Along with the indentation, and the lump when I am flaccid, I also have trouble maintaining fuller erections, and I have noticed pain at times even when flaccid. Is it safe to try and maintain erections, masturbate and/or have sex?

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Dr. Levine answers: Peyronie’s disease is manifest in the early phase with pain, which can be present in the flaccid state when touching the penis, or especially when erect or trying to have intercourse. Typically the pain will diminish with time. The pain and the deformity can result in psychological distress, which can interfere with your erection, but there may also be vascular changes, which may contribute to this as well. It is unlikely that if you try to stimulate your penis without putting excessive stretching forces on the penis that you will worsen the Peyronie’s disease. Sexual positions, which might cause excessive stretching forces, could reactivate or aggravate the acute inflammatory process, which would result in pain and possibly progressive deformity. Published reports have suggested that use of a PDE-5 inhibitor such as Viagra, Levitra or Cialis may enhance the erection. There is some research in the animal model of Peyronie’s disease, which has suggested that this class of drugs may actually stop the scarring process.

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