After discussing my personal situation with my family physician about E.D., he prescribed Staxyn. In reviewing the medication and similar ones (Viagra & Cialis), there is a general concern about these E.D. medications and Peyronies. I do have a slight curvature which may have been caused by catheterization about three years ago but I'm not sure. Since that time, I've noticed about a 20°-30° curvature during times when I'm erect. What are the general concerns about using any E.D. medicine on a patient with Peyronies Syndrome? While they all say it, none give any specifics as to what to be aware of, what to watch for or be concerned about. Thank you for the wonderful service you provide...
Since one patient's inquiry may provide information to another, Doctor Gelbard is opening an anonymous public forum as an online exchange for the questions of patients, physicians, and family. Hopefully this will become a place to share your concerns and experiences. Submission to this Forum implies your consent for the material and commentary to appear on the site or in subsequent educational publications. The doctor's commentary is intended to be educational information for the public, not individual medical advice. The unique background of each person must be considered when making medical decisions, which requires a specific history and examination. Topics submitted from all sources will be posted anonymously unless specifically requested to the contrary.
This whole class of medicine (phospodiesterase inhibitors, Viagra, Cialis, Staxy, Levitra) was never specifically studied in a group of men with PD, so the manufacturers have to make this type of a disclaimer. Most authorities are of the opinion that they are not harmful to men with PD, and there are some urologist who recommend them specifically for this purpose as they my tend to counteract scarring. They are widely used by men with PD who have erectile problems an should be considered safe in this setting. MG
Hello, I'm 23 years old and about a week ago I noticed something on my penis. There are two cord like structures located on the shaft on the right side near the center of the penis when it's flaccid. They look like large veins and run around the penis, the visible portion starts on the underside and go almost halfway to the top of the penis, forming almost half a circle around it (like if I were to wrap a piece of string around the shaft, but not encircling it completely, or like half a ring put at the right side of the shaft). So if they are indeed veins, they are not like most veins on my penis which run parallel to it, along its length. They are close to half a centimeter in diameter(maybe about 4mm) and there's about half an inch between them. They feel somewhat like a vein, but I think they feel a little harder than a vein should be. Also I can't move them but I can see them behind the skin(when I move the foreskin, it seems they stay in place, not moving with it, like if they were attached to the structure that forms the penis). They are better felt and seen when the penis is flaccid. Also they tend to bulge more when i'm standing up and the penis is flaccid. Also when the penis is flaccid and only in the flaccid state, I can see a small indentation in the space between them. They are not painful or tender to the touch. But I think I might have felt a very, very mild pain or discomfort lately when i'm erect, but this pain usually lasts like a second or so and might just be my imagination. When my penis is erect I can still see them if I compress the skin a little, though it's more difficult to feel them. When erect they also look more like veins. Also my penis has always curved slightly downwards and to the left. So, my concern here is, could these structures be some kind of plaque from peyronie's disease or are these only veins or maybe something else? I' ve heard the penis should curve to the same side which the plaque is located but that's not the case with me since mine curves to the opposite side, but I've only recently noticed these structures so if they are indeed scar tissue, the curve could still be under development, couldn't it? Also are there veins which run around the penis rather than along its length? And is a nodule from peyronie's disease always hard or could it be more soft like a vein or just slightly harder than it? Thank you
This doesn't sound like PD to me, just prominent veins. MG
I am 59, have had PD for 20 years and married. 30-40% curve to the left, some small scarring at the base of the shaft, and some shortening of the erect penis. I think I got it during sex with minor bleeding that led to scar formation. I saw a Urologist for it when it started but he steered me away from surgery and said it might self-correct if I just do nothing. Since then for the most part I've been able to achieve and maintain an erection and have as normal a sex life as I could expect but in the last year the issue has become maintaining an erection. Cialis doesn't work. I'm on Diovan HCT for blood pressure but my research shows that drug does NOT have the ED side effect, so I'm still on that. Should I go back to a Urologist and get a scan and see what the scar/calcification situation is? Any thoughts on the erection issue? Who do you recommend in the Columbus, Ohio area? As a side story, I was on finesteride last year for about 9 months (1 mg/day) as a preventive (prostate cancer runs in my family) but I took myself off it when I read it can cause ED problems. That was coincidentally around the time I started having the ED problem -- not sure if it's connected to the finesteride or not. I can probably live with the curvature/shortening, but I really need to address the erection issue as I thought Cialis would take care of it but no luck.
I think having a penile duplex doppler ultrasound to look at blood flow might help to clarify the ED issue. You can check the physician locator link in this site for a qualified Dr in your area. MG
Hello Doctor, I am a 30 year old man that has been diagnosed with PD by Urologist today. The diagnosis consisted of him just listening to my description and feeling the bumps I have and I am wondering if this is definitely PD. Two weeks ago after having rough sex I started to notice an mild irritation during erections. A few days later I found two lumps under the skin on the top of the shaft near the base of my penis. the lumps are tender when pressed on but are not visible nor do they hinder an erection or cause any type of curvature of the penis. The doctor says they were probably there for a while but I think that would be something I would notice unless I maybe just felt around because of the pain. Does this sound like PD in the early stages? Am I headed toward a worsening condition where this is just the first stages of the problem? Lately Ive been having sex but have just been taking it easy in fear of worsening any condition and I have no clue if I should be abstaining from rough sex forever....I have been taking glucosamine for a few months and I read in your posts that it can be related to it so I should probably stop that. Thanks for any info you can provide I greatly appreciate it Richie
It is a little unusual for the bumps in PD to appear that quickly. You may have a temporary condition called mondor's syndrome which is little clots in some of the penile veins. It usually goes away on its own. If the bumps are mobile with the skin - when you move the skin around the bumps move with it rather than the skin moving over bumps deeper down which don't move - it is probably not PD. MG
Last Oct.(2012) I was given two steroid injections in my lower back for pain. Those Steroids were later found to have been made by NECC and were suspect of being tainted. I went through several tests to confirm that I didn't have fungal meningitus, and thankfully I didn't get the tainted doses. However, shortly afterward, I developed a bend in my penis and have become impotent and can no longer achieve an erection. Is it possible that the two incidences are related? Would taking Vitimine E possibly help in my situation? I read in other letters about a new drug that is on the horizon that looks promising as well. Do you have any idea when or if it may become available and do you think it would work for me? Thank you in advace for any information you can share.
I seems unlikely that these injections are related to your PD. The new drug you are referring to is Xiaflex. I believe we should have word from the FDA regarding approval or not by early September. MG
I was recently diagnosed with PD but the condition likely began 9-12 months ago. I experienced a recent worsening of the condition which my urologist says is likely due to another inflammatory event. The same urologist is recruiting for a double blind study on a new topical compound that he thinks is likely to produce positive results. I can choose to participate in the study but there is a 50% chance I will be in the placebo group. The study doesn't start for another month and a half and runs 3 months. Before and during this time I won't be able to use any form of treatment so there is a possibility that by participating in the trial, I may miss the opportunity to treat the symptoms while still in the inflammatory stage. I know there is limited clinical research on Pentox and L-arginine but in your experience, what is the approximate proportion of patients that have seen significant improvement on each of these treatment options? I will have had PD for 13-18 months by the end of the study. If I opt for the study and end up in the placebo group or if the treatment is ineffective, what are the chances it will be too late for pentox or verapamil to be effective? I have only minor curvature and some ED at this point. Are oral treatments effective enough to warrant beginning treatment immediately or should I delay treatment and take a chance on my urologist's clinical trial?
You are doing a good job of weighing complex issues. The experience that most of us urologists have is that oral therapy, even early on in the inflammatory phase, are usually not that effective. I don't know the potential effects of the clinical trial drug since you did not mention it. If there is good potential to the trial it might be worth participating, because missing a chance at oral therapy is not a major problem. Also, if you fail to respond by the time you no longer are in the acute phase, it is possible you might have Xiaflex as an option. This is a drug with promising results that is in FDA review now. If it gets approval, it is known to be effective in the later or chronic phase of PD. MG
I had a curvature of 60 degrees and had an operation 5 months ago. After the operation I still had a 10 degree curve that my doctor said was a satisfactory result but my penis was at least 2" shorter. I was advised to purchase a traction device and have looked online to see what is available. I'm sure some are probably better than others in terms of lengthening and comfort. My question is which brand is more popular or recommended by the majority of doctors that would most likely give the best result.
I can't really give you a fair survey of all the available devices, but the patients I have seen who have used the andropenis device have found it acceptible. MG
Is it simply money??? After millions of years of evolution under the moon, mankind decided to go to it. After transplanting faces, hands, hearts; after stem cell therapy for organs; after regrowth of tissue around scaffolding; after observing a Salamander's ability to regrow extremities; after going to the moon, mankind can't repair a penis??? Mankind can't relieve the sufferers of this atrocious malady. I wonder if it deeply affects patients and their wives on a psychiatric level. My question is: WHY IS FAILURE ACCEPTABLE. Is it simply money?
All good questions. I think with the new research being done with collagenase, progress is being made. MG
Should iontophoresis be performed with the penis erect or flaccid?
There isn't really any research to back this up, but drug penetration into the tissue is probably more effective when it is soft. MG
hello doctor - thank you for taking the time to answer our letters - pd is a cruel disease, i am 56, single and most likely to remain that way - it is so humiliating and embarrassing and renders one useless in sex. my penis lost length and girth and the ability to erect - viagra does not help at all - the vacuum device is painful, but somewhat helpful, regarding girth right after use. i have pd for about 8 months now and i just felt a serious hard area, almost like a bone forming, about an inch long, which scares me enormously.. i am taking 6 pentoxifylline a day, according to my doctor, the ONLY thing that is beneficial... my main question is, is the new medicine, which is about to be approved, we hope, truly helpful? - what would it exactly do for us pd patients, especially regarding calcification? thank you for your kind response in advance!
The new medicine, Xiaflex has been much more effective at improving curvature and symptoms than placebo in extensive clinical trials, so it really does seem promising. If an x ray shows speckles of calcification, it can be used, though if there are large calcifications it probably won't be effective. Be assured, having a plaque that feels very hard does not mean it is calcified. MG
Hi, i am suffering of some form of PD and today i have explored, that there is a white-house-petition ongoing until 9. of may about PD and trying to focus the government on spending more money in researching a cure. My plea is, that all readers sign up for yourselves and tell your friends or others about it. Recognize Peyronie's Disease; A Quality of life condition "NOT" a lifestyle choice. | We the People: Your Voice in Our Government http://wh.gov/MGLP With kind regards
thank you - I actually signed this petition last week. MG
The pain from erection has subsided now, after about 7 months, but am left with a major indent and maybe 20 degree bend to the right, making sex uncomfortable. Another web search advertises Neprinol to break down the scar tissue that causes both. Can you recommend it? Is it likely that calcification has occurred by now, and will Xiaflex be of any use to me now?
