A flexible sigmoidoscopy is performed for evaluation of the rectum and lower sigmoid colon. This procedure, to my knowledge, has not been associated with triggering Peyronie’s disease as there is no direct trauma to the penis or the genitalia. Certainly, it is possible that any trauma in the pelvic area may activate Peyronie’s disease as is seen in patients following radical prostatectomy where up to 10% of men will develop Peyronie’s disease following this surgery where there is no direct trauma to the genitalia. It is my opinion that in the latter circumstance, there may be some release of proteins which can activate the scarring process in the penis. Therefore, if we take the same scenario, it may be that trauma in the rectal area may activate release of such proteins and in the genetically susceptible individual, Peyronie’s disease could be activated. This is all theoretical, of course, and at this point, one could not place blame for developing Peyronie’s disease on the surgeon performing radical prostatectomy or the physician performing colonoscopy.