Peyronie’s disease is a condition of abnormal curvature during an erection. It is characterized by a plaque, or hard lump, that forms within the capsule around the penis. The plaque, a flat plate of scar tissue, develops inside a thick membrane called the tunica albuginea, which envelopes the erectile tissues of the penis. The plaque begins as a localized inflammation and develops into a hardened scar. This plaque has no relationship to the plaque that can develop in arteries. The exact cause of Peyronie’s disease is unknown.

Cases of Peyronie’s disease range from mild to severe. Symptoms may develop slowly or appear overnight. For most men with a mild form of Peyronie’s, erections are not painful, and the bending does not interfere with sexual intercourse. In severe cases, the hardened plaque reduces flexibility, causing pain and forcing the penis to bend or arc toward the area of plaque during an erection. In many cases, the pain decreases over time, but the bend in the penis may remain a problem, making sexual intercourse difficult. The sexual problems that result can disrupt a couple’s physical and emotional relationship and can lower a man’s self-esteem.

The plaque itself is benign, or noncancerous. It is not a tumor. Peyronie’s disease is not contagious and is not known to be caused by any transmittable disease.

A plaque on the top side of the shaft, which is most common, causes the penis to bend upward; a plaque on the underside causes it to bend downward. In some cases, the plaque develops on both top and bottom, leading to indentation and shortening of the penis. At times, pain, bending, and emotional distress prohibit sexual intercourse.

Estimates of the prevalence of Peyronie’s disease range from less than 1 percent to 23 percent.1 A recent study in Germany found Peyronie’s disease in 3.2 percent of men between 30 and 80 years of age.2 The exact cause of Peyronie’s disease is uncertain. It is speculated that it is related to weak connective tissue and mild trauma, that cannot usually be identified. Although the disease occurs mostly in middle age, younger and older men can develop it. About 30 percent of men with Peyronie’s disease develop plaques of scar tissue in other parts of the body, such as the hand or foot. A common example is a condition known as Dupuytren’s contracture of the hand. In some cases, Peyronie’s disease runs in families, which suggests that genetic factors might make a man vulnerable to the disease.

A French surgeon, François de la Peyronie, first described Peyronie’s disease in 1743. The problem was noted in print as early as 1687. Early writers classified it as a form of impotence, now called erectile dysfunction (ED). Peyronie’s disease can be associated with ED—the inability to achieve or sustain an erection firm enough for intercourse.

However, experts now recognize ED as only one factor associated with the disease — a factor that is not always present.

1 Wessells H, Joyce GF, Wise M, Wilt TJ. Erectile dysfunction and Peyronie’s disease. In: Litwin MS, Saigal CS, editors. Urologic Diseases in America. U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. Washington, DC: U.S. Government Printing Office, 2007; NIH Publication No. 07–5512:483–530.

2 Sommer F, Schwarzer U, Wassmer G, Bloch W, Braun M, Klotz T, Engelmann U. Epidemiology of Peyronie’s disease. International Journal of Impotence Research. 2002; 14:379–383.

Risk Factors

  • Trauma
  • Genetic factors

Symptoms

  • Curvature of the penis during erection (can be permanent)
  • “lump” that can be felt in the erectile tissue of the penis
  • Pain during erection (often decreases over time)
  • Erectile dysfunction

Diagnosis

Doctors can usually diagnose Peyronie’s disease based on a physical examination. The plaque can be felt when the penis is limp. Full evaluation, however, may require examination during erection to determine the severity of the deformity. The erection may be induced by injecting medicine into the penis or through self-stimulation. Some patients may eliminate the need to induce an erection in the doctor’s office by taking a digital or Polaroid picture at home. The examination may include an ultrasound scan of the penis to pinpoint the location(s) and calcification of the plaque. The ultrasound can also be used to evaluate blood flow into and out of the penis if there is a concern about erectile dysfunction.