The acute phase of Peyronie’s disease is variable from patient to patient and may not include any pain. In addition, the onset of a painless palpable plaque may be the first indication of Peyronie’s disease with subsequent or even immediate onset of deformity. Some patients will present with discomfort of the penis without a palpable plaque or deformity and may notice gradual appreciation of the plaque and deformity. Therefore, the widely-held presumption that the patient with Peyronie’s disease presents first with pain followed by palpable nodule and then deformity needs to be modified as there is no uniform presentation. It also should be recognized that patients may present acutely with a calcified plaque and that a calcification is not necessarily a sign of a mature or an old plaque.
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