Peyronie's disease

Last reviewed 08/2023

• in Peyronie's disease, the penis becomes curved due to asymmetrical fibrosis in the fascia surrounding the corpora cavernosa. Curvature towards the affected side is increased during an erection making intercourse difficult and painful
• incidence of 0.3 to 3%; most common in men aged 40-60 years (1)
• the aetiology is unknown - it is theorised that this condition may be the result of recurrent penile trauma during sexual intercourse
• calcification in areas of fibrosis may be visible on X-ray - most plaques are more than 1.5cm in diameter and therefore also easily palpable
• there is a high rate of spontaneous resolution in this condition (2)
• surgical options for treatment include:
• surgical excision of fibrotic areas may allow symmetric erection
• alternatively, skin opposite the area of fibrosis may be reflected and excised to improve cosmesis (Nesbitt's operation)
• note that surgical procedures should only be undertaken after a period of at least one year with no disease progression - this is because the results of surgical intervention might be jeopardised by recurrent curvature if the disorder progresses (1)

Peyronie's disease is associated with:

• Dupuytren's contracture
• premature atherosclerosis

Reference:

• (1) Hauck EQ, Weidner W (2001). Francois de la Peyronie and the disease named after him. Lancet, 357 (9273), 2049-51.
• (2) Gelbard MK et al (1990). The natural history of Peyronie's disease. J Urol, 144, 1376-9.