Peyronie’s disease Archives | St Pete Urology

What Is Peyronie’s Disease and How Does It Affect Men?

St Pete Urology — Tue, 19 Aug 2025 11:49:55 +0000

3 Key Takeaways:

Peyronie’s disease affects approximately 1 in 11 men and involves the development of scar tissue in the penis, causing curvature, pain, and potential erectile dysfunction that can significantly impact quality of life and relationships.
Early diagnosis and treatment during the acute phase (first 12-18 months) often yield better outcomes, with both non-surgical options like Xiaflex injections and surgical interventions available depending on disease severity and patient needs.
St. Pete Urology’s board-certified specialists offer comprehensive evaluation and personalized treatment plans, combining advanced medical technology with compassionate care to help men overcome Peyronie’s disease and restore sexual function.

Peyronie’s disease is a condition that affects approximately 1 in 11 men, yet many remain unaware of its impact on male health and intimate relationships. This connective tissue disorder of the penis can cause significant physical and emotional distress, but with proper understanding and treatment, men can regain confidence and sexual function.

At St. Pete Urology, our board-certified urologists—Dr. Reid Graves, Dr. Nicholas Laryngakis, Dr. Adam Oppenheim, and Dr. Ankur Shah—specialize in diagnosing and treating Peyronie’s disease with compassion and expertise, helping men in the Tampa Bay area overcome this challenging condition.

What Is Peyronie’s Disease?

Peyronie’s disease is an acquired connective tissue disorder that affects the tunica albuginea, the thick elastic membrane surrounding the erectile chambers of the penis. According to the American Urological Association, the condition is characterized by the development of fibrous scar tissue or plaques within this membrane, which can cause the penis to curve, bend, or become shorter during erections.

Named after François Gigot de la Peyronie, the French surgeon who first described the condition in 1743, this disease represents an abnormal wound healing process that results in excessive collagen deposition and plaque formation. Unlike congenital penile curvature, Peyronie’s disease develops later in life and typically progresses through two distinct phases.

Symptoms and How It Affects Men

The symptoms of Peyronie’s disease can vary significantly from man to man, but typically include:

Physical Symptoms

Penile curvature during erections – The most common presentation, occurring in over 70% of cases, involves upward curvature when scar tissue develops on the top of the penis
Palpable plaques or lumps – Hard areas of scar tissue that can be felt under the skin of the penis
Penile pain – Especially during erections, though this typically subsides as the condition stabilizes
Penile shortening – Loss of length or girth due to scar tissue formation
Hourglass deformity – Narrowing of the penile shaft creating an indented appearance
Erectile dysfunction – Difficulty achieving or maintaining erections, affecting up to 40% of men with Peyronie’s disease

Psychological Impact

Research indicates that Peyronie’s disease can have profound psychological effects, including:

Depression and anxiety
Decreased self-esteem and body image concerns
Relationship difficulties and decreased sexual satisfaction
Avoidance of intimate relationships
Increased stress and emotional distress

The emotional impact often extends beyond the patient, affecting partners and relationships. Many men experience embarrassment and reluctance to discuss their symptoms, which can delay diagnosis and treatment.

Causes and Risk Factors

While the exact etiology of Peyronie’s disease remains unclear, medical experts believe it results from a combination of factors. Research from the National Institute of Health indicates that the condition involves an abnormal wound healing process:

Primary Causes

Penile trauma – The most widely accepted theory suggests that micro-injuries to the penis during sexual activity, sports, or accidents trigger abnormal wound healing
Genetic predisposition – Family history plays a role, with some men having inherited tendencies toward abnormal connective tissue formation
Autoimmune factors – The body’s immune system may mistakenly attack penile tissue, leading to inflammation and scarring

Risk Factors

According to recent studies, several factors increase the likelihood of developing Peyronie’s disease:

Age – Most commonly affects men between 40-70 years old, with risk increasing with age
Connective tissue disorders – Including Dupuytren’s contracture, which affects up to 20% of men with Peyronie’s disease
Diabetes mellitus – Men with diabetes-associated ED have a 4-5 times higher risk
Erectile dysfunction – Pre-existing ED may contribute to penile trauma during sexual activity
Smoking and alcohol use – These factors may impair healing and increase inflammation
Certain medications – Some drugs may affect connective tissue formation

