Your doctor may recommend a wait-and-see (watchful waiting) approach if:
- The curvature of your penis isn't severe and is no longer worsening
- You can still have sex without pain
- Pain during erections is mild
If your symptoms are severe or are worsening over time, your doctor may recommend medications or surgery.
A number of oral medications have been tried to treat Peyronie's disease, but they don't appear to be as effective as surgery.
In some cases, drugs injected directly into the penis may reduce curvature and pain associated with Peyronie's disease. If you have one of these treatments, you'll likely receive multiple injections over several months. You'll be given a local anesthetic to prevent pain during the injections.
Evidence on the effectiveness of penile injections is limited. Medications that are used include:
- Verapamil. This is a drug normally used to treat high blood pressure. It appears to disrupt the production of collagen, a protein that appears to be a key factor in the formation of Peyronie's disease scar tissue.
- Interferon. This is a type of protein that appears to disrupt the production of fibrous tissue and help break it down.
Collagenase, an enzyme that breaks down fibrous tissue scar, is currently being studied for treatment of Peyronie's disease.
Your doctor may suggest surgery if the deformity of your penis is severe or prevents you from having sex. Surgery usually isn't recommended until the curvature of your penis stops increasing, and your erections have been pain-free for at least six months.
Common surgical methods include:
- Shortening the unaffected side. A variety of procedures can be used to shorten the longer side of the penis (the side without scar tissue). The shortened side of the sheath and the less elastic, scarred side of the sheath end up being about the same length when the penis is erect. This results in a relatively straight erection. However, this procedure usually shortens the overall length of the penis. It's generally used in men who have adequate penis length and a less severe curvature of the penis. Nesbit plication is an example of this type of procedure. In some cases, this type of surgery causes erectile dysfunction.
- Lengthening the affected side. With this type of surgery, the surgeon makes several cuts in the scar tissue, allowing the sheath to stretch out and the penis to straighten. The surgeon may have to remove some of the scar tissue. A piece of tissue (graft) is sewn into place to cover the holes in the tunica albuginea. A graft may be tissue from your own body, human or animal tissue, or a synthetic material. This procedure is generally used if a man has a shorter penis, severe curvature or a complicated deformity. This procedure runs a greater risk of erectile dysfunction than does the shortening procedure.
- Penile implants. Surgically inserted penile implants replace the spongy tissue that fills with blood during an erection. The implants may be semirigid — manually bent down most of the time, and bent upwards for sexual intercourse. Another type of implant is inflated with a pump implanted in the groin or scrotum. Penile implants may be considered if a man has both Peyronie's disease and erectile dysfunction. When the implants are put in place, the surgeon will likely make some cuts (incisions) in the scar tissue to relieve tension on the tunica albuginea.
The type of surgery used will depend on your condition. Your doctor will consider the location of scar tissue, the severity of your symptoms and other factors. If you are uncircumcised, your doctor may perform a circumcision during surgery.
Depending on the type of surgery you have, you may be able to go home from the hospital the same day or you may need to stay overnight. Your surgeon will advise you on how long you should wait before going back to work — in most cases, a few days. After surgery for Peyronie's disease, you'll need to wait four to eight weeks before you masturbate or have sex.
Several other nondrug treatments for Peyronie's are being investigated, but evidence is limited on how well they work and possible side effects. These include radiation therapy, using intense sound waves to break up scar tissue (shock wave therapy) and devices to stretch the penis (penile traction therapy).
Aug. 18, 2011
- Peyronie's disease. National Institute of Diabetes and Digestive and Kidney Diseases. http://kidney.niddk.nih.gov/kudiseases/pubs/peyronie. Accessed May 31, 2011.
- Brant WO, et al. Peyronie's disease: Diagnosis and medical management. http://www.uptodate.com/home/index.html. Accessed May 23, 2011.
- Brant WO, et al. Surgical management of Peyronie's disease. http://www.uptodate.com/home/index.html. Accessed May 23, 2011.
- Kumar R. Surgical and minimally invasive treatments for Peyronie's disease. Current Opinion in Urology. 2009;19:589.