I have had Peyronie’s disease for 7 years and have recently noticed my penis shrinking in the flaccid state and becoming hard all over. When I get an erection my penis is bent 45 degrees to the right and when semi-erect it won’t get fully hard. Is the scar preventing the corpus cavernosum from expanding or is the corpus cavernosum actually turning into fibrous tissue as well? What is the cause of this shrinkage effect?

Dr. Levine answers: This scenario appears to be one of a progressive Peyronie’s disease where there is a loss of elasticity in the entire jacket tissue of the penis, known as the tunica albuginea. This tunic is the tissue which expands in girth and length during the normal erection and contains the vascular tissue as it fills with blood. If the jacket tissue has lost elasticity we can see a variety of deformities including curvature if only one side of the jacket is compromised or we can see generalized loss of length if there is widespread loss of elasticity. A loss of girth may occur as well. For the most part, the scarring process involves the tunic, but there is recent evidence that there may be even an invasion of the scarring process into the underlying vascular tissue which may compromise erectile rigidity as well. To determine the nature of your Peyronie’s disease, usually a duplex ultrasound evaluation is performed to examine blood flow, the characteristics of the tunic and cavernosal tissue, whether there is calcification within the plaque, and to determine erectile response and curvature when the penis is erect.