Peyronie’s Disease (Penile Curvature)

Peyronie’s disease is when fibrous scar tissue develops in the penis resulting in curvature and sometimes hourglass narrowing and painful erections. All men have some penile curvature but this is significant bend or pain with an erection.

Men with Peyronie’s disease can experience difficult, or painful sex, for both themselves and their partners and may experience issues getting or maintaining an erection.

Symptoms may occur suddenly or over a long period of time. Symptoms include some or all of the following:

  • Scar tissue (often called plaque) – this presents as a hard band of tissue which you can noticeably feel
  • Penile curvature (bend of the penis)
  • Change in shape of the penis – this can include hourglass narrowing, indentations, twisting or hinging
  • Erectile dysfunction (hyperlink to ED): difficulty getting or maintaining an erection
  • Pain – most commonly experienced with an erection

Causes of Peyronie’s Disease

The exact cause of Peyronie’s Disease is not understood though we know this condition is typically associated with a wound healing issue where some men are predisposed after some trauma or micro-trauma to the lining around the erectile tissue in the penis. Scar tissue is deposited in some men and this causes the above symptoms.

Peyronie’s Disease Treatment

Treatment is determined by what phase your Peyronie’s Disease is in:

  • Acute phase (actively changing) – your doctor will work with you to try and stop things from worsening. This is typically done with oral medications.
  • Chronic phase (no longer changing) – when men are in the chronic phase your doctor and you will do an assessment and see which treatment option is best for you.


Xiaflex® (collagenase clostridium histolyticum) is the only FDA approved medication for Peyronie’s Disease. Xiaflex® treats the plaque or scar tissue by incising the tissue bands (breaks down the collagen scar tissue). This is done in a series of shots and will be explained to you by your urology team.

Our experts at EvergreenHealth are some of the most experienced doctors in the region with this therapy.

For Xiaflex to be a viable treatment, patients need a palpable plaque, curvature greater than 30 degrees, and the ability to get erections.


If a Peyronie’s Disease patient is able to get erections, there are two main surgery types that may help correct the penile curvature:

  1. Penile plication: permanent stitches are placed to straighten the penis
  2. Incision and grafting: the scar tissue is incised and a graft (extra piece of tissue) is inserted to straighten the penis

If a patient is unable to experience erections, than the curvature and erectile dysfunction is treated with a penile implant.

At EvergreenHealth Urology & Urogynecology Care, our team of specialists will work with you to discuss each of the options and treatment options best suited for your care plan.