Peyronie's Disease Treatment
Curvature, pain and shortening — a distinct condition, treated distinctly.
Peyronie's disease is scar tissue within the penis causing curvature, pain, or deformity. It frequently coexists with erectile dysfunction and requires its own treatment plan.
- Phases
- Acute, then stable
- Injection course
- Up to 4 cycles
- Traction
- Daily, several months
- Surgery
- For stable disease only
01Overview
Peyronie's disease is a wound-healing disorder. Fibrous plaque forms within the tunica albuginea — the tough sheath around the erectile chambers — and because scar tissue does not stretch, the penis bends toward the plaque during erection.
It progresses in two phases, and knowing which phase you are in determines the entire treatment plan. The acute phase, typically six to eighteen months, involves active inflammation, pain with erection, and changing curvature. The stable phase follows: pain resolves, and the deformity stops changing.
Surgery in the acute phase is a mistake, because the curve you correct is not the curve you will finish with. Injection therapy and traction, by contrast, are most useful earlier. Getting this sequencing right is most of the clinical skill involved.
Roughly a third to a half of men with Peyronie's also have erectile dysfunction, and the two problems interact. We assess and treat both together rather than in isolation.
02How it works
The mechanism, without the hand-waving.
- 01
Micro-trauma and abnormal healing
Repeated minor injury during intercourse triggers an inflammatory response that, in susceptible men, resolves into fibrous plaque instead of normal tissue.
- 02
Loss of elasticity
The plaque cannot expand with the surrounding tissue during erection, producing curvature, indentation, or an hourglass deformity.
- 03
Enzymatic plaque disruption
Collagenase injected directly into the plaque breaks down the excess collagen, allowing modeling to reduce the curve.
- 04
Mechanical remodeling
Traction applies sustained gentle stretch, encouraging tissue to remodel along a straighter axis. It is unglamorous and depends entirely on adherence.
03Candidacy
Who this is for — and who it is not.
Likely a good candidate
- Men with a palpable plaque and curvature greater than roughly 30 degrees
- Men with painful erections during the acute inflammatory phase
- Men whose curvature interferes with penetration or causes distress
- Men with stable disease considering surgical correction
Cautions & contraindications
- Collagenase is not appropriate for plaques at the base where the urethra is at risk
- Corporal rupture is a rare but serious complication of injection therapy
- Surgery should be deferred until disease has been stable for at least three to six months
- Oral vitamin E and similar supplements have not performed well in controlled trials
04 — Our protocol
What actually happens, step by step.
- 01
Objective measurement
Curvature is measured on a pharmacologically induced erection and photographed. Self-reported estimates of angle are unreliable in both directions.
- 02
Determine the phase
Pain, duration of symptoms and stability of the curve tell us whether the disease is active or settled — and therefore what is appropriate now.
- 03
Non-surgical treatment
Collagenase injection cycles with in-office modeling, and a structured daily traction protocol. Adherence to traction is the single biggest predictor of result.
- 04
Surgical referral if warranted
For stable, severe deformity — or deformity with refractory ED — we refer for plication, grafting, or implant with straightening.
05Risks & side effects
The part other clinics put in a footnote.
You cannot consent to something you have not been told about. Your physician will go through all of this with you again in person, and answer every question you have about it.
- Injection site bruising and swelling, which is common and expected
- Penile pain during the treatment course
- Corporal rupture, rare but requiring urgent surgical attention
- Incomplete correction — the goal is functional improvement, not a perfectly straight result
Will it go away on its own?
Spontaneous improvement occurs in only a minority of men, and a further group worsens without treatment. Waiting is a decision with consequences, particularly since some treatments are most effective earlier.
Do the supplements advertised for this work?
Vitamin E, potassium para-aminobenzoate and similar oral agents have been studied and have generally failed to outperform placebo in controlled trials. We do not recommend spending money on them.
Can I be completely straightened?
The realistic goal is functional improvement — enough correction for comfortable, satisfying intercourse. Most men achieve meaningful reduction in curvature. Complete straightening is not the standard against which success is measured.
Important
The information on this website is provided for general education and does not constitute medical advice, diagnosis, or treatment. Erectile dysfunction can be the first sign of cardiovascular disease, diabetes, or hormonal disorders. Always consult a licensed physician about your individual circumstances, and never start, stop, or change a prescription based on what you read here.
Next step
Find out whether peyronie's disease is right for you.
Candidacy for every treatment on this site is decided by assessment, not by a questionnaire. Start with the consultation and let the findings choose.