If you notice a bend in your penis or begin experiencing painful erections, a lot of things go through your mind — questions about how and why this happened, and fears of how it will affect your sex life.
Knowing the symptoms of Peyronie’s disease and understanding what may be causing them may relieve some of that anxiety. For some men, Peyronie’s disease may appear quickly, seemingly overnight. For others, it develops gradually.
Common Signs and Symptoms
Plaque (or nodule)
A plaque (pronounced “plak”) is a thickened nodule or lump that develops under the skin of the penis shaft.
Plaques are caused by the build-up of excess collagen and development of scar tissue within the penis. These plaques are different from the plaque that may build up in blood vessels. (Learn how Peyronie’s disease occurs.) They can occur anywhere along the shaft of the penis but often appear on the upper side.
Many men can feel a plaque (or several) under the skin. How plaques feel may change over time — they may feel soft at first, and become firmer as they develop.
Because plaques are made up of scar tissue, they do not stretch like normal tissues in the penis and prevent the affected area from expanding properly during an erection. This leads to changes in the shape of the penis (also called penile deformity).
Penile deformity or shortening during erection
Changes in the shape of the penis may include curvature, indention, hourglass narrowing, or shortening.
Most men with Peyronie’s disease have some sort of penile deformity — curvature is the most common. Because these deformities are caused by plaques, which do not expand like normal penile tissue, they are most noticeable during an erection.
The shape of the erect penis with Peyronie’s disease depends on the location and size of the plaque. The penis bends toward the side where the plaque is located. The most common curvature is upward (caused by a plaque on the top of the penis), but curvature downward or to the left or right also occurs. Some men with multiple plaques may have curvature in more than one direction.
Generally, the larger the plaque, the greater the degree of curvature. A small plaque may cause an indention rather than curvature. If plaques are present on opposite sides of the penis, hourglass narrowing occurs. Shortening may occur with or without curvature if the plaque is located farther within the penis; shortening may be noticeable with or without an erection.
Penile curvature and other deformities can make sexual intercourse (penetration) difficult or impossible. The greater the degree of curvature, the more likely it is to interfere with the ability to have intercourse. Indentations and hourglass deformities are less likely to interfere with intercourse but can cause penile instability, or buckling, during penetration.
Pain may occur with or without an erection. More than half of men with Peyronie’s disease experience penile pain. For many, it is one of the first symptoms they notice.
Although pain usually occurs during an erection, it may also occur when the penis is flaccid due to inflammation in the area where the plaque is forming. Pain during an erection may be caused by tension on the plaque as the nearby tissues expand. Fortunately for most men, pain resolves within 12-18 months after it begins. (Learn more about the phases of Peyronie’s disease.)
Peyronie’s disease can cause erectile dysfunction (ED). It is estimated that over two thirds of men with Peyronie’s disease experience ED.
Although some men with Peyronie’s disease have medical conditions that may contribute to ED (such as high blood pressure, heart disease, and diabetes), there is little doubt that Peyronie’s disease itself can cause erection problems.
- Penile curvature. Curvature may prevent intercourse or cause pain for the man’s partner. Combined curvature and shaft narrowing may lead to penile instability, even at maximum erection, and cause the penis to buckle.
- Penile pain. Some men may avoid having an erection due to penile pain.
- Anxiety. Anxiety about performance or the condition may prevent a man from having or sustaining an erection.
- Physical changes inside the penis. The plaque may damage erectile tissues within the penis and prevent them from functioning properly. Erections may not occur or the penis may be less rigid beyond the plaque.
If you have been experiencing any of these signs or symptoms, discuss them with a physician experienced in diagnosing Peyronie’s disease.
Is it congenital penile curvature or Peyronie’s disease?
Part of diagnosing Peyronie’s disease may be ruling out other conditions, such as congenital curvature.
While congenital penile curvature also causes the penis to bend during an erection, it is not the same as Peyronie’s disease.
- Peyronie’s disease is an acquired condition — that means that there was a time when the curvature or deformity was not present. Congenital penile curvature is a condition that has been present all of a man’s adult life.
- Peyronie’s disease involves the buildup of scar tissue in the penis. Congenital penile curvature is caused by asymmetrical (or uneven) chambers within the penis.
- The signs and symptoms of Peyronie’s disease may change over time, especially early on. Congenital penile curvature does not progress; it remains the same over time.
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To help you find answers and better understand this condition, a question-and-answer forum has been developed, where Dr. Laurence Levine and Dr. John Mulhall, along with other members of the APDA Medical Advisory Board and guest contributors, answer questions from patients and their partners. As leaders in Peyronie’s disease research and treatment, board members provide comprehensive and unbiased information about a broad range of topics.