Diagnosis and When to See a Urologist

Early diagnosis and treatment of Peyronie’s disease are crucial for optimal outcomes. Men should seek evaluation from a qualified urologist if they experience:

New onset of penile curvature or deformity
Palpable lumps or plaques in the penis
Pain during erections
Difficulty with sexual intercourse due to penile changes
Concerns about penile appearance or function

Diagnostic Process

At St. Pete Urology, our comprehensive evaluation includes:

Medical History

Detailed discussion of symptoms, onset, and progression
Assessment of sexual function and relationship impact
Review of relevant medical conditions and medications
Family history evaluation

Physical Examination

Careful inspection and palpation of the penis
Assessment of plaque location, size, and consistency
Evaluation of penile sensation and blood flow

Diagnostic Testing

Penile ultrasound – The gold standard for visualizing plaques, measuring curvature, and assessing blood flow
Doppler studies – To evaluate erectile function and vascular health
Photography – Documentation of penile deformity for treatment planning
Questionnaires – Standardized assessments of sexual function and quality of life

Treatment Options Available

Treatment for Peyronie’s disease depends on several factors, including disease phase, severity of symptoms, and impact on sexual function. The Mayo Clinic emphasizes that early intervention often yields better outcomes. At St. Pete Urology, we offer comprehensive treatment options tailored to each patient’s needs.

Non-Surgical Treatments

Oral Medications
While evidence is limited, some oral therapies may help in the early stages:

Anti-inflammatory medications
Vitamin E supplementation
Pentoxifylline for improving blood flow

Intralesional Injection Therapy

Xiaflex (collagenase) – The only FDA-approved non-surgical treatment for Peyronie’s disease, administered in office cycles
Verapamil injections – May help reduce plaque formation and improve curvature
Steroid injections – Can reduce inflammation and pain during the acute phase

Mechanical Therapy

Penile traction devices – May help improve length and reduce curvature when used consistently
Vacuum erection devices – Can help maintain penile health and potentially reduce progression

Surgical Treatments

For men with stable disease causing significant functional impairment, surgical intervention may be recommended:

Penile Plication

Shortening the longer side of the penis to correct curvature
Preserves erectile function with minimal complications
Best suited for men with good erectile function and adequate penile length

Incision and Grafting

Lengthening the curved side by incising the plaque and placing a graft
Preserves penile length but carries higher risks
May be combined with penile implant placement

Penile Implant Surgery

Recommended for men with both Peyronie’s disease and erectile dysfunction
Can correct curvature while restoring erectile function
May involve additional procedures to optimize penile straightening

Advanced Treatment Options

St. Pete Urology stays at the forefront of Peyronie’s disease treatment, offering:

da Vinci robotic-assisted surgery for precise reconstruction
Minimally invasive techniques to reduce recovery time
Penile prosthetics and implant procedures when indicated
Combination therapies for optimal outcomes

Living with Peyronie’s Disease

Peyronie’s disease affects not just physical function but emotional well-being and relationships. Our team at St. Pete Urology understands these challenges and provides:

Comprehensive counseling and support
Partner education and involvement in treatment planning
Referrals to mental health professionals when appropriate
Ongoing monitoring and adjustment of treatment plans

Prognosis and Outlook

The natural history of Peyronie’s disease varies significantly:

Approximately 20% of cases may improve spontaneously
40% stabilize without progression
40% may worsen without treatment

Early intervention during the acute phase (first 12-18 months) often yields better outcomes and may prevent the need for surgical intervention.

Conclusion

Peyronie’s disease is a common but often misunderstood condition that can significantly impact a man’s quality of life and relationships. However, with proper diagnosis and treatment from experienced urologists, most men can achieve significant improvement in their symptoms and sexual function.

At St. Pete Urology, our board-certified specialists combine clinical expertise with compassionate care to help men overcome the challenges of Peyronie’s disease. We offer comprehensive evaluation, advanced treatment options, and personalized care plans designed to restore confidence and improve quality of life.