There is no peer - reviewed research on Neprinol, so there is no real science to recommend it, but it seems to be safe and may be worth a try. Calcification is not common, and the chance of it occurring does not always increase with the passage of time. MG
Hi Doc. I am 47 years old and developed PD around 6 years ago as a result of an injury during sex. I lived with the 60 degree curve and a downward spiral until last year when I opted for surgery. At first I tried the vitamin E and copper with DMSO (topically) and E orally along with gentle stretching excercises, but after several months of no results, I went to a urologist. (I believe I waited too long for the natural remedies to work) At any rate, the doctor informed me I was to get the Nesbitt procedure. I researched it online as best as I could, and the surgery was preformed. Initially, the penis was strait with maybe a 5-10 degree lean toward the left. (before the surgery it was a bad curve to the left) then after several weeks, I noticed it leaning more to the left. Erections were never a problem before, and the first several weeks after the surgery, I was always getting them. But since then, I have noticed numbness on my right side of shaft, a rather large bump on the right side near the base, and the head is so sensitive, it hurts when it rubs clothing that I wear. I tried sex with my wife several times and was only able to ejaculate once, but the pain is bad around the base of the shaft and I have refrained from having any more sex since. I have also lost interest, and nothing seems to get me aroused. I noticed when I came home after the surgery, the incision was on the testicles not the typical de-gloving incision. I asked the surgeon about it, and he said it was a much less invasive surgery than the nesbitt. I told him about the rather hard bump and he examined it also about the numbness and he waved it off as nothing to worry about and advised me to keep taking vitamin E along with C. I'm not sure if I should go back to the natural treatments, or hope that in time the problem will resolve. Any advise. Thanking you in advance.
sometimes the firmness and bulk of the plication (tissue gathered up to correct the curve) can be very noticeable for several months after surgery. Likewise, the nerves traumatized on the right side of your penis to creat the tuck that pulls it over to the right and corrects the left bend may take 12 months to fully recover. MG
I have PD and am a couple of years into it. My issue is that now that I have a lump, I don't get full flow and erection. Therefore, only during the heightened point, do I get fully erect. Before and after, I get quite soft. Is there something that can help this? Thanks
You will probably notice a big improvement if you use one of the phosphodiesterase inhibtitor drugs (Viagra, Cialis, or Levitra). MG
I was extremely ill in June of 2012 and hospitalized. I have had to have stretching of the urethra about 3 years prior to this. They tried to cath me and they Nurse pinched the top of the penis just up from the base and could not get the catheter in. I was hospitalized three more times and in July of 2012 had a colon re-sectioning. I had no problems before this illness. After coming home for the re-cover period I had an erection with sever pain and bending of the penis and hard lumps where the penis was handled during hospitalization. The prescribed medicine did not help and sexual intercourse is not possible due to pain. Can PD come on this quickly? Should surgery be the best option?
Peyronies disease can occaisionally come on after catheterization or urethral instrumentation. Whether surgery is a good options depends on how severe the bend is, how much your problem interferes with intercourse, and how well the erections function. If erections function well, you might want to wait until the new medicine (Xiaflex) is FDA approved. One thing that will reassure you is that pain will ultimately go away on its own. MG
Hi, I am 55 years old and had the excession and graft surgery back in November 2011 for PD. I experienced a loss in length of approx. to 2 inches and now have an even more deformed penus with excessive skin that hangs down on the bottom side in all states. I am no longer able to have an erection without aide. I was prescribed Cialis, even though I have a heart condition and am on two different types of Nitrates. I was told I had to use it or loose, so I quit taking my Nitrates and would take Cialis, wait a few days and take my Nitrates again. Sex is now possible, but my erections are pointed to the extreme left, the same direction as the original bend. When erect my penus can be moved from my left to a straight position, but cannot be moved to the right. I also have a 1/4 inch hard knot on the surgical side that gives me an itch I cannot scratch and after a day of just moving around it becomes sore at night so I sleep with a pillow between my legs. I was told the knot is a stitch that has not dissolved. That knot also causes a raw feeling during and after sex and can become quite sore. Before I had the surgery, I did go through a series of shots every week for 6 weeks, and the location I was given the shots is not the same place as the graft. It's been over 5 months and I am not too sure about my current Doctor. Should I just give it more time?
After 6 months you may want to get a second opinion from a urologist that has a special interest in this field. MG
I am 38 years old and was recently diagnosed with Peyronie's. I would consider my case on the minor side (I hope) but would just like some clarification. I noticed this condition about 3 months ago and have an indentation and have lost some rigidity as well. My erections usually curve upward and slightly to one side. My urologist only prescribed vitamin E (1200 iu's daily). 1.) Is this too much Vitamin E and what I else should I be taking? 2.) Can I expect to gain full rigidity? 3.) What should be my next step? My urologist said to come back in 6 months but told me I should be "better" by then and didn't offer much of anything else than Vitamin E. As a married man, who's had one life partner and is utterly confused and a bit frightened by this condition, I want to say thank you for having this forum and answering these questions.
It has been shown that high doses of vit E can cause problems, so it's probably best to limit this supplement to 400 units (1 pill) daily. There are other meds which have been helpful in some cases, such as pentoxyfilline and colchicine - you may want to ask you doctor about this. MG
I have been diagnosed with PD for about 13 months. I still have some pain at times but it has mostly subsided. I am still able to have intercourse but my wife complains that it is painful to her at times. I saw a specialist who my urologist recomended today and he said he could remove the plaque by going into the side of the penis. He said he does this surgery every week and it is successful. It is not the same as the patch and it is also not the common surgery that causes shortening. This specialist is well known and he said that this new technique is working the best for people like me. He said that the plaque in my case is under the part of the penis that would require the patch and that he can remove it from the side without needing a patch. Will this procedure give me back the length I lost? Will it fix the indentation at the base? Thank you for giving me your opinion.
I'm really not sure what procedure is being recommended - I understand he is proposing to remove the plaque, but not do a graft or patch. By the way, most Peyronies surgeries (not just the nesbit or plication) shorten the penis somewhat. MG
I am a 52 year old male 2 months post-op from labroscopic RP. Prior to surgery always had very strong erections without pain. As part of the penile rehabilition I was given a vacuum pump by a nurse at my surgeon's office at my first PSA draw. She said watch the DVD and practice with it when I thought my body was ready for it. I "practiced" with it a few times and was encouraged by the erections I was getting, very similar to pre-surgery. Upon my 8 week post-op visit my surgeon said to start using the vacuum pump for intercourse at least once a week. The next time I used it the shape of my penis inside the tube looked remarkably different than I had ever seen. The base of the shaft looked somewhat engorged, with the middle of the shaft somewhat limp, and the head somewhat engorged and slightly curving like a "C" shape to the left. Is that the "hourglass" shape I've heard described? I am on a daily 5mg dose of Cialis but have not had any "erections" except for those I described when I first started using the pump. I posted my concern on a prostate cancer forum and received a reply that this may be PD. What do you think?
It is known that PD is considerably more common in men who have undergone radical prostatectomy, and that sounds like what is going on here. At this point I would continue using the cialis + vacuum device for rehabilitation of the erections. MG
I have PD, recently diagnosed. My urologist offered no treatment except future surgery if the bend becomes too severe. Currently, I have a slight bend downward with an indentation on the left underside of the shaft. I have read on numerous forums that ved's and traction devices are beneficial in correcting the bend and restoring lost length. Do you see any benefit in using these devices? If so, do you prefer one over the other? Thank you for maintaining this forum.
Research suggests these devices may help, though the data is preliminary and not well confirmed. For isolated angulation a traction device will serve, while for combined angulation and girth loss the vacuum device may be more appropriate. MG
Hi Dr I wonder how common it's that pd start a second time once it has gone into stable phase. Thank you.
The reactivation of Peyronies Disease once it has truly stabilized is rare, in the absence of repeat injury. MG
Sir, I am a 63 year old white male. At 52 I developed hyperthyroidism which was treated with RAI and since them I have stabilized with 175mcg Levoxyl daily. During recovery, I developed peripheral neuropathy, symmetrical in both feet. Since about 2005 I have mediated the pain with Fentanyl patches, 100mcg/hr, and oxycodone, 3-325, 2 tabs daily. In the past two years testosterone has dropped markedly and is being regained with Testim application to the skin, 10mg daily. I have not had intercourse for 3 years and over the last 18 months I have developed Peyronies-like curvature half-way along the penis of approx 30 degrees. Girth is reduced along the length of the penis and a formerly smooth, solid erection is now lumpy and irregular. I cannot feel anything new or abnormal in the penis, flaccid or erect. There has been no pain before or during erections. I can easily gain and maintain erections for 10-40 minutes. The immediate problem is that orgasm and ejaculation are painful and very uncomfortable and accompanied by very deep, rapid breathing, uncontrollable yawning (! lack of oxygen?) and near-fainting. While intercourse is not possible due to other reasons on my wife's part, my condition is interfering with other enjoyable sex play and affection. My questions are: Can Peyronies-causing plaque always be felt with the fingers in the flaccid or erect penis? Is Peyronies known to be associated with hyperthyroidism or other auto-immune hormonal problems? Is Peyronies known to be associated with continued opioid use? With reduced testosterone levels? Are the painful ejaculation, yawning and fainting even related to the Peyronies-like symptoms? I don't think I need the curvature of the penis corrected, but must address the orgasm and ejaculation problems. Thanks for your patience and advice.
Peyronies plaques are not always easy to appreciate in the flaccid penis. The is no known association of PD with hyperthyroidism, other autoimmuned disorders, opiod use, or low testosterone. I do not recognize the combination of yawning and fainting as anything I have seen reported in the past, though painful ejaculation is clearly a part of early PD. Fortunately that will resolve on its own. MG
Hi Doc, I'm 43 and been diagnosed with Peyronie about 6 weeks ago. The urologist that saw me prescribed a treatment with Nolvadex and vitamin E 400iu for two months after which I'm to undergo an Ultrasound scan again. I've seen however on this forum and on other forums online that as an alternative treatment some are recommending streching devices and vacuum pumps. My question(s): are these accepted by the medical community as effective means of treating Peyronie? Many thanks...
Yes these methods are accepted - see the response above. MG
Hi, I'm 47, and live in Australia. I have been diagnosed with an extreme case of Peyronies, curvature, hourglassing, calcification (some 18mm)and ED due to the condition. The only urologist for hundreds of miles has said it is a major operation with the risk of complications. Anyway - I'm a single dad with my kids 24/7 and as such have no social life let alone any sex life. The doc said I could have the op, with a very long recovery period in case I ever did meet someone with whom I wanted to start a sexual relationship.... or look at having an operation if I found myself in a relationship. Is it worth the hassle? I have been offered no other form of treatment.
If you have severe curvature and calcification, surgery may be the only way to restore function. I realize in your situation travel may not be an option, but if you elect surgery have it done by someone with a lot of experience. In Australia I would recommend Dr. Chris McMahon. MG
I noticed a small bb sized bump under the skin just below the head of my penis on the left side. It has been there for approx 1 month. During erection I have no pain but noticed the head of my penis seems to be bending slightly to the left. Again, no pain but was curious if this could be the start of pd or something else? I am a 31 year old healthy man otherwise.
This is more likely to be Mondor's syndrome, which is a localized blood clot in one of the superficial veins. This usually resolves spontaneously. MG
Hi Dr. I was diagnosed with PD a year ago and I had one lump under the top of my penis and indentation. The doctor did not tell me much about it. This past summer I felt pain a couple of times with erection but the pain went away after a few weeks. I have one indentation were the lumpe is and last summer I also hade one indentation on top of the penis, the one on the top is now gone and I discovered a small lump were that indentation was. I decided to talked to my doctor again last week. I told him the story and he could still not tell me much. But he said that the scar could be PD or a "normal" scar healing slow. The first lump was about 5mm a year ago and is now flatter and about 10mm, the second one is about 3mm and has been the same since I discovered it. I discovered the first lump about 4 month after receiving a hard elbow to my penis (Training). I have minimal bend just were the 10mm lump is, the injury happened 18 month ago. I think both lumps has been the same size for at least 3 month and I have not had any problem with erections during this time. I take acetyl l carnitine since september 2012 and I just started to take l arginine, hopefully the indentation will get smaller. I´m 46 years old and train a lot of sport. The only health thing I have exept this is a small scar of Duprenes in my right hand, the scare is minimal and has not changed for worse in 8 years. It´s better now than 8 years ago. What is your opinion of this? PD or not? If PD, is it now stable or can it still get worse? What should I do? Best regards
The size of the lump, the prompt resolution of pain, and the lack of bending all suggest this will probably not be a functional problem, but the fact that you have Dupuytrens in your hand means this is a minor case of PD as those two disorders are closely related. MG
How long from the onset of Peyronies symptoms until calcification of plaque occurs? I first noticed symptoms and felt the plaque formation about 4 years ago, and am now 58 year old. Plaque does not feel hard but may be a bit more stiff than it was originally. Just hoping and praying that I will be a good candidate for Xiaflex once it's approved. thanks Dan
In some patients calcification can be present after a relatively short duration of the disorder, and in others this can take 10 - 12 months. If the plaque is smooth and narrow after 4 years it is unlikely to be calcified, though it would take either a low kilovoltage Xray or ultrasound to know for sure. MG
They say they are guaranteed to add length and girth is there any truth to this? I lost both to P.D.
