Peyronie's disease is a condition characterized by the development of fibrous scar tissue, or plaque, inside the penis. This scar tissue forms beneath the skin of the erectile chambers, causing the penis to bend, curve, or lose length during an erection. While mild curvature can be entirely natural, the plaque associated with Peyronie's is a distinct, non-cancerous structural change that can make erections painful and intercourse physically difficult or impossible.

Primary Symptoms

• Curvature or Bending: A noticeable curve or bend in the penis during an erection, which can project upward, downward, or to one side.
• Hard Plaques: Physically palpable lumps or bands of hard scar tissue felt beneath the skin of the penis.
• Pain: Discomfort or localized pain during an erection or during sexual activity, which often improves naturally over several months as the acute phase subsides.
• Erectile Changes: Difficulty achieving or maintaining an firm erection (erectile dysfunction), often compounded by the structural instability caused by the bend.
• Shortening: A reduction in total penile length or narrowing/indentation (often called an hourglass shape) during an erection.

Diagnostic Approach

1. Clinical History and Physical Exam: A careful assessment of the timeline of the curvature and localized physical palpation of the penis in the clinic to identify the exact location and size of the plaque.
2. Intracavernosal Injection (ICI) and Duplex Ultrasound: A specialized diagnostic test performed in the office where a brief medication is administered to induce an erection. This allows for precise visual measurement of the degree of curvature and blood flow mapping via ultrasound to assess vascular health.
3. Photographic Review: Reviewing self-taken, high-quality multi-angle photographs provided by the patient to track stabilization or changes over time.

The two phases

Peyronie's disease usually has an active phase, often lasting 6 to 18 months, when the curve may change and erections can hurt. It then settles into a stable phase, when pain is gone and the curve stops changing. Non-surgical treatment is aimed at the active and early stable phases; surgery is done once the curve has been stable for several months.

Options without surgery

• Traction therapy: a device that gently stretches the penis over time can help preserve length and reduce curvature. How to use traction.
• Collagenase (Xiaflex) injections: an enzyme injected into the plaque, combined with gentle modeling, can reduce curvature in selected men.

If you also have erection problems

When curvature and erectile dysfunction occur together, a penile implant with straightening done at the same operation can address both.

Recommended Surgical & Treatment Pathways

Dedicated Subspecialty Center: Genital Reconstruction, Peyronie’s & Curvature Hub →

Surgical Reconstruction: Penile Plication — Minimally invasive 16-dot plication correcting curvature with preserved erectile capacity.

Surgical Reconstruction: Plaque Incision and Grafting — Plaque unroofing with biocompatible graft for severe curvatures (>60°) or hour-glass deformities.