Peyronie’s Disease

Peyronie’s disease occurs when fibrous scar tissue, called plaque, develops inside the penis. This scar tissue can affect the way the penis bends or functions and may lead to several symptoms, including:

  • Penile curvature during erections

  • Difficulty with sexual intercourse

  • Painful erections

  • Shortening of the penis

  • Narrowing or indentation along the shaft

For many men, the physical changes caused by Peyronie’s disease can also lead to emotional stress or anxiety. Without treatment, the condition may continue to affect sexual function and overall quality of life. Urology specialists can evaluate the condition and recommend treatment options, which may include monitoring, medication or injections, and in some cases surgical correction.

Questions and Answers

What Causes Peyronie’s Disease?

Peyronie’s disease develops when irregular scar tissue forms within the erectile tissue of the penis. The exact cause is not fully understood. While about 20% of men recall a specific injury during sexual activity that may have triggered the condition, most men do not remember any single event. In many cases, experts believe that repeated minor trauma or normal wear and tear during sexual activity may contribute to the formation of scar tissue.

Certain medical conditions may increase the likelihood of developing Peyronie’s disease, including erectile dysfunction, Dupuytren’s contracture, and diabetes. However, the condition can affect any adult man at any stage of life. It is a common and treatable condition, and a variety of safe and effective treatment options are available.

Am I At Risk for Peyronie’s Disease?

Peyronie’s disease occurs most frequently in men over the age of 55. Your risk may also be higher if you have a family history of the condition or a personal history of connective tissue disorders.

How Do You Diagnose Peyronie’s Disease?

A diagnosis of Peyronie’s disease is often straightforward because the condition typically causes noticeable physical changes. In many cases, a urologist can confirm the diagnosis during a physical examination.

Imaging or additional tests are rarely needed unless there is concern about another underlying condition. Many men first notice a small lump or hardened area in the penis along with a new curvature during erections. A physician can confirm the diagnosis through a careful exam and, if necessary, additional diagnostic testing.

What are the Most Effective Treatments for Peyronie’s Disease?

Treatment for Peyronie’s disease depends on the severity of your symptoms and how much the condition affects your daily life and sexual function. Common treatment approaches include:

Observation: If the curvature is mild and you can still have normal sexual function, your urologist may recommend monitoring the condition. However, if symptoms worsen or begin to interfere with intercourse, treatment may be recommended to break down plaque or surgically correct the curvature.

Injections: Xiaflex® is an FDA-approved medication injected directly into the plaque within the penis. When combined with specific stretching and straightening exercises, it can help break down the scar tissue that causes penile curvature. Treatment typically involves a series of injection cycles spaced several weeks apart.

Surgery: In more severe cases, surgical treatment may be recommended. One option is a penile implant, which can help straighten the penis and restore sexual function. This procedure is typically performed on an outpatient basis.

If Peyronie’s disease is causing pain, curvature, or sexual difficulties, evaluation by a urologist can help determine the most appropriate treatment options.

What is XiaFlex®?

Peyronie’s disease develops when scar tissue (collagen) builds up inside the penis, causing it to curve during erections. Xiaflex® is an injectable medication made from enzymes that specifically target and break down this scar tissue.

During treatment, a urologist administers a series of Xiaflex® injections directly into the plaque, combined with gentle reshaping techniques to help reduce curvature. This treatment can gradually break down the scar tissue and improve penile shape and function. Xiaflex® is a nonsurgical option that has proven effective for many men and typically requires little to no downtime.

Is XiaFlex® Right for Me?

Xiaflex® may be recommended for men who meet certain criteria, including:

  • A Peyronie’s plaque, or a palpable area of scar tissue beneath the skin of the penis

  • An erection with a curvature of at least 30 degrees

Your urologist will review your symptoms and perform an evaluation to determine whether Xiaflex® is an appropriate treatment option. During your consultation, you can also discuss other available treatments for Peyronie’s disease to decide which approach is best for your needs.

What Can I Expect from XiaFlex®?

Xiaflex® treatment is performed in the office and typically begins with applying a numbing cream to the area where the Peyronie’s plaque is located beneath the skin. Once the area is numb, the medication is injected directly into the scar tissue to begin breaking down the plaque.

After the injection, your urologist may gently stretch and straighten the penis to help reshape the tissue and improve the curvature. You will also receive instructions on how to perform specific stretching exercises at home to support the treatment and enhance the results.

XiaFlex® Results and Recovery

Most patients need a series of Xiaflex® treatments, typically one to four treatment cycles spaced about six weeks apart. This allows time for the medication’s collagenase enzymes to gradually break down the scar tissue that causes penile curvature.

During treatment, you will also perform straightening exercises at home as directed by your urologist. Following these instructions is important for achieving the best possible results. While Xiaflex® treatment generally does not require significant recovery time, patients are usually advised to avoid sexual activity between treatment cycles. This nonsurgical therapy has helped many men reduce curvature and improve symptoms associated with Peyronie’s disease.