Traction devices are legitimate (see above) but the guarantees are not. MG
about 10 months ago i was diagnosed with pd and was given verapamil injections for 6 weeks the curvature went away yet now i have hour glass will vitamin e help and is cialis a good idea , as well as a vacuum pump. I still get erection just shorter. What will testosterone do?
Unfortunately testosterone is not known to contribute to the treatment of PD - at this time. Future studies may clarify this. MG
Hello, and thank you very much for your help. When my penis is flaccid, the left side feels firmer than the right. I can't really tell if I feel a lump or not...it's just firmer. There is also a spot on the left where I notice a very slight (almost hard to see) "dent" when flaccid. When erect, the base of my penis is narrower than the shaft, and around this same spot on the left, the width changes a bit more dramatically from base to shaft. About four years ago, I noticed I had some painful erections(and I eventually was unable to get an erection for some time), but I had other medical problems going on then so I didn't make much of it. Fast forward to the present--I am able to get and maintain an erection, I don't have any pain during erections, and my penis isn't curved/bent. All I notice is the firmness on the left side, which I am worried is plaque. One last thing--when I started masturbating (around age 15), I did so from the prone position, usually rubbing my penis against the floor or bed. I stopped doing this once I learned it was wrong, but I've always worried that the time spent doing that caused some damage. I have two questions: 1) I know it's harder without a physical examination, but does this sound like PD? and 2) If I have even a mild case of PD, is it something that's likely to get worse over the rest of my life? I'm 22 now and still a virgin--I don't want to be worried that something I do whenever I start having sex will aggravate a condition I don't even know I have. Thanks again for your help and very informative website.
I don't think you have PD, so future problems seem unlikely. MG
Mid-50s, developed PD approximately 6 months ago after sex-related injury. Cord-like structure formed on left side of penis, extending from base of penis to bend approximately half the length of the penis from the base. Some constriction of girth at this point, along with minor reduction in length. Intercourse somewhat painful with increased sensitivity/premature ejaculation a problem. Other problems include embarrassment regarding appearance and fear of further damage during intercourse (me) and increasing frustration regarding frequency of intercourse (my partner). Surgical treatments described on this web site and others do NOT seem promising. Is there a downside to simply waiting for XIAFLEX to be approved? Or, should I be doing something now to prevent further damage/scarring? Is there a published study describing the XIAFLEX trials, including how effective they the drug has been toward reversing the condition?
There is no significant downside to waiting, though most authorities would recommend getting on a nutrtional supplement regimen of vit E 400 units daily and l-argenine 1,000 mg twice a day to keep things stable. The phase IIb results of Xiaflex were published in the June 2012 issue of the Journal of urology. The phase III paper reflects the largest most comprehensive placebo - controlled clinical trial ever conducted in PD, about 800 subjects in USA and Australia. It confirmed the positive results seen in the phase IIb study, with statistically significant correction of bend (mean angular improvement 34%) and subjective bother scores. It is currently available on line, and is due to be published in the Journal of Urology in July 2013. MG
is it ok to use viagra if my erections are not painful
Yes. Viagra (and the other drugs in this class) have not been shown to be dangerous to use in PD. It's just that their FDA -compliant literature must contain a warning since these drugs were never tested specifically in patients with PD. MG
Developed PD two years ago, awaiting the Xiaflex. There are no solid lumps present more of a strand of something harder along the side of the penis. At the start the penis was shaped as a wedding cake, larger base, then half way up becoming smaller around the entire circumference, leaving it straight, but as I said, looking like a wedding cake. Lately the front side has regained much of it's shape, becoming fuller and has created a slight curve over the entire penis, not an angle and no pain at all. The length seems to have suffered. Is the common in PD or it something else occuring? Xiaflex is currently used to treat other conditions? Why the lengthy approval process, are there downsides? In tests are shape and length impacted? Urologist in the area took part in the test some time ago. Is there something on the market that may treat the condition successfully or just wait for approval?
Diameter changes such as you descibe are commonly seen in PD, in addition to loss of length. Xiaflex is currently approved by the FDA for the treatment of Dupuyten's contractures. The FDA approval process always takes its time, and xiaflex was submitted for approval in November of 2012. There are no other medications on the market that have shown the same results as Xiaflex. MG
I developed Psoriatic Arthritis shortly after receiving a Hepatitis vacination. My Peyronies, soon after that. Could this be related to an auto-immune response, and if so is it possible that my Embrel injections might help? Thank you very much for your website.
I think that is a possiblity, though I know of no published data that answers your question. Perhaps you would be willing to report what if any progress you see with your PD after starting Embrel. MG
I couple months ago I had painful erections. And did notice a small sunken spot on the middle of my penis shaft.I started vitamin E 400iu every day and also vitamin C. I haven't noticed any curve as of today and went to see a urologist yesterday. He said peyronies and didn't aid me in any way other then saying he would have said to take the vitamin e. He said that nothing really works and that 50% of men clear within a year. I can say the pain has gone with erection. My question is if the pain is gone does this mean the peyronies is in the stable stage or can I look forward to a bending of the penis.Also have been looking at a traction device to help.
A fair number of men with bending due to PD have never gone through a painful phase. It usually takes 12 - 18 months for the disorder to settle into a more stable stage. MG
I discovered a lump in the muscle of my penis. it looks like a raised half ring on the right side, (and not going fully around the penis shaft). The raised area does not seem to follow a vein, and does not follow the penis lengthwise. Rather, as i said previously the raised area follows halfway or less around the shaft. When i move the skin up and down, the lump remains in place and does not move. When the penis is fully deflated, it is hardley noticible except for slight discompfort or occaisonal and very minimal pain. When the penis is erect, it is not noticable and no pain. no curvature of penis. When the penis is deflating from erection it is most visable, and the bump is very prominant. Also I have felt a vibrating sensation in the penis, which occurs on and off during the day, some days more often than others. It also feels like the penis muscle is sometimes rigid when in deflation. If I massage lightly the rigidity goes away, although it may return soon after. Will this get worse with sex and or masturbation? Will the vibrating and mild pain go away? will it progress into something worse?
This sounds more like a blood clot in superficial circumflex veins (Mondor's syndrome, which will resolve on its own) than PD. MG
Hello Appx 5 months ago I was slightly injured during sex. I was numb afterwards but no bleeding nor bruising. Injury was not visible. MRI was negative. Dr. Advised to wait and recommended Acetyl L Arginine 1000mg 2X day, Cq10 100 mg 3X per Day and Vitamin B and 200 mg Vit E 3x per day in addition to OMega 3. 1.5 months after injury I saw slight indent on left side yet still straight and NO pain with full erection. Three weeks later the indent was almost gone and slight bend to side was present with full erection, still no pain. A few weeks further (scar visible under skin) and maybe just slightly more bent (barely more though) and still no pain. Forward another month and the scar is visible under skin when erect and is about the shape of a small capsule (like a small herb supplement) but completely flat and cannot be felt (been that way for weeks and has changed little). Still No pain whatsoever and bend has not gotten worse in last several weeks or a month or so. I have had some problems with erection but this seems partially self inflicted from complete disgust with this mentally. IS IT POSSIBLE my problem has begun to stabilize and the bend may not get much worse? Would it have gotten worse by now? Have you heard if warm compresses help or hot baths or should i leave well enough alone. My bend is there but its by no means drastic at this point. Inotice it because it was perfectly straight before, I would estimate it at 15 degrees or so but the scarring is there under skin Thanks
Considering it has been 5 months since the injury and your situation is currently as described, I think it well may have reached a stable point. Not all penile injuries result in PD. MG
About a year ago, at age 63, I noticed the rather abrupt onset of an upward curve of the erect penis--no obvious change in the appearance of the flaccid organ. This has worsened until the curve is now around 80 degrees, and the erection is at least an inch or two shorter than before. No trauma has occurred as far as I know. I do ride a road bicycle with a narrow saddle a moderate amount. I read that beta blockers are thought to be an etiological factor, and I have taken metoprolol for the past two years for my CAD and hypertension. It seems the connection with Peyronie's is unclear. What's the story? And is there hope for improvement if one stops taking metoprolol? Thanks.
There have never been any careful studies of the issue, but the association between beta blocker use and PD has been noted by many in our field. I don't think we really understand the mechanism of this effect, though it would make sense to replace the metoprolol with something else if your cardiologist approves. MG
Have had PD for approximate 3 years. I am 64 years old. Recently I have been experiencing KORO which is most annoying not to mention dealing with PD as well. My question is ..are the two related? Does having sex lead to the Koro due to my bend? Have an upward 35-40 percent curve. Have read some sites that say the Koro is psychological . Is there a treatment or anything out there to help with Koro?
It is my understanding that to diagnose Koro (obsession that penis is shrinking), one must first undergo a physical examination to rule out physical causes of penile shrinkage - such as Peyronies disease. If you have peyronies, the shrinkage is probably real, not in your head. MG
Dear Doctor, I am a 21 years old man, healthy, no pains during erection or ejaculation. I have 40-45 degrees upwards congenital penile curvature (starts at the middle of the penis). I haven't had sexual intercourse yet due to this embarrassing situation. My penis's girth is about 4.7 inch, the length while curved up, measured straight from the basis of the penis from above is about 6 inches. Length while stretching the penis to a straight pose is about 6.5 inches. My questions are: a)Since I haven't had sexual intercourse yet, will this curvature, taking into account the girth, length and the upward curved, be painful for the woman? Will I have penetration difficulties? Will I be limited in some positions? -- This is extremely important to me, and I would appreciate your answer according to other people's reports with the same characteristics of my problem. I have read about the Nesbit procedure, and in with regard to it I have some questions: a. Is it really considered a relatively easy and safe procedure? b. What would be the expected shortening, if I choose to undergo it according to my characteristics and your experience? c. The expected shortening is from what? I.e. since the penis is curved up, there are different measuring results depending on how one measures it. Because if in Nesbit, the long side is shortened to match the short side, then will the post-operation measurement will be as if I am stretching the penis today to make it straight while erect? Thank you for your kind help.
With a 45 degree upward bend, some partners may be uncomfortable and some positions will be restricted. Length loss with a nesbit procedure for this amount of bend would be around 1/2 inch - the postoperative condition would be similar to what you would see now by stretching the flaccid penis. The nesbit is usually uncomplicated in experienced hands, though occasionally it can produce areas of indent, or less that perfect angular correction. MG
Hi From.the UK i have just been diagnosed with pd by a urologist who recommended potaba however my gp was reluctant to prescribe it because its not known to be very effective and it means taking around 16 tablets per day. I am getting pain with erection and have been for a few months but i am just noticing a slight curve. Would you recommend to use potaba or something else such as vitamin e which i have seen mentioned here? Also is there anything to do to help the pain and how long will it last? Can getting regular erections help to lessen the pain and effects of pd? Lot of questions here i know which have probably been answered but this page is so long! Thanks
some day I would like to break the page into searchable sections for ease of use. Basically, Potaba is not an unreasonable option if your stomach can take it. Most of the remedies for PD are not all that helpful with the pain, so using ibuprofen before sex is a consideration. fortunately the pain will eventually resolve on its own. Mg
In May 2008 I was diagnosed with peyronies, (photo evidence) Right after that diagnosis my PSA started to increase. It is now at 6.52 I had a prostate biopsy done 12 sections i section came back endocarcinoma measuring o.2 mm in length and 1 cm to the linked end. My question was peyronies linked to my prostate cancer?
there is no known connection between PD and prostate cancer - though patients who have undergone surgery for prostate cancer have a slightly higher incidence of PD. MG
I went to a urologist and he was puzzled over my case. I've had penis pain for almost 7 months. My penis always hurts and burns down the left side, and I am curving more to the left when flaccid, but when fully erect there's no curve. The penis burns along the whole left side whether erect or flaccid. It seems like a clear cord runs down the left side, along with a big blue vein. Is it possible to injure this white cord or blue vein, so that it hurts for 7 months, or is this the acute pain phase of Peyronie's? Help would be greatly appreciated.