If you’re experiencing symptoms of Peyronie’s disease or have concerns about penile health, don’t suffer in silence. Contact St. Pete Urology at (727) 478-1172 to schedule a confidential consultation with our experienced urological team. Located at 830 Central Ave, Suite 100, St. Petersburg, FL, we proudly serve men throughout the Tampa Bay area with state-of-the-art urological care.

References:

Bella, A. J., Perelman, M. A., Brant, W. O., & Lue, T. F. (2007). Peyronie’s disease (CME). Journal of Sexual Medicine, 4(6), 1527-1538. https://doi.org/10.1111/j.1743-6109.2007.00614.x
Mulhall, J. P., Creech, S. D., Boorjian, S. A., Ghaly, S., Kim, E. D., & Moty, A. (2004). Subjective and objective analysis of the prevalence of Peyronie’s disease in a population of men presenting for prostate cancer screening. Journal of Urology, 171(6), 2350-2353
National Institute of Diabetes and Digestive and Kidney Diseases. (2024). Penile curvature (Peyronie’s disease). https://www.niddk.nih.gov/health-information/urologic-diseases/penile-curvature-peyronies-disease
Nehra, A., Alterowitz, R., Culkin, D. J., Faraday, M. M., Hakim, L. S., Heidelbaugh, J. J., … & Burnett, A. L. (2015). Peyronie’s disease: AUA guideline. American Urological Association. https://www.auanet.org/guidelines-and-quality/guidelines/peyronies-disease-guideline

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5 Things You Need to Know About Men’s Sexual Health

St Pete Urology — Wed, 22 Jul 2020 12:41:00 +0000

Sex is a critical part of life. It helps in the perpetuation of species and provides an amazing source of pleasure. It ensures intimacy between partners while making bonds stronger and unions enduring. It is also a wonderful form of exercise that releases stress, gets rid of anxiety, boosts prostate health and improves overall health.

What is sexual health?

It is the state of wellbeing that enables a man to engage in and derive pleasure from sexual activity. You are sexually healthy if you have sexual desire (libido), can get and sustain an erection, and can participate in satisfactory sexual intercourse. Sex is a hormone-driven activity that begins at puberty and lasts your entire life.

On average, couples have sex once a week. Each sexual encounter typically lasts 15-30 minutes, though the actual penetration time averages 2 minutes. If you are in a relationship, you may be having less sex than you want due to a lack of intimacy or time. But by working on communication and spending quality time together, you and your partner can improve your intimacy and have a more gratifying sex life.

What should you know about men’s sexual health?

Sexual health in men is affected by a number of physical, psychological, social and interpersonal factors. For example, physiological changes can impact both the desire and the ability to have sex, while emotional and mental factors can determine the satisfaction achieved during sexual intercourse.

As a man, the knowledge of the following male sexual health issues can enable you to achieve better sexual and overall health.

Aging and sexual health

With increasing age, changes are bound to occur in your sexual function, most of which are normal. But even in your 80’s, you should still be able to enjoy sex and intimacy in your relationship. Nevertheless, one frequent effect of aging on sexual health is loss of libido (sex drive)—often due to decreasing testosterone levels. Loss of libido means you have reduced interest in sexual activity or diminished sexual thoughts. You can also lose your libido because of stress, anxiety, relationship issues, side effects of medication or some medical conditions.

If you are experiencing a reduced drive for sex, look out for the symptoms so you can describe them correctly when you speak with your urologist. One way to deal with reduced sexual urge is to take more time in direct stimulation or foreplay. For changes that occur drastically or refuse to go away after sex therapy, work with your urologist to differentiate normal from abnormal changes and receive proper treatment.

As a rule, do not assume that every change that occurs in your sexual function is because you are growing older. After age 40, make sure you are aware of the following health indicators:

Cholesterol levels
Blood pressure
Blood sugar levels
Testosterone levels
PSA (Prostate-specific antigen) levels

Erectile dysfunction (Impotence)

Erectile dysfunction (ED) means you are not able to get and maintain an erection that is firm enough for satisfactory sexual intercourse. It is a common sexual health issue affecting up to 50% of men above the age of 40. You may experience erectile dysfunction because of blood flow problems such as vascular disease or blood pressure, which are quite common among aging men. But other factors such as certain medications, use of alcohol and drugs, smoking and surgeries involving prostate cancer may also cause impotence.

