Peyronie's Disease (Penile Curvature): What Are the Treatment Options?
What is Peyronie's disease and how is it treated? The difference between the active and stable phases, medication, ESWT, surgery and penile implant options explained.
Peyronie's disease is a condition in which scar (plaque) tissue forms in the membrane surrounding the erectile bodies (tunica albuginea), leading to curvature, pain, shortening or indentation of the penis. It is more common than assumed, is nothing to be ashamed of, and is a treatable problem.
What are the symptoms?
- Curvature that becomes apparent with erection (upward, downward or to the side)
- A palpable plaque or hardness in the penis
- Pain, particularly in the early phase
- Loss of length or hourglass narrowing
- Erectile dysfunction that may accompany the curvature
Why does the active vs stable phase matter?
- Active (acute) phase: pain persists and the curvature is still changing. Surgery is not advised in this phase because the shape has not settled. The focus is on pain control and limiting progression.
- Stable phase: some time after symptom onset the curvature settles and pain resolves. Surgical correction is only considered in this phase.
This distinction is critical to avoid unnecessary or premature surgery.
What are the non-surgical options?
- Oral and supportive treatments: considered mainly for pain and progression management in the active phase.
- ESWT (shock wave therapy): a non-surgical option evaluated in selected cases for pain reduction; its effect on correcting curvature is limited.
- Intralesional injection therapy: approaches targeting the plaque may be considered in suitable cases.
- Traction (stretching) devices: may be recommended as supportive treatment under specific protocols.
Non-surgical methods do not produce the same result in every patient; suitability is determined by detailed examination.
When is surgery required?
- Plication (shortening) techniques: the penis is straightened with sutures placed on the side opposite the curvature. Preferred in patients with good erectile function.
- Plaque incision/grafting: for more advanced curvature, the plaque is addressed and repaired with a graft.
- Penile prosthesis: where Peyronie's disease is accompanied by significant erectile dysfunction, an implant corrects the curvature and restores erection, solving both problems in a single procedure.
Are Peyronie's and a penile implant considered together?
Yes. In patients with both erectile dysfunction and advanced curvature, a penile implant is often the most appropriate option; additional straightening manoeuvres can be applied during implantation when needed. Such cases require surgical experience.
When should you see a doctor?
If you notice new curvature, a firm area, or pain during erection, it is important to be assessed without delay. Early presentation allows both pain management and timely measures aimed at limiting progression.
Assoc. Prof. Zülfü Sertkaya is one of Europe's leading high-volume penile implant surgeons, holding Boston Scientific AMS 700™ and Coloplast Titan® Center of Excellence credentials and operating with the no-touch technique, in which the implant is placed without skin contact. At his clinic in Istanbul, all assessments are carried out confidentially.