Peyronie's disease is a condition in which a layer of hardened scar tissue (plaque) builds up under the skin of the penis. The plaque commonly causes pain and bending in the penis during erection and may also cause indentations or shortening of the penis. For some men, the changes in the penis' shape make intercourse painful or impossible.

Diagnosis

A physical exam is often sufficient to identify the presence of the plaque in the penis and diagnose the condition. Your doctor will also talk to your partner about your sexual relationship.

A digital photo of an erection at home can help your doctor see the severity of the curvature.

Your doctor will personally examine the penis with ultrasound to assess the plaque formation and blood flow. The sensitivity of the penis will also will be tested.

It is important to ensure that the erectile mechanism of the penis functions well before considering surgery.

Treatment

In a small percentage of men, Peyronie's disease goes away on its own. But most times, treatment is required.

Surgery is the most effective way to treat Peyronie's disease. Nonsurgical treatments are usually recommended in the first 12 to 18 months of treatment.

All medical treatments are regarded as experimental — none is approved by the Food and Drug Administration.

Medications

A number of medications have been studied for Peyronie's, including L-carnitine, colchicine, aminobenzoate potassium, tamoxifen and vitamin E. There is little evidence that using any of these is better than watchful waiting.

Injections

Doctors have tested injecting drugs directly into the scar tissue (plaque). Two have been found to have some positive effect:

• Verapamil, a drug usually used to treat high blood pressure, stops creation of collagen — a part of the plaque — and promotes transformation of scar tissue into normal tissue
• Interferon injections have been shown to reduce collagen formation