Fortunately, medications treat 50-70% of ED cases effectively. However, if your condition does not improve with medication, your urologist can apply various non-surgical techniques to promote blood flow. There are also surgical options such as penile prostheses or implants. Surgery is not advisable as initial treatment; but when done as a last resort it usually delivers satisfactory results.

In some cases, erectile dysfunction is not due to a detectable physiological problem. Your urologist will evaluate your condition in terms of emotional or mental well-being and may recommend you work with a sex therapist. Stress, anxiety, depression or other emotional or psychological problems can often be alleviated by therapist who encourages a comfortable, honest and confidential discussion of the problem.

Peyronie’s disease

Peyronie’s disease develops when scar tissue or plaque occurs inside the erectile tissue of the penis. Though the actual cause of scar tissue formation is unknown, many men have suffered the condition following a minor trauma that elicited bleeding inside the penis. The resulting plaque is usually benign and noncancerous, but it tends to cause the bending of the penis downward or upward depending on its location.

Men with Peyronie’s disease usually experience pain during an erection and find it difficult to have sex. If you have this problem, you need to see a urologist for a timely diagnosis and treatment. The condition is diagnosed using an ultrasound exam which gives a clear picture of the erectile anatomy and function. Most cases of the disease are mild and the initial pain disappears within 6-12 months, allowing patients to return to normal sexual activity. Urologists treat remaining plaques using personalized treatment plans.

Ejaculation disorders

Ejaculation issues in men include premature ejaculation, inhibited (delayed) ejaculation and retrograde ejaculation. When you have premature ejaculation it means you are not able to delay ejaculation until the point when it is mutually desirable for you and your sex partner. It is the most frequent ejaculation issue, particularly among younger men.

Inhibited ejaculation means your ejaculation occurs slowly or never happens at all. Both premature and inhibited ejaculations have psychological causes, such as anxiety about sex, performance or trauma. But there are techniques that can be used to overcome these issues and a qualified therapist can help you. Speak with your urologist for treatment and referral to a sex therapist when necessary.
Retrograde ejaculation means the ejaculate is forced back into your bladder instead of through the urethra and out of the end of the penis at orgasm. It can be due to nerve damage, side effects of medication or surgery for bladder or prostate.

When you experience retrograde ejaculation, your urologist will change your existing medications or prescribe new ones to treat the issue. However, if the problem is caused by surgery, it might not be correctable. But that should not worry you as treatment is not usually medically necessary with retrograde ejaculation unless pregnancy is your goal.

Vasectomy is permanent contraception

Vasectomy is a simple, effective and minimally invasive surgical procedure offered as a permanent method of birth control. The 30-minute procedure involves cutting tubes that transport sperm within the male reproductive system.

The procedure does not affect the sexual health of a man and is very effective in preventing pregnancy. While vasectomy can be undone, the reversal is quite complex and comes with a lower chance of success. The time to undergo a vasectomy is when you are sure you no longer need to make your partner pregnant, for whatever reason, and consider it as a permanent method of birth control.

At St Pete Urology, we offer timely help to men with sexual health issues. We believe that speaking about these issues with a skilled and experienced urologist will help you resolve them. We also remind our clients that any sexual health issue that lasts several months may be an indicator of a more serious underlying medical issue that needs to be treated.

For instance, premature ejaculation may be due to nerve damage, medication or underlying urinary conditions. Problems with libido or erection may be the first indicator of diabetes or hormonal imbalance; while problems with erection may be due to underlying prostate cancer or cardiovascular issues. Hence, seeing a urologist for your sexual health may help uncover a potentially life-threatening condition.

Of course, there is also a connection between your overall health and your sexual health. In fact, hormonal, cardiovascular, neurological and psychological systems all contribute to your sexual performance. A healthy lifestyle that includes a good diet, healthy weight and regular exercise will promote your overall health while enhancing your sexual health and performance. For more information on men’s sexual health issues, visit the St Pete Urology website.

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