Causes 

No one knows the exact cause of Peyronie's disease (PD). In general, we believe that it is an abnormal healing response. That is, there is an injury (sometimes very very minor) but the body acts abnormally and causes inflammation and scarring.

Along with Peyronie’s disease, erectile dysfunction (ED) is VERY common. At least 50 percent of men with PD have some ED also. Since the scarring affects the tissue surrounding the erection bodies (and often affects the erection bodies themselves), men often have arterial (inflow) and storage (outflow) problems.

How common is PD?

Peyronie's disease occurs in 3.5% to 9% of men, depending on age.

Diagnosis

How is PD evaluated?

Several items are crucial to making sure you get the right diagnosis and treatment. We start with a questionnaire. In addition to the physical exam, the deformity needs to be examined and documented. The patient may take a photograph of the erection at home or we can give an injection in clinic to give an artificial erection that we can evaluate in clinic.

Additionally, an ultrasound (safe, quick, and painless) is very helpful to assess the penile tissue and direct treatment strategy.

Treatments

In the early stages, the best treatments are medical, not surgical. There are many, many reported treatments for PD, most of which have no data whatsoever supporting them. However, men are often desperate and will try anything, even if it is unlikely to help. This is unfortunate because, while there is no perfect medical treatment for PD, there are certain strategies that are more likely to help than others. The treatment strategy depends on many factors and needs to be individualized for each patient. They may include the following:

  • Pills
  • Injections (a medication that goes directly into the affected area)
  • Traction devices

In the later stages, once the deformity is stable, treatment is usually surgical. A patient only needs surgical treatment if the deformity is enough that they cannot have intercourse (for example, if they have pain or their partner has pain) or if there is associated ED.

Surgery

The actual surgical treatment depends on both the situation as well as patient goals. We have developed a chart that summarizes the different general surgical approaches. Generally, surgical approaches include reconstructive and/or prosthetic surgery.

  • Plication - The most popular reconstructive approach is to place permanent sutures in the penis on the opposite side of the curvature to straighten it out (plication). This approach has few risks; however: 1) this does not correct notches, waists, or other non-curvature deformities; 2) this cannot correct any of the length/width loss that is often associated with PD.
  • Grafting - Alternatively, the plaque/scar can be expanded and a patch can be placed (grafting). Although this can correct other deformities and may possibly reclaim some of the length/width loss, there are significant risks associated with this approach including worsening ED (up to 40 percent, depending on the patient) and further scarring. This should only be performed by a surgeon who has extensive experience in this type of reconstruction.
  • Penile Prosthesis - If the patient has ED associated with PD or if the patient develops ED (after a grafting procedure), usually the best approach is with a penile prosthesis. This usually corrects both the ED and the deformity at that same time. Occasionally, the prosthesis does not fully correct the deformity and additional procedures must be done, such as plication or grafting.

Sara Lenherr, MD, MS

Patient Rating:

4.6

4.6 out of 5

Dr. Lenherr is a urologist who focuses on treatment of female incontinence and management of bladder dysfunction. She received her medical degree from the University of Chicago and completed a 6-year residency in urology at the Lahey Clinic outside of Boston. She then elected to pursue two years of sub-specialty clinical training in female pelvic m... Read More

Specialties:

Adrenal Cancer, Bladder Augmentation, Bladder Cancer, Complications of Spinal Cord Injury, Complications of Urologic Surgery, Endourology, Erectile Dysfunction, Female Incontinence, General Urology, Kidney Cancer, Laparoscopy, Male Incontinence, Male Infertility, Men's Health, Mesh Erosion, Neurogenic Bladder, Pelvic Fractures and Urethral Injury, Penile Cancer, Peyronie's Disease, Radiation Injuries, Robotic Cystectomy and Diversion, Robotic Kidney Surgery, Robotic Prostatectomy, Robotic Ureteral Reconstruction, Robotic Ureteral Reimplant, Stone Disease, Testicular Cancer, Ureteral Stricture, Urethral Stricture, Urinary Diversion, Urinary Strictures and Fistula, Urologic Oncology, Urology, Vasectomy, Vesicovaginal Fistula

Locations:

A location has not yet been added by this physician.

Kelley E. Taylor, NP

Patient Rating:

4.7

4.7 out of 5

Kelley is a board-certified adult-gerontology acute care nurse practitioner (AG-ACNP). She has been with the University of Utah Department of Urology since 2014. Prior to this, her educational emphasis was adult urology. Clinical emphases include men’s health and male infertility as well as clinic procedures for hypogonadism, erectile dysfunction, ... Read More

Specialties:

Erectile Dysfunction, Hypogonadism- Low Testosterone, Male Infertility, Men's Health, Nurse Practitioner, Peyronie's Disease, Urology

Locations:

Farmington Health Center 801-587-1454
South Jordan Health Center 801-587-1454
Utah Center for Reproductive Medicine 801-587-1454
University of Utah Hospital
3rd Floor, Room 3A100
50 N Medical Drive
Salt Lake City, UT 84132
Map
Appointments
801-213-2700
Farmington Health Center 165 N. University Ave.
Farmington, UT 84025
Map
801-213-2700
South Jordan Health Center 5126 W. Daybreak Parkway
South Jordan, UT 84009
Map
801-213-2700