Peyronie’s Disease: Causes and Symptoms

Peyronie’s disease is a condition where scar tissue, also called plaque, forms inside the penis. The plaque gradually builds up inside the tunica albuginea, a thick elastic fibrous tissue which surrounds the corpus cavernosum, and does not swell along with the healthy tissue during an erection. In extreme cases, this causes a severe bend in the penis either upwards or to the side, leading to severe pain and sexual difficulty.

The condition is estimated to affect anywhere between 1 to 23 percent of men between the ages of 40 and 70. The exact number is hard to pin down, though, as it relies on self-reporting by patients and health care providers. Peyronie’s disease is rare in young men, and the chances of developing it increase with age.

Despite Peyronie’s disease being relatively common, medical experts do not yet know the exact cause. Current research indicates two leading theories. The first is that the condition is caused by injury to the penis, where internal bleeding and swelling causes blood clots to form, which then release substances that create an excess of scar tissue. Studies show that men who engage in vigorous sexual or nonsexual activity which cause acute or chronic injury to the penis may have a higher risk of Peyronie’s disease.

The second theory says the condition is related to certain autoimmune disorders which sometimes attack cells in the penis, causing inflammation and scarring. Links have been shown between Peyronie’s disease and autoimmune disorders that affect connective tissue or cause blood vessel inflammation, including Dupuytren’s disease, systemic lupus erythematosus and Behcet’s syndrome. Plantar fasciitis and scleroderma, other disorders which affect connective tissue, have also been associated with Peyronie’s disease.

If you or a loved one is showing symptoms, you should immediately see your doctor. Although Peyronie’s disease will often fade on its own, any curvature which has developed will remain if untreated. Urologists may prescribe medications such as vitamin E, tamoxifen or colchicine to reduce plaque size, inflammation and curvature. Other treatments include injecting collagenase or steroids directly into the plaque, along with ultrasound or radiation therapy to break it up. Penile traction systems and vacuum devices could also potentially be helpful, although research is still ongoing. In select cases, surgery may be needed to remove the plaque or straighten the penis.