Penile curvature, medically known as Peyronie’s disease, is a condition in which curvature, shortening and sometimes pain occur in the penis during erection due to fibrotic plaques that develop in the hard tissue inside the penis (the tunica albuginea). It is usually seen in middle-aged and older men, but it can also occur at younger ages.
This disease can affect sexual life both physically and psychologically.
What Causes Peyronie’s Disease?
The exact cause is not always clear, but the most important mechanism is microtrauma in the penis and the abnormal healing process associated with it.
The main risk factors:
- Microtrauma during sexual intercourse
- Genetic predisposition
- Diabetes
- Smoking
- Vascular diseases
- Connective tissue diseases
Recurrent small injuries can lead to plaque formation in the penis.
Symptoms of Peyronie’s Disease
The disease usually develops slowly and is examined in two stages:
Acute (early) stage
- Pain during erection
- Tenderness in the penis
- Slow onset of curvature
- Recent plaque formation
Chronic stage
- The curvature becoming fixed
- Pronounced deformation in the shape of the penis
- Feeling of a hard plaque
- Decrease in erection quality
How Does Penile Curvature Appear?
The curvature can be in different directions:
- Upward curvature
- Downward curvature
- Curvature to the right or left
- Deformations in the 12 o’clock direction or 3-9 direction
In some patients a narrowing such as an “hourglass deformity” can also be seen.
Does Peyronie’s Disease Affect Sexual Life?
Yes. The effects of the disease can be:
- Pain during sexual intercourse
- The penis not becoming sufficiently erect
- Difficulty with intercourse
- Psychological stress and performance anxiety
- Compatibility problems with the partner
Severe curvature can make sexual intercourse difficult or impossible.
How Is Peyronie’s Disease Diagnosed?
The diagnosis is usually made by a urology specialist:
- Physical examination (palpation of the plaques)
- Evaluation using the patient’s erection photograph or during the examination
- Penile Doppler ultrasound
- Erection tests if necessary
Peyronie’s Disease Treatment
Treatment varies according to the stage of the disease.
Medical Treatment (Early Stage)
In the acute stage, the aim is to stop the progression of the disease:
- Antioxidant medications
- Vitamin E and similar supplements
- Pain control
- Some special injection treatments
Injection Treatments
The curvature can be reduced with medications applied into the plaque.
- Collagen-degrading enzyme treatments
- Local injections
Shock Wave Therapy (ESWT)
- Can reduce pain
- Can affect plaque hardness
- Can improve the curvature to a limited extent
Surgical Treatment
The most effective method in severe curvatures:
- Plaque removal or release surgeries
- Suturing (plication) methods
- Penile prosthesis (if there is an advanced erection problem)
Surgery is usually performed after the disease has become stable.
Does Peyronie’s Disease Progress?
The disease can progress within the first 6 to 18 months. After this period it usually becomes stable. Early intervention can slow the progression.
Does It Correct Itself?
Complete recovery occurs very rarely. In most patients:
- The curvature remains fixed
- It can progress in some patients
- It may require treatment
When Should You See a Doctor?
A urological evaluation is required in the following situations:
- Newly starting curvature during erection
- Feeling of a hard plaque in the penis
- Painful erection
- Difficulty with sexual intercourse
Summary
Peyronie’s disease is a disease that causes curvature and loss of function during erection due to fibrotic plaques that develop in the penis. Its progression can be slowed with early diagnosis, and in advanced cases successful results can be achieved with surgery. Correct evaluation of this condition, which can affect sexual life, is of great importance for choosing the appropriate treatment.
