Peyronie’s disease is a hard scar (plaque) in the lining around the erectile tissue that causes penile curvature or deformity during erection, sometimes with pain or erectile dysfunction. It is different from a mild congenital curve present since puberty without pain or a plaque. Treatment depends on the phase of the disease and the degree of curvature.
Medically reviewed by Prof. Dr. Samir Ahmed Al-Samarrai, consultant urologist. Last reviewed:
What are the phases of Peyronie’s disease?
- Active (inflammatory) phase: painful erections, sometimes a palpable lump, and a curve that starts or increases.
- Stable (fibrotic) phase: the plaque hardens and may calcify, the pain stops and the curve stops changing.
What causes it?
The exact cause is unknown; the most accepted explanation is repeated small injuries to the lining of the erectile tissue. Risk factors listed in the European Association of Urology (EAU) 2025 guidelines include:
- Diabetes, high blood pressure, high cholesterol and heart disease.
- Erectile dysfunction and low testosterone.
- Smoking and heavy alcohol use.
- Autoimmune disease and pelvic surgery such as radical prostatectomy.
How is it diagnosed?
- A history of duration, pain, degree of curvature, difficulty with intercourse and erection quality.
- Examination of the penis to locate the plaque and measure length.
- Assessment of the curve with a photo taken at home during an erection, or an erection produced by an injection in the clinic.
- Routine imaging is not needed; Doppler ultrasound is used to assess erectile dysfunction or before surgery.
What are the non-surgical treatments?
- Anti-inflammatory painkillers for pain in the active phase.
- Shockwave therapy for pain only, not for the curve.
- ED tablets when erectile dysfunction is also present.
- Collagenase injections into the plaque for stable disease with an upward or sideways curve over 30 degrees, in men who prefer non-surgical treatment. Interferon is an alternative.
- Traction or vacuum devices may reduce deformity; data are limited.
Not recommended by the guidelines: oral vitamin E, tamoxifen, colchicine, pentoxifylline and similar tablets, steroid injections, and PRP or hyaluronic acid injections outside clinical trials.
When is surgery the answer?
Surgery is done only after the disease has been stable for at least 3 months without pain or a worsening curve, usually about a year after symptoms began, and when the curve makes intercourse difficult. Options include:
- Plication (shortening the opposite side) for less severe curves with adequate length.
- Grafting for severe curves or complex deformity with good erections.
- Penile prosthesis when erectile dysfunction does not respond to medicines.
Before surgery the doctor discusses expectations and the expected effect on penile length.
Related topics
Frequently asked questions
Does penile curvature go away on its own?
In many men the disease settles after the active phase; the curve may improve slightly, stay the same or get worse. Your doctor follows it until it is stable before any surgical decision.
Does shockwave therapy correct the curve?
No. European guidelines use shockwave therapy only to relieve pain in the active phase, not to correct curvature or shrink the plaque.
Do PRP or steroid injections help Peyronie’s disease?
European guidelines advise against steroid injections, and against platelet-rich plasma or hyaluronic acid injections into the plaque outside approved clinical trials.
When should I see a doctor?
If you have pain with erections, a hard lump in the penis, a new or worsening bend, difficulty with intercourse, or weaker erections.
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Book a consultation
Prof. Al-Samarrai and Dr. Amer Mousa assess penile curvature at Prof. Al-Samarrai Medical Center, Dubai Healthcare City, and discuss the options that suit the phase of the disease. Medical consultations are confidential.
This information is for health education and does not replace a medical examination. See our medical content policy.