 to 90 degrees, although availability varies by country. Verapamil or interferon are alternatives with weaker evidence.
• Plication surgery: Stitches on the longer side straighten the penis. It is reliable for curves under about 60 degrees with good erections, at the cost of some shortening.
• Plaque incision and grafting: For severe or complex deformity in men with strong erections. It carries a higher risk of later erectile dysfunction.
• Penile implant with straightening: The choice when Peyronie's disease and significant erectile dysfunction occur together.
• Shockwave therapy: May reduce pain but does not correct curvature.

When it is urgent

A sudden snap or crack during an erection followed by immediate pain, loss of the erection and swelling or bruising is a penile fracture and needs emergency surgery locally. An erection lasting more than 4 hours after an injection also needs urgent care.

Travelling to Türkiye for treatment

Surgery for stable disease is a planned, one-off operation and suits a visit of about 7 to 10 days. Make sure the curve has not changed for at least 3 to 6 months, and bring photographs. Ask the surgeon how many Peyronie's operations he or she performs and what loss of length to expect. Intercourse is avoided for about 6 weeks, and traction or rehabilitation may continue at home. Injection courses take several visits over months and travel poorly.

Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.

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