This does not sound like PD to me. If you've had any kind of skin breakout in the area I would suspect shingles or herpes. MG
Thanks for the excellent forum everyone. I've just been diagnosed with Peyronies, which came out of nowhere about 4 weeks ago. I'm 32. No overt trauma though my wife can be very small at times and some positions can pinch a bit. Penis is painless unless erect, where pain is located at the lump and sharp bend in middle of my penis. Rather than a slow curve I seem to be more kinked and pointing up suddenly, though the angle is maybe only 15% or so at present. I have a large firm lump about the size of two peas stacked on top of each other, shaped like one of those long pills you take sometimes. But rather than being on the top of my tunica albuginea it runs straight from the top vertically down through the tunica albuginea's septum, ending almost near the tissues surrounding the urethra (straight down through the center of my shaft perpendicular to the erect penis). Ultrasounds were difficult due to the location of the lump, and while traces of calcification and fibrosis seemed to be evident, they were not in abundance for such a large lump (though cancer was ruled out). I felt I was diagnosed on symptoms rather than imagery of a typical plaque. My question is about the size and location of my lump, is this typical or common? to be a dense lump going through the septum rather than on the outer surface somewhere? About 12 months ago I had some benign cysts found on the surface of my testicles but they were no cause for alarm, quite common they said. Thanks for your input, I can live with Peyronies but at 32 and with no onset and an oddly positioned lump I'd like to keep my options open! :)
What you have is plaque involving the intercorporal septum, which is not terribly unusual. If the bend is very well localized into a small area this implies there is less tunica fibrosis which bodes well for eventual healing. MG
I have been using a quad mix injection for ED for about a year now. I recently noticed what appears to be Peyronies Disease. My erection bend severely upward near the head. Based on a small amount of research that suggests scar tissue or internal bleeding may be a cause, is it likely that the injections on the side of the penis may have caused this and if so, is it possible that it will get better over time?
We do know that men who use intracavernous injections are at increased risk to develop PD. It may be a good idea to hold off on injections for a while. MG
My boyfriend has Peyronies. Do stretching/traction devices help? Can manual manipulation/massage/stretching help correct the curve and gradually reduce the pain/
Preliminary research suggest stretching devices can help. They need to be used on a regular basis for several months. MG
I am a 26 year old male recently diagnosed with Peyronies. At my first visit, the Dr. recommended we start a trial of Verapamil injections on 1/25/2013. What would be more benefical- begining treatment with Verapamil now or wait the possible 6 months-1 year for Xiaflex? My problem is less about curvature and more hourglass deformity and pain near the base of my penis.
A course of verapamil now will not interfere with the use of Xiaflex in the future, should it get FDA approval. As there is little downside to verapamil, it may be a consideration. MG
Will implant surgery restore the 2.5 inches I have lost with PD or will the implant simply help girth and the curve? My curve is slight, but my length and girth loss is great. Also, is sensation and organsam the same with the implant? In reading the forum, I know you have said the successful PD treatment (including Xiaflex) rarely restore length. Thanks so much for your time. It is greatly appreciated.
unfortuntely implant surgery will probably not restore lost length. Sensation and orgasm should not be significantly altered after implant surgery. MG
I've been diagnosed with "it". Will penis traction stretching work to help the curve? How about Vacuum devices used several times a day for several weeks?
While these haven't been tested extensively, there is evidence that use of a stretching device for 2 hrs per day for 4 - 6 months , or the regular use of a vacuum pump may improve curvature due to PD. MG
64 years-old; 5'9", 150 lbs. Healthy hair, no gray to date. Strong build, never broken bones, except for arthritis related hip issues, addressed below. Weight variation negligible since being "grown", at approx. 18 years-old. Never an erection problem, very active sex life, with no issues of any kind, since becoming active in early teens. Participated in all major athletics. In April of 2012, I was shocked to see a sudden 55-60% bend to the left in my penis. There was no indication of any issue a month to six-weeks prior, and there has been no trama, whatsoever, during my life. I am healthy, although I have had 4 total-hip surgeries, (2 each side), beginning with the left in 1996, right.-1999, left 2010, and right 2012. Due to a lifting injury, I have had 3 lower vertebra fused, 2009. I have had gout since graduate school, (1971), which necessitated the removal of the left side of my right great toe, and subsequent reduction in length of approx. 1/2 ", (2007). No further flare-up since the surgery, except after total-hip, 2010, I had a larger build-up of tofi which when "lanced" drained and did not re-appear I returned to work within a week of total hip(s), with the only noticeable effect of absolutey no pain after 30 days. This is extremely embarrassing, and depressing. The bend is now perhaps 65-70%, but has not increased, nor decreased, noticeably since May 2012. I discussed the "condition" with my primary care physician in May, at which time he referred me to a well-respected urologist here in Memphis. His advice, come back in six-months. I have an appointment in 3 weeks, but cannot imagine what he could add. There seems to be little if any advice, hope of treatment, explanation of how it happened, not why. The only generice contributing factor of which I am aware is my blood type is A+. I have great insurance, and even if I didn't I could and would pay for any treatment that had a reasonable chance of correction. Have you any advice? If it matters, I am 3 hours away from Vanderbilt, where there seems to be a source of deep resources on may medical problems.
We may never really know how or why you developed PD, this is often hard to explain. Xiaflex is a new drug, potentially effective in your situation provided the plaque is not calcified. At this time it is being reviewed by the FDA, and would not be expected to get approval until this summer. It might be a good idea to get an exam and opinion from one of the urologists at Vanderbilt. MG
I've had a burning pain in the left side of my penis for 6 months. I can't seem to find the exact spot of the pain. I went to a urologist, and he said the penis looked and felt 100% normal. He said the only reason I'd have a burning pain in the side of my penis for 6 months is Peyronie's. Then he told me to take two 400 UI of vitamin E a day. Is it possible this isn't Peyronie's? I have recently gained 20 pounds and I sit for about 10 hours a day. I wonder if those are factors to consider...
It is possible that Herpes could cause a persistant burning pain, but it would not be expected to last that long, and would probably be associated with some type of skin breakout. MG
Is traction generally considered safe as a peyronies therapy. What would you recommend. Afraid to do anything that might cause another flare up, or worsen condition, but also would like to attempt some form of therapy.
Yes it is generally considered safe if not used to the point of causing discomfort. MG
My husbands penis has always had a normal upright erection. Suddenly the past 2 times of erection. His penis is literally bent. Bending so drastically that when you try to move it. it as a hinge like effect. It bounces right back into the bent position. Like a complete L shape. Almost trying to make a U shape. What is happening. He is 46 yrs old.
This certainly sounds like Peyronies. I would suggest he see a urologist with experience in this area. The Physician locator in the links section of this site may be helpful. MG
I noticed a distortion in my penis about 14 months ago, although I didn't recognize it as PD so ignored it. The PD progressed fairly quickly, the plaque size stabilized and is no longer painful but has left a bend of approx 70-80 degrees when erect. I'm 52 & don't really have a sex life so wasn't too bothered (although going to the toilet at 7am has been occasionally a challenge, but I am now having second thoughts as it is making me feel a little 'past it'. Is it worth going to see my doctor still?
Yes, it is not too late to look into treatment options after your doctor has confirmed the diagnosis. MG
1. Peyronie's disease is characterized by a plaque, or hard lump, that forms within the penis. 2. In severe cases, the hardened plaque reduces flexibility, causing pain and forcing the penis to bend or arc during erection. 3. The plaque itself is benign, or noncancerous. It is not a tumor. Peyronie's disease is not contagious and is not known to be caused by any transmittable disease. 4. Treatments for Peyronie's disease include oral medicines, injections, and surgery. 5. Medical experts suggest waiting 1 year or longer before attempting to correct Peyronie's disease surgically.
I agree. MG
I am a 65 years of age and live in the UK,I still have a very active sex life, well did have until I was diagonised with Pyronnes about a year ago, at which time my urologist told me that as I was in no real pain to defer any treatment for a further year to see how it progressed, as it has appeared to have worsened he is now arranging for me to have ULTRASOUND treatment which he has said will be over a 3 month period. On looking at the post on your forum, I cannot recall this treatment being mentioned, and whereas I am grateful that my treatment will be funded by our NHS service, would appreciate your comments on Ultrasound treatment. JH...UK
Ultrasound treatment has been used in the past for PD, and it is certainly safe. Most centers no longer offer it however, as it was not very effective. MG
Hi, I have had a case of peyronies pain without deformity. It cleared up. I recently used a rubber cock ring that was a little too tight even in a flaccid state. I only wore it in a flaccid state, and took it off after a few seconds because of the discomfort, like pinching. There was no bruising. What is the likelihood that it could reactivate any peyronies if I only wore the rubber ring flaccidly and for a few seconds? Do mild pressure injuries reactivate peyronies? Thanks.
I don't think this would re activate your PD. MG
Hi I am 17 years . I have been excessive musterbating 2 times a day until one day I noticed a narrowing at the shaft of the penis . Now when semi erect it has hourglass shape but gets to normal when fully erect . Iam worried if anything is wrong . Pls answer asa possible
A normal erection with hourglass configuration when semi erect does not suggest anything to worry about. MG
Hello, I had a few questions about measuring penile curvature and the tolerance of curvature in the vagina. My first question is how one is supposed to measure the curve - I've been measuring by placing the protractor as far back into the base of my penis of possible without pushing into my pelvic area, centering it, and measuring to the center of the head. Is this the correct way to measure? If not, how? My second question is how much of a tolerance for curves can a vagina handle. When I measure my curve, it comes out to be somewhere between 30 and 40 degrees to the left, and it does not curve up or down. What is the tolerance for penile curves in the vagina, and will I experience any problems with penetration? (I'm a 16 year old virgin). I'm not certain that I have Peyronies disease, due to the lack of any plaque or bumps that I've ever felt, and because I've had my curve since early puberty. Could TMS (Traumatic Masturbatory Syndrome, I was a bed humper) have caused my curve? I've had no problems achieving or maintaining an erection however, the curve is what concerns me. Thanks for your time, A worried teen
It sounds like you simply have congenital curvature, which occurs when one corpus cavernosa (the right in your case) develops slightly larger than the other causing curvature away from the larger side. You can just take a cellphone picture and measure it with a protractor. Generally, curvature less than 45 degrees will not cause vaginal pain. MG
Have been diagnosed with PD due by urologist. Not ba so far but now the head of the penis seems tp psometimes swell and be very tendr. Is that also part of PD? Any treatment? suggestions? Thanks!
Swelling and pain in the glans is not usually part of PD. MG
Thank you Dr. for replying to my question regarding colcrys and calcification. However, I am now now concerned as I am taking generic Lipitor which is a statin in addition to the colcrys. I informed my Doctor of this at the time he prescribed the colcrys. Is there a problem with interactions between these two drugs? I feel fine other than having peyronies. The plaque does not appear to have hardened over the past several years, and I hope that it will be treatable once xiaflex becomes available. Thanks, Dan
Rarely colchrys can interact with lipitor and produce rhabdomyolysis, a damaging inflammatory condition of muscles. This causes severe muscle aches and really makes you feel sick, so if you have been on the two drugs for a while and are feeling fine it probably isn't a concern. MG
Further to your last reply to my original question regarding Verapamil injections, I think that 65-70% success isn't bad at all. What might an individual realize in terms of percentage of correction? What is the frequency of theses injections, if it is more than one? Is this painful? What is the cost? Is this something that you can provide to me in your office? Thank you MG, I really appreciate your time
Verapamil injections are given once every two weeks, usually for a total of 6 injections. After the 12 week injection course has finished, we re evaluate patients 8 weeks later as the effects take a while to be seen. If there is clear improvement at this juncture, we may reccommend a second course of injections. They are given after a small dose of lidocaine (local anesthetic) and are not painful. Typically patients who respond will loose 20 to 40% of the bend. The cash price for doing this in our office is $185 per injection, though most insurance companies cover the treatment. If you need to reach our office please use the contact link in the site. MG
I'm 64 yrs of age. Have between 30-45 degree bend up. Had this for 2 to 2-1/2 years. Will Vitamin E and I Argenine help or is it too late? Also, would you please comment on Verapamil (sp) injections. I tried a Verapamil topical and could not deal with the itching it was causing. Thank you so very much.
After 2 1/2 years, neither Vitamin E nor l-argenine are likely to change the bend. Verapamil injections definitely have a better track record than topical application, though 30 - 35% of patients will not experience much improvement. MG
Hello, I'm a 72 year old married male and I had Prostate surgery 3 years ago at the age of 69. After the surgery everything was fine in terms of erection and intercourse. I said to myself, I can live with this with this situation. My erection was good and intercourse was also good. After about a year and a half after the surgery I developed peyronies disease. My penis bends down rather severely and intercourse is almost impossible. My wife and I try to fine a semi workable position which most of the time doesn't work. It's a very frustrating thing for both my wife and I. I don't have any pain. After the surgery my doctor recommended using the Pump which I did use for about a year. I don't use it any more. I have had 6 Verapamil injections from my urologist which have not worked. He suggested implants which I will not do. At this point I'm not doing anything. Would you have any suggestions that I might try? Thanks.
Peyronies disease is more common after radical prostatectomy. If your erections are working well, your downward bend prevents intercourse, and medications have not helped, you may wish to consider a Nesbit plication. The risks would be shortening of the penis, and a chance of sensory reduction due to placement of dorsal plications. Xiaflex, which is currently in FDA review, might be an option in the future, though clinical trials with this agent excluded downward bending for safety reasons, and it could well be mid to late 2013 before this is available. MG
56 year old with PD for about 7 months. Is there anything I can take besides vitamin E that would help relieve the bend? Also, how can I join a study for experimental meds?
The other oral supplement that may be of help is l-argenine, 2000 mg daily. I don't believe there are any open clinical trials with Xiaflex at this point. Dr. M. Khera at Baylor medical center in Houston has been conducting clinical trials with other agents - you might check on clinicaltrial.gov. MG
I'm 30 and have been reading about peyronies. I have a very slight downward curve, been there for years. Will masturbation harm this or make it worse? Would the frequency of masturbation (I.e. Twice a day make a difference) kind of has me worried.
Masturbation will not cause a problem, provided it doesn't hurt or traumatize the under side (shorter side of the curve) of the penis. MG
I have had pd for ~4 years and am 58. My Dr prescribed colcrys about 5 months ago which I continue taking. Does this make sense? Is it safe to keep taking this until I can get the xiaflex collagenase treatment? What is calcification and will it block xiaflex efficacy? Thanks Dan
that makes sense if you have no intestinal problems with the drug or are currently on statins for high cholesterol. Calcification refers to small areas of bone formation within a plaque. If they are large enough, they may limit the use of Xiaflex as this agent will dissolve scar but not bone. MG
I am 24 years old unmarried guy and never had sex in my life and masterbate 10-12 times a year roughly!!I had a nighfall and was awaked with a painful erection(second erection after nightfall) and I thought this pain will go within some hours but its been 50 days now I feel pain during full Erection and some times when penis is not erected. To check, i masterbated and the enjoyable feeling was good but rubbing of penis was weak and felt some pain and i ejaculated without pain and with good feeling!!after ejaculation,first 8-10 hours, I had severe pain in my penis and slowly pain got reduced.I constantly feel pain/ache(not that severe pain that came right after masterbation) and pain during full erection!!I dont feel pain while urinating!!I went to a urologist and my urine test etc was clear and he didnt understand my problem and rather suggested me to get married!!but i am very worried!!What is the problem and immediate solution!!Reply soon plz!!
pain in the erect penis without bending raises the possiblity of early PD, so starting on Vitamin E 400 units daily may be of help to stabilize the situation - until you get a second urological opinion. MG
I am now 64 years old. About 7 1/2 years ago, soon after climaxing from oral sex, my penis was held between the base and the testicles and squeezed progressively harder for several seconds, whereupon I felt a sharp pain below the base in the front chamber or corpus spongiosum and immediate congestion of the area. I tried hot showers, DMSO, massage, etc. over the next number of months; after eight months I went to a urologist I'd seen a few times for prostate exam and blood tests but he was dismissing it before even examining me and you could only detect the problem if I was erect or semi-erect, so he could find nothing. Soon after I went to a second urologist who, after a more thorough exam, diagnosed that I had had a rupture of erectile tissue at the base of the corpus spongiosum and said ultrasound wouldn't be any help, there is no treatment, it takes about a year to soften up, be happy. After seeing him several times over the next year and asking him about the prognosis, because it wasn't much better, he didn't respond, so I stopped seeing him. A couple years later I saw third urologist who had me lie down for the exam but didn't find anything – when I told him about the previous diagnosis he said maybe I had a slight tear, just don't do that again – very dismissive and infuriating. What this injury has done is to cause a swollen and overly sensitive area below the base of the penis in the corpus spongiosum and a weaker deflated area above it on the bottom half of the corpus spongiosum, so that it feels like my penis is divided into two parts and the energy, blood and feeling doesn't flow continuously across the blockage at the base. Erections take longer and are harder to maintain and it feels like someone else's penis when I'm masturbating. For several years I would have to pull my testicles out when I sat down because there wasn't enough room and I felt I felt pressure in my groin when I walked around. Although I can maintain an erection during intercourse, the orgasm is slowed down and when I masturbate instead of shooting out a foot or so it most often dribbles out. There was a period of a couple years after it happened when it hurt when I had an orgasm during sex but that passed. I may have caused additional damage in my attempts to manipulate, massage, and even out the feeling. I previously had no issues with erections or PD. I had already taken a lot of supplements for many years before this such as vitamin E, coenzyme Q 10, ginkgo biloba, B vitamins, and minerals, etc. but not arginine or acetyl L carnitine because they overstimulate me. I recently tried serrapeptase for a couple months but it didn't help, may have made it worse. I occasionally use infrared light or DMSO. Any suggestions you have would be appreciated. Thank you.
It sounds as if an examination of the erect penis (done after a vasoactive intracavernous injection) might be helpful in identifying the long term effects of your injury. MG
62 years old, pd for at least 3 years, decided to do something about it. before surgery , had lost some girth and length, but still at least 5 inches, good feeling,used the pump,worked good,increased size, but did not take the curve out, masturbate, no problem. no pain ,30-45 degree bend , right below head of the penis.backwards to the body. had the local urologists perform, the stitch surgery, uncircumcised, after surgery was a question mark, more bleeding than normal, a lot more swelling than normal, all the surgeon had to say was, he had to do something different, and stop short of saying any thing else. very few words were spoken, no remarks on the surgery, had to wear a bag home. six weeks later, i have to sit down to pee, too much skin in front of the penis. the head would not go through the skin. i thought that holding my length back.hardness no problem. second surgery,circumcised and another stitch. four weeks later ,healing well, but all of a sudden , i noticed, hardness, good feeling, but something had gone wrong with my length,it feels like something was holding it back and it still does, i may have two inches. I lost over three inches, i can't do any thing,too small for anything. doctor says that's what you had before, which is not true. i was told before surgery no loss of length. then he says , well i could take the stitches back out , to see what that would do. then he says , try the pump for 4 weeks and come back to see me . i tried the pump, penis doesn't move. everything fine except the length. feeling, hardness is good etc. he look like he was guessing on taking the stitches out. what do i do ?? second opinion ?? i am located in little rock arkansas, this driving me crazy! resconstructive surgeon ? please help
I think getting a second opinion from a reconstructive surgeon with particular experience in Peyronies work would be a good idea. There is a physician finder link in this site that should help to locate someone in your area. I know there is good group at Baylor Medical Center in Houston. MG
I am a 21 year old male. I was diagnosed with peyronies and I have a curvature of about 45 degrees to the left. I have had the curvature for about 5 years without it getting better or worse. I recently went to a urologist for the first time for treatment. he has me taking 1000 mg of vit-E a day and massaging the scar tissue daily to see if it will resolve itself. I've done this for a month with no improvement. also, the curvature causes my girlfriend pain during intercourse and it also makes me feel very tender on the right side (due to the increased pressure and friction). this is starting to damage my relationship with this girl, but the urologist seems to want to be very conservative with treatment. what advice can you give me? what would the best treatment options be for me?
If your condition has been stable for 5 years, it is unlikely to get better with vitamin E. Based on your age I wonder if this condtion, first noticed at age 17, was truly Peyronies or if it was worsening of a congenital bend (curvature that had been present since puberty). If that was the case, a Nesbit Plication by someone skilled in this field would be the answer. If not, and if you have a hard lump or plaque in the curved area, you may want to wait and see if Xiaflex is approved by the FDA, as this biologic agent appears to hold promise. MG
Healthy fit 60 year old vegan in a thirty five year relationship with my wife. Condition began a little over a year ago. About a 30 degree upward bend. Lost one inch in length. At first I had some minor pain during erection at the bent area, but none in the past year. Got one small drop of blood at first, none since. Base of my penis has deformed or flattened some during erection. The odd part is where the bend is, my penis when erect has a "hinge" effect that allows the penis to flex slightly when erect. Can feel some firm areas above base when flaccid but no pain. Sex continues to be excellent, no organism or erection problems. Does this all sound like Peyronies? All seems stable and would give up sex before considering surgery. Any reversal possibilities? Supplements? What a great service you provide with this website, thank you.
A hinge effect due to narrowing is not uncommon in PD. If you are careful not to bend the penis and it doesn't interfere with intercourse, it can be safely left untreated. You may want to consider supplements such as vitamin E 400 units daily, l-argenine 2,000 mg daily or acetyl carnetine. If your sexual function remains good, there is probably nothing further that you need to do. MG
I was operated on for serious Peyronies, 90 degree curvature to the left. This required a bypass of the left blood vessel. To do this there it required a incision around the glans to pull back skin to do the bypass as I understand it. This resulted in loss of sensation to the glans area. I was told this would correct its self after a few months. It has been several years now with no return of sensation in the glans. I cannot feel anything inside my wife's vagina during intercourse. I used to be able to wiggle the glans by finger manipulation, with no stroking of the penis and have an orgasm. Today the only way to orgasm is to watch porn, which is fake and totally boring, but sometimes I find an act that is a little exciting, but then it takes up to an hour to orgasm and the penis must be stroked at an extremely fast rate along with total concentration and imagination on the fantasy. I don't believe there is a remedy?
If there has been little return of sensation after 2 years, you will probably need to identify other erotically sensitive zones on your body, or consder the use of a vibrator. MG
Four years after diagnosis( with apx. 30 deg. bend ) and trying different treatments with no improvement I believe length and diameter are worse. Is this in my minds eye or is it possible.
This is not just in your perception - unfortunately physical length and girth loss can occur with PD. MG
I am 53 years old and in good condition. I have developed all of a sudden a pronounced bend (maybe 30 degrees?) at the top third of the shaft, and my penis is noticeably shorter when erect. No pain. The bend recently appeared, but for six months or so before that i was experiencing softer erections, and difficulty in staying erect. Then the ED symptoms seemed to go away, but were then followed by the development of the bend. I would like to reverse this before the scar tissue gets to old. The first urologist appointment I could get is inFebruary. Is that too long to wait? Do I need to get on therapy now?
Waiting a month or so is probably not a problem. Not everyone responds to medications for PD, but when they are effective it is usually in the earlier phases of the disorder. MG
My urologist diagnosed me with early Peyronie's. He has recommended that I take Vitamin E and daily doses of Cialis (5 mg). He said the Cialis will give me erections in the night that will keep the blood flowing to the penis, delivering oxygen, helping with the healing and reducing plaque buildup. Is what he says about the Cialis correct?
There is no good controlled clinical trial evidence that cialis helps peyronies disease, but there is rationale to use it and many urologists are doing so. MG
I am 65 and developed about a 40-45 degree curvature to the left about 15 years ago. I was told it was peyronies, but my urologist tells me every time I visit and have exam that he has never been able to identify a "spot" or "nodule" to locate the area precisely. In the last year or so, I was told I have Dupetrins(sp) Contracture as well. I have an issue on my right ring finger. If this isn't Peyronies, is there something I could be doing to improve about my erectile condition?
If you have Dupuytrens contracture in your hand, this bending is almost certainly PD. Somtimes a "spot" or plaque cannot be felt, only a linear scar or cord that can be identified by stretching the penis. MG
I've had PD for about two years, my case seems to be a bit different I have found three lumbs and have three curves, up, left and right. I'm taking Pentoxifylli L-Arginine amd E with no results. I've been thinking about trying a traction devise but have heard sometimes it can make the PD worse is this true? I've lost over and inch in length and afraid to lose any more. Will it give me the length back I once had? If they are helpful what traction would you recomend? I've read something about a new medication that may be approved will they treat all curves or do they have to be a certain degree of a curve to treat? The reason I ask is my curves are hard to judge because they work against each other. Thank you for this forum its very helpful!!!!!
Early reports indicate that using a traction device more than 2 hours per day can help to straighten the penis, though many patients cannot accomplish this. The new medication currently in FDA review, Xiaflex, may be worth waiting for as our studies have shown it is effective in reducing bending. MG
Hi, About 6 months ago i have notice a small dent on the right side of my penis about 2 centimeter down from the ring's head. It is not causing pain when having erection or sexual activities but i am wondering if i should consult right away or simply wait and see if my condition worsen, i am in total darkness regarding the evolution of this condition and somehow nervous of what might be in store for me when looking at pictures of more serious conditon on the internet but at the same time feel a little embarass to consult if my situation is not that serious at the moment.
Some authorities feel vitamin E may stabilize this process, so taking 400 units daily may be a consideration. If on this regimen you notice no further progression, it would probably be safe just to observe it for the time being.MG
I am 43 years old and have had peyronies for about 2 1/2 years. Started with one scar on left with little painand a small bend. Then about 8 months later after sex one day with my wife I started to have pain and noticed new scar on top and right side. I have been on pentox and vitamin E. since then. The right scar with the left has made me shorter but straight. My wife and I have oral sex and are safe. I have 2 questions. First is I have erections most of the night. Almost everytime I wake up I have an erection. They go away if I wake up completly or go to the bathroom. This has been happening since this started. Can erections that last at night like this cause damage? Second question is over this 2 1/2 years it seams that my peyronies will not stablize. Could this be because of the night time erections? Thank you!
Night time erections are normal, and are not likely to contribute to damage. A small percentage of men with PD may continue to experience changes in their disorder beyond the 18 month point where most patients stabilize. MG
I’m 42 and developed peyronies in early 2006 as a result of minor trauma due to rough sex and recreational Viagra. My bend is very mild, maybe 5 degrees left at the glans, but I have a bigger problem. I have lost sensation at the area right under the glans where the plaque has developed. During an erection it used to be very sensitive, throbbing sensation, but now it is very dull. I don’t believe the nerves are dead because I can still feel pain, of course, if I push hard enough on it. Do you think Xiaflex Collagenese will help my situation? Even a little restored sensation would be better than nothing. Let me clarify that the glans themselves are still very sensitive. It’s the area just below the surface on the topside where the plaque resides that feels dull. Hopefully that is an accurate description.
We don't have any data on this from our recent clinical trials, but I can tell you I had one patient in my collagenase clinical trial at UCLA many years ago who had sensory loss that improved with this treatment. MG
Hi. I'm 31 years old. About two years ago I started experiencing health issues that I'm wondering could have caused PD. The health issues began when I had pneumonia. Shortly after I started having intestinal issues. The intestinal issues lasted for about a year and a half during which time a regular bowel movement was rare. During this time I began having discomfort in my penis and rectum (which was discharging). As of now my intestinal problems have gone away but I still have discomfort in my rectum and pain in my penis has increased along with the curvature. It has become very obvious this is PD. The curvature has become very pronounced and I can feel the plaque. Having sex has become very difficult and even when flacid my penis can be quite painful. Is it usual for patients with PD to have other symptoms?
No that is unusual. I often tell patients that PD is not really a "disease", because other than dupuytrens contractures of the hand, it is unrelated to other internal or medical issues. MG
Hi I am 17. Have always had some degree of left congenital curvature, but noticed about 1-2 months ago that it became more severe (at least doubled)I would not associate this with any injury unless it happened without me realizing it. The right side curves smoothly however there is a distinctive point on the left side where the bend occurs. It is hard to estimate the degree because a curve does not line up with a protractor but I would estimate between 30-40 degrees. I can not feel any plaque when flaccid,and the curve is visible while flaccid but this could be the congenital curvature. While erect, I can feel an irregularity (inward fold, narrow ~3mm) in a on the left side bend point but this could be related to the bend itself, not a cause of the bend as it is narrow and not present while flaccid. Could this recent gain in curvature be peyronie's or can this happen with congenital curvature as well. Should I see my doctor?
This can happen with congenital curvature, as the concave side is vulnerable to increased tissue stress during sexual activity. It would probably be a good idea to see a urologist. MG
I have been diagnosed with PD on 29/09/2012. First noted a lump 3/4 way down. Have since onted a curve. My doc said it's 43 degrees. No rela pain in erection but since have had some mild pain when flaccid. I am on Trental (since 10/10/2012 now on 4 tablets) - L-arginine 3g (last 5 days) L-Acetly Carnitine 1g - low dose Vit E - CoQ10 300mg. My doc suggested verapramil injections and traction. Will start early next year as I have a planned overseas trip. I have applied some soft manual stretching - but this has caused mild itchy type pain on my penus. Not sure if traction will help as I am not sure what stage I am in. Doctors who I have seen have mentioned: Urologist 1 believed 6 months old condition - said to come back in 4 months --- Urologist 2 said 6-8 months condition - said to come back in 6 months and suggested VED - Doc 3 noted two nodes - and said it was a mild case -Trental might help and recommend L-Acetly Carnitine and come back in February. Doc 3 suggested Trental 4 per day - L Arginine - Traction and Verapramil Injections. He meassured the angle and gave 43 degrees. I had tohught it was more like 30 degrees but I might have measured wrong - or it might have worsen. I have bought the traction device should arrive this week. But not sure after getting the mild pain manually with gentle stretching. Not sure either how to measure properly the traction device. The guide takes about the length of the stretched penus and add 1 cm. But is the stretched penus the length of an erect penus or what? I have has sex with care - which was still pleasurable - so I don't know if the mild pain I am now getting is because of this or because of the gentle manual stretching. This is certainly a frustrating condition - I only wish there was an EFFECTIVE treatment. The fact of not knowing how it will progress - is probably the hardest. Your comments will be valued. Thankyou
The different recommendations you have received underline how responses to the various therapies (including traction) can differ. The released top-line data for Xiaflex are quite encouraging, and it was submitted to the FDA for approval just under one month ago. My opinion is that in many cases this new drug will prove to be more effective than some of the remedies you have mentioned, but all the options you have been given are reasonable and I would follow those for the time being. If traction hurts you need to back off the tension. MG
I have recently found a small hard bump on the tip of the corpus cavernosum near the head of the penis on the lower side as it joins up to the corpus spongiosum. It is stationary and about the size of a grain of rice. Had a pinching injury 2-3 weeks ago with clothing getting bunched up in a sitting position. No pain until sex and now have a mildly irritated feeling (just minor soreness) Could this be related to PD or something else?
PD usually takes much longer than 2-3 weeks to develop, so I would say this is some kind of transient response to trauma - it will probably resolve on its own. MG
About a week ago I was having sex in the "cowgirl" position when my penis slipped out and my partner didn't realize it. She came down on my penis which caused some pain and we stopped. Over the next few days we had sex a couple more times without much pain, although we had to go slowly because I was slightly tender. A few days later I looked into the mirror and my penis that was already slightly curved previously looked more curved, also there seems to be more of a "bend" shape than a curved shape with the point of the angle being near the base of my penis. I went to a urologist and talked to him about what happened, because I was concerned about developing Peyronie's disease. He didn't seem to know much about what Peyronie's was and was only really concerned about whether I suffered a fracture. Over the last few days, since i went to the doctor, my pain has worsened and I feel a hardness on the left side of my flaccid penis. The parts that feel hard are also tender to the touch. Is it possible that the trauma has lead to the beginning stages of Peyronie's in only a week or is this all a response to trauma? Should I be taking L-argitine and Vitamin E, in case Peyronie's is developing? I am only 16 but I was already getting treatment for erectile dysfunction which my urologist is not sure of the cause of, for which i was taking 15mg Cialis as needed.
The short time span since this began suggests it is probably not PD. It probably wouldn't hurt to take the vitamin E and l-argenine for a couple of months anyway. MG
Two days ago, my husband and I were having intercourse in the morning with me on top. I was using a lot of friction and force when he accidentally slipped out and I came down hard against his penis with my inner thigh. His erection started to go down so I began to initiate oral sex to "get things going again" but he said that it hurt. We inspected everything and there was no swelling, no redness or bruising, no bending, no popping noise. The only issue was tenderness in a pin point area on the right side of his shaft about 1/2" below his glans. I palpated the area and it seems to be a very small area where tenderness exists only when directly pressed upon. He said he thought he'd be fine by the evening and wasn't worried. The next morning,24 hours later, I woke him up to gentle oral sex (no manual stimulation) just to see how things were going down there. He said his penis was still tender to oral stimulation but that oral sex felt great. He easily achieved a full erection and was able to ejaculate. Again, no swelling, no bruising, no bend or curve, and no urinary issues. Then, later that night (about 30 hours after injury) he complained that he might have a "bladder infection" because it kind of hurt when he started urinating. I expressed that this was not normal and that I was concerned. He said that he felt "achy" everywhere including his butt and his scrotal area. Nothing major, just achy, and he had no idea why his scrotal area was now tender. The next morning, around the 48 hour mark, he woke up and said that he felt totally fine. I wasn't convinced because I felt he was just trying to avoid the doctor visit that he knew I'd make if he wasn't miraculously better. He insisted that he was totally fine now so I asked him let me inspect the area again. I did so, and again, there was no swelling in the scrotum or penis, no discoloration, no nodules, bends, etc... Everything looks normal. I then decided to test things out and initiated oral sex. He was immediately able to get a full erection and experienced a lot of pleasure from the act. He did not ejaculate, however, which is atypical. He said it was because he was distracted by the fact that he had to leave for a meeting within 15 minutes and felt pressed for time (again, him not ejaculating is strange). I was trying to be gentle at first and asked him several times if he had any discomfort at all and he emphatically said "no" that it felt great and that he didn't want me to stop. So, I started to use my hand over his shaft to give him the stimuli/friction he needed. I also gently kneaded his scrotal area and he had not problems with that at all. Again, he was loving every minute of if and indicated no discomfort at all- in fact he was really into the whole thing. Immediately afterwards, he said that his penis felt tender and sore and that I needed to be careful about my teeth rubbing against him and causing this irritation. I have been married to this man for over 2 decades and can assure you that my teeth were not an issue as I know what I'm doing. The bottom line is that his penis is much more sensitive to oral sex or touch since our "incident" two days ago- it feels good to him during the act, but then is sensitive and slightly painful after the activity. Is this likely to be a penile fracture, or possible a slight penile fracture, the onset of Pyronie's, or something else? We're getting ready to go a vacation next week (for an entire month)and I need to know if we should avoid sex or if its okay. I called his urologist and explained the situation but he just blew it off and said "oh, it's not a fracture it sounds like Pyronies and there's nothing you can do except maybe take CoQ10 and have him come see me sometime. Have a good vacation." This is unacceptable to me as I need to know what signs to look out for, when to seek medical attention, and when we can safely resume sexual activity. Also,he takes Cialis (he has taken this for a few years due to slight ED which occurred after taking Propecia to prevent hair thinning) so will this mask the symptoms/problems if there are any? Is it okay for him to still take Cialis if we want to have sex of any sort? I am hoping that the burning during urination that he said only happened briefly and the tender small region on his penis is only indicative of mild trauma that will resolve on its own and without complication. I am a realist, however, and need to know what we're likely facing so we can get with a good urologist if deemed necessary. If it is Pyronie's what should we expect and what is the normal trajectory for PD if caused by mild trauma from intercourse. Will his penis likely start curving or bending? Will the tenderness likely subside or escalate? I really need your direction on this. We have not tried to have intercourse again and I don't know if/when we should try to do so. Also, is it a bad idea for me to give him oral sex each day even if it is gentle (without use of manual stimulation)? This is my gauge to see how he's doing because he's not always straight forward about these things so I'd like to be able to test the waters. With that said, I don't want to cause him further irritation if the area needs time to heal. Thanks for taking the time to share your expertise.
The observations you have made are probably based on the trauma your husband experienced. I think you need to "give it a rest" and stop checking out his sexual response for a week or two. This does not sound like PD to me. MG
A week or so ago you helpfully answered a general question about L aginine and Acetyl L carnitine. I would now like to ask a more specific question regarding my situation. I am a sexually active 70 yr old. At the beginning of this year I began noticing an indentation on the side of my penis near the base. I did some web searches and came across your helpful site. One of the fourms mentioned ACL and it seemed worth trying, which I did and have been taking 1000mg twice daily for about the last 6-7 months. I also went to my doctor and confirmed that I had PD - small lumps can be felt when not erect. The condition seems to have stablized. I can maintain an erection and engage in intercourse. I am otherwise healthy and physically active. Quesitons: if the changes are stablized at this point (after about 10 -11 months, can I assume it will not deteriorate further? also, I started taking L agrinine after receiving your response to my question - 1000mg twice daily. This is in addition to the ALC. Do these treatments make sense as far as you can tell? Any recommendations appreciated. I would obviously like to avoid surgery and would welcome any other suggestions.
It is likely that after 11 months or so that your situation has stabilized and will not progress further. Since you are functioning well, surgery would be out of the question. Continuing on the nutritional supplements would be a safe bet. MG
Over the last few months I have been experiencing telltale PD symptoms (chronic penile pains/aches, slight curvature) and I had a question about potential shortening. As far as shrinkage is concerned, is it reversible if the Peyronie's Disease itself is reversed? Is shortening permanent in all cases? I have heard that the elasticity never returns even if you get rid of the bend/plaque/disease. Also, is it a good idea to abstain from masturbation at this time to help with healing? It seems to get worse with the act but I also don't want to repress myself either. Luckily these symptoms are still in the early stages since they've only started around summer time and I'm seeking more advice/help on the issue so I can deal with it as soon as possible.
There is no need to avoid masturbation. Unfortunately, most of the length loss that occurs with PD cannot be fully recovered. MG
Dear Dr., I'm a 60 year old man in peak physical condition. I exercise daily, eat well most of the time and except for a bit of overwhelm and burn out I'm usually a pretty happy guy. I contracted Peyronies disease about 5 years ago. I believe the onset occurred after I banged myself pretty good during intercourse and then again during a masturbation session where I felt and heard a definite popping sound near the base of my shaft. Shortly thereafter I noticed a significant change in the shape of my Penis. It morphed in to bottle neck appearance with a slight bulge at the base, indentations on each side about 1/4 of the way up, lost length 1-1/4 in. and lost girth near the head approx. 1"in. I also noticed a significant decline in sensation and it was much more difficult to attain/maintain an erection and have an ejaculation. Needless to say I was very scared and quite depressed. That was one cold winter. I was embarrassed and finally got up the courage to see a doctor about 3 months later. He basically told me that there was nothing I could do except surgically remove the scars. By that time I was able to masturbate to the point of ejaculation! But usually my penis would loose it's firmness a couple of times prior to that occurring. I found a website called the Peyronies Disease Institute and created a supplemental program based on the recommendations therein that apparently has stabilized the disease. Over time I've amended my supplemental program several times over the years. My penis still changes shape and sometimes appears somewhat normal and at other times it shrinks up and / or leans to the right. Recently I had some dull aching but never really had to much real pain. Prior to the onset of Peyronies I had never really experienced ED and I was pretty popular with women and have always had lovely and sexy partners. Currently I can have intercourse but usually my penis goes from erect to semi-erect several times before I climax. I also need some manual assistance to initiate an erection. When I masturbate and I'm highly aroused (while viewing porn videos) I seem to be able to maintain a longer lasting and harder erection. However the porn is no substitute for a loving companion. I have tried some of the popular natural supplements to augment my erection capacity but they have not helped. I'm not in a relationship at the moment and quite frankly my confidence level is pretty low. I'm intending to finally submit to seeking additional assistance either with a urologist or a sex therapist or both. I'm not interested in surgery at all!! However reading over some of the PD victims stories and personal histories leaves me pretty confused on what I can or should do. I haven't tried Viagra or Cialis because I didn't want to create a dependency. I guess I was more focused on trying to deal with the issue holistically, privately with the hope of over coming the disorder with pure intent and courage. So much for that train of thought. I'm not sure what to do next. I understand that the clinical trials and FDA approval for the plague attacking drug XIAFLEX will be completed in 2013. Perhaps that will be the answer many of us are seeking. In the mean time any suggestions or recommendations that feel real to you in relation to my personal PD sage would be appreciated. Thank you in advance for your good work and any insights you submit to me.
Xiaflex is expected to help with deformity, but is not intended to treat the ED that can accompany PD. I would suggest you go ahead and try Viagra, Cialis, or Levitra. MG
Hello, 24 years old here, after masturbating harder than normal a few weeks ago, my penis felt a bit swollen after a while so I stopped. Not a sharp pain, just some discomfort and irritation though as a result of the tight grip. Kind of like after an intense sex session. BUT later that day I noticed that I had a thin, soft-ish, puffed up ring (and another half one) encircling around the middle of my penis, it is more prominent on the sides. It can be seen best when "Deflating"... going flaccid. Also, strangely, the ring completely disappears for at least an hour when I ice my penis... It is a very thin structure, soft and rubbery, and totally painless. It looks almost exactly like a vein, but it doesn't move with the skin... which is why i'm worried. Again, I have no pain or curvature, but am worried... is this is some early stage peyronies? Is any tissue in the body of the penis automatically peyronies? Also, why does it disappear when I ice it? Is it some sort of lymph structure or vein perhaps?
This sounds like Mondor's syndrome, a harmless condition where the veins under the skin get temporarily hard and prominent in response to trauma. It will go away; it is not PD. MG
exactly two weeks ago i noticeed a small lump directly in the center of the shaft of my penis a little less than half way through it has an uncomfortable feeling sometimes a little painful no problems with getting erection no curve a little uncomfortable during sex seems to be a little smaller and not as hard as when i first noticed it ive seen a regular md he said no worries i wasnt satisfied with that seen a urologist said it might be peyroines and said see u in a year take advil for the pain definitely wasnt happy with that ive been riddled with anxiety have an appt on friday with a specialist my brother was diagnosed with pd but does not have coverage for treatment
PD can run in families. MG
i am a 31 yr old male. i recently have had reaccuring problems with my penis such as leesions after intentercourse. i also have pearl inserted in my penis. about a year ago right before i ejaculated my penis blew up like a hourglass. also i have had my penis peal like a snake do to my blood sugar level is this peyronies disease
From your description that is hard to say. Probably best for you to see a urologist. MG
Hi, I am 24 years old... I'm not exactly sure when I found it but I roughly believe it to be a year ago... I discovered this pencil eraser sized lump on the shaft of my penis, its not on the skin but under the skin, I can feel it whenever I have an erection and its almost impossible to find when flaccid... it hasnt gone away... I don't think its cancer or some serious crap like that... I just want an opinion without wasting a ton of money at a doctor's office with him looking at my junk... there has never been swelling or pain and I don't believe it has changed in size at all.. Thanks
Keep tabs on it, if it isn't changing and you are functioning normally you can probably safely ignore it. MG
I was diagnosed with PD about a month ago. I have had the condition for roughly 7 months after a bad bend during sex and it seems to be getting worse. I do take glucosamine for knee issues and I have seen the possibility of it irritating PD mentioned in this blog. My doctor prescribed vit E, but my wife and I don’t see how that could cure my condition. What treatment do you recommend? Should I stop using glucosamine? Should I get a second opinion from another doctor? Thank you sir.
I would stop using the glucosamine, as in some cases it may aggravate or be related to PD. Vitamin E will not "cure" PD, but it may help to stabilize it. If you are not getting the answers you need, a second opinion is never a bad idea. Check the doctor finder link in that section of this website for someone in your are with a lot of PD experience. MG
About 8 months ago, I was trying to get my penis erect and was masturbating fast and hard. I ejaculated while my penis was still very soft. I had a sharp pain in my penis (seemed near the head) during ejaculation. I didn't think much about it until about 3 weeks afterward when I started feeling like I had a urinary tract infection - sore burning at tip and along shaft. Antibiotics were prescribed and didn't seem to help much Anyway, over the past several months, I have had problems with pain on the side of my shaft about midway down after intercourse. The pain would last for a few days and then subside. Then 2 months ago, it was painful for about two weeks after intercourse. I saw a urologist who mentioned PD but didn't feel any real noticable plaque and recommended taking Vitamin E, which I have been doing since. My last 2 erections (today and two days ago) were very strange. My penis had much more girth from the base to midway up the shaft. The top half of my penis was much smaller in diameter. Also, the larger base felt a little painful. What is this?
The distal tapering or loss of girth out near the far end of the penis does sound to me like PD. MG
my doctor started me on testosterone shot due to low testosterone. now i always have an erection and it is painful. someone please give me suggestions for relief.
Talk to your doctor about checking testosterone levels in your blood, and possibly changing your dose. MG
i have a sore on the middle of my shaft, and it happened i believe after sleeping with my wife. Initially i i did not think that it is something major but it is not dying away.At first it was on the left side at the middle of the shaft, about an inch long and half inch wide, but now it has shifted in a layout of starting from below the head on the left to the middle right. It is not painful unless i press the sore. It has been a week since i have experienced this, and it worries me.
If this has only been present for a week, you may want to try ibuprofen daily for 7 -10 days. MG
I'm 23 years. 6 days ago while having sex with my gf (she was on top) the penis somehow slipped out and missed the hole. It quite hurt there, but the pain subsided and we continued the intercourse to the end. During the rest of the day I had no discomfort, but in the evening I noticed the infamous hourglass shape. This would go away while in full erection, and it seems to me it's not noticeable while flaccid. Anyway it's new, and made me think a minor trauma occurred (i also started to feel a mild ache to the left testicle, more intense while I seat). Seems to me i'm having less erections than usual and those are harder to mantain (this maybe psychological, but then again I can't be sure). Altough I notice no lumps at the moment, I fear there could be problems in the future if some sort of trauma occured (today doctor dismissed me after a quick look, he noticed nothing unusual). Testicle seems less aching every day, but the hourglass in semi-erection is still present six days later. I have actually no pain in the shaft, no pain while peeing or ejaculating. Questions are: will the hourglass go away over time? am i at risk of having PD in the future for these kind of injuries? thanks.
Although this kind of injury can lead to PD, it sounds to me that given the time duration in yours the condition will probably reverse itself in relatively short order. MG
Dr. Gelbard, I am 40 years old. Over the course of the last last 10-14 months I have had a few issues, I had bouts with occasional ED early on which was diagnosed mainly as stress. A variety of tests showed that everything appeared normal, even testosterone test levels were normal. However, one thing that has been becoming more frequent over this time is that I no longer feel my orgasms. When the penis is erect, I notice the left side of the urethra appears to be “opening up”, and that the semen seems to just ooze out. It is difficult to tell if there was ejaculation other then the penis goes flaccid and my sex drive at that time drops. Even not having sex or masturbating for extended period of time did not make a difference. Occasionally because of the “opening up”, the stream when I urinate is some times split. There is no pain, and there is no blood in my urine or semen. I am not sure what to do at this point as this is a somewhat embarrassing issue to discuss with my PCP, and I believe these issues have contributed greatly to the issues in my relationship as it has made me want to shy away from sex as it no longer feels satisfying as it once did. Please advice to some course of action. Thank you.
Fortunately PD is not an issue here. You should see a urologist. MG
Hi Dr, I´m 46 yers old and I was diagnosed by a urologist with peyronies disease ten month ago. I wrote to you about this four month ago. I still have a small lump on my penis right side half way up. I still have no bend but I still have small indentations close to the lump. The only change I can feel is that the lump is a bit harder now compared to four month ago. The indentation are about the same or little less than before. Do you think It will stay like this without getting worse? I read that erectile dysfunction may develop in the stable phase. Do I have to worrie about this? I'm still stressed about this and often check for new lumps or signs of Peyronies progressing to worse. The only treatment I had taken is acetyl l carnitine for tree month (read a lot of good things about it) should I continue taking l carnitine? Thank you for providing me with information that my doctor didn't give.
If you don't have ED now, you are unlikely to develop that problem. It usually takes PD 12 - 18 months to stabilize completely, so continuing the supplement would be a good idea. MG
I'm 24 and uncircumcised. When erect there is a small 2-4 mm nodule on my shaft about a half cm below the glands under the skin. It is ONLY present when erect and is not near the vein. I do not experience any pain with the nodule unless I have prolonged intercourse in which case it seems to ache for 30 min afterwards. Would like to know what this may be and if I should see a urologist?
It's possible it could be a mild form of PD, but that is just a guess. Probably a good idea to see a urologist and be examined. MG
Thank you Dr. Gelbard for your time and effort in this excellent web page. I am new to peyronie disease, found about five months ago. Am 49 years old and going through a depression since last year. Married although had lost sexual atraction to my wife for several years. Due to the different medicine I am already taking I am looking for a natural treatment to PD. Have you heard of massages with oil, particularly Argan oil, rich in vitamine E? Thanks so much. JAM
I know of no reports on results with this oil, but I doubt it would be harmful. MG
I have firm mass in the large vein on top of my penis at the base. It's been there about a year and seems to be getting just slightly larger. No pain really though it sometimes feels a little irritated. It used to disappear when flaccid but now I can locate it all the time. I think it started after a particular vigorous sex session with my wife when it slide out of her but she kind of slammed down on it funny with her body, and it hurt a little at the time. I made an appointment with a urologist in my area, but it's not for two months. I'd like to know a little more beforeI go in. Thanks.
If the mass is truly in the vein, it would not be expected to be PD. MG
8 months ago my former girlfriend was on top of me and accidentally sat on my erect penis as I lied on the bed. It felt really painful but the penis didn't lose erection. Later on, it felt like a blood rush or breakage of a blood vessel... but this was a few moments later as we were cuddling. I went to the Urologist after the next few days being in a good amount of pain (4-5 sharp/dull pain at the base of the penis). A few months later it started to stop hurting but now it started up again. I think its because my current girlfriend and I got a little too rough and she hit it a little too hard which initiated pain the base of the penis again. I'm worried because in the region where it hurts, the base of the penis, there is a bunch of indentations that you can feel by pressing on my erect penis. I feel that this area is much narrower (4" compared to my 4.4" at the midshaft in girth). This I've hard most of my life. I don't know the reason exactly as to why I have it but I think its an hourglass figure but I am not quite sure. Also, since i can remember, my penis can only "rise when erect" as I am standing at full 100% hardness and me tightening my kegal muscles too push blood in. I'm worried about impotency... erectile dysfunction... I feel like I shouldn't be dealing with this at my age. As of now all i feel is sharp pains that periodically happen throughout the day. Is this PD? Should i be worried? What can i do to stop it from progressing further?
At this point, with the presence of pain and indent without firm nodules or bending, it is a little hard to tell. It is possible this is just the inflammatory reaction to injury and re-injury. You might want to consider taking low dose vitamin E (400 units only) and l-argenine for 3 to 4 months and see if it subsides. MG
I'm 30 and just started using a PE Extender. Trying to straighten my dick. 2 week in an I have noticed that it is getting straight! Anyways I have noticed that the skin between my balls and anis is sore and has two stretch marks . They feel like scars should I be worried?
3 months ago I had penile surgery to remove a benign fibrous lump right below my glans (I am circumcised). The incision healed ok however I now have a new mass which is scar tissue about the size of a raisin, which is slightly hard and stuck to the skin. If I attempt sex it causes abrasion and inflammation due to tearing where it is surrounded by healthy softer tissue. Do you think it will return if I have a revision surgery ? If the scar tissue softened the problem would be resolved. Would an injection or topical cream help ? Or an oral medication like pentox or supplement be beneficial ? I would prefer to avoid surgery again unless there is no alternative. Also I am in within driving distance, so please let me know if you offer any of these services. Many Thanks.
This may just be a keloid (excessive scar) in the skin, and these respond to local corticosteroid injections in some cases. I have had experience with this problem, so if you are in the area I would be glad to help you. MG
11/01/2012 - 13:47 bent during sleep In the above forum you mention I arginine as a possible Rx. when I try to search the web for information all I can find is L argenine. Are these the same? what is the relative merit of either compared to Acetyl L caritine? thanks for your help.
L-arginine is an amino acid that is a precursor to nitric oxide, a neurotransmitter involved in erection. It also takes part in modulating the wound healing response, hence its use in PD. Acetyl carnetine is an antioxidant, like vit E. MG
I have been diagnosed with PD now for 4 years. I have a 70 degree deformity upward. i have been receiving interferon injections 2 rounds with little to no result and at the recommendation of my urologist starting a third. i am aware that xiaflex may soon be out but i fear that the plaque i have is too large to have a significant effect. Is it time to conisder surgery? I do not want the nesbitt procedure so that leaves graft versus implant and i am leaning towards implant because with the PD i lose the erection rather quickly, dos this make sense?
Yes it does. It certainly appears you have given non-surgical methods a reasonable trial, and you have a severe bend. Given the proper indications, implant surgery can be a very effective way to overcome many of the problems caused by PD. MG
My penis is going left and at the bace the left side the nerve is sweling and my urine also go left when i pres that nerve i feal a bit pain and my age is 15 my abdomen is fat i no iced that when i sarted master bulating it is swolen
Not sure what this is but you should ask to see a urologist for an examination. MG
I Notice That When I Get An Erection That It Seems Like If My Penis Doesn't All Come Out. It Looks Like If Some Is Still Stuck Within The Skin And It Hurts A Bit When It's Hard. I Tried Easing It Out But It Hurts. I Feel It Hard Underneath So It's Still Got Room To Go But I Think The Skin Is Too Tight And Won't Let It All Come Out.
This sounds like Phimosis, a restrictive problem of the foreskin that can be cured with circumcision. MG
I have had ED for some time and in the last year and a half have been using injections. Never really that effective and causing seven hour erections. In the last three month's I have now developed an upward curve of around 30%. Is this considered extreme and how much does it generally affect intercourse. I am considering an implant and was under the assumption it would help with straightening, is it your experience that it would? Thanks for your time and input
A 30 degree bend is not extreme, but if the erection is hot hard, it can make it difficult to have sex. Implant surgery will generate a hard erection, and can also help to straighten out a bend. MG
Dear Sir, Unmarried 30 yrs age. My penis when flaccid is twisted towards right and the blood vessels on the penis is not straight. when try for erection penis erects to some extent then bends towards right and then the erection is gone. sometime it feels that the penis also bends downwards from base. this all started after i had rough masturbation; i frisked my penis against bed while masturbating two to three times. its nearly 10 months now. No nodes are present, but there is itching and sometime slight pain sensation on the right shaft below the skin. But somehow when full erect the bend is not noticeable. Currently i am taking Vitamin E 400 mg + Pentoxifylline 1200 mg. it has made me crazy and depressed. life has become tasteless to me.Does it sound like peyronie disease or some other sort of problem.
If a bend is not noticeable during full erection, I doubt this is PD. MG
Hey Doc Im 16 years old and when my penis is erect it bends downwards and slightly to the left, i have done a bunch of research and found that they're may be possible scar tissue built up which is causing the bend so i started taking Vitamin E daily and doing jellying techniques to try and correct the bend but im not sure if its working and if i will stunt my growth by this what should i do could this be pyronies? Thanks
No I don't think this is PD - the downward bend is probably congenital curvature. If it is a problem, it can be corrected with the nesbit procedure. MG
I emailed you about the possible relationship between glucosamine and PD, but just remembered that the PD recurred a few weeks before I restarted the glucosamine. However I have begun to feel discomfort in my penis when flaccid in the last week, since beginning the glucosamine again- so not sure if the two are related. Also, I had a phone consultation with my Kaiser Urologist about a month ago, soon after the PD returned, and his advice was let it run its course for 6 mos. or so without treatment. Does that seem right? It seems worse this time than last, more painful, a marked bend to the right, and very hardened tissue at the site of the dent. What would you recommend, especially regarding L argenine, vitamin E, or any of the other drugs I have seen mentioned here: sildenafil, tadafil, etc.
If it seems worse to you now, you might want to discuss taking some medication with your Urologist - a common combination would be colchicine + Pentoxyfilline + l-arginine + vit E. MG
I had an occurrence of what I now know to be PD a couple of years ago, which just went away after several months. Recently it has flared up, and is worse than before: a significant indent near the base on the right side, and +/- 15 degree bend to the right. Reading thru your forum, I realize I just started a new regimen of glucosamine at 2000mg/day for back pain, and that I used to take it a few years ago but stopped - I don't recall when. There may well be a relationship between these events, and I will stop the glucosamine and report back. Second, as I recall from last time, it seemed that the more erections I had the less painful they were, and eventually the pain subsided completely. I am 64, and I just get fewer erections now unless I seek out ways to stimulate them. Do erections in themselves stretch the scare tissue? I am relieved and grateful to have found this site. Thanks for operating it.
If the erections are firm they may stretch the scar tissue slightly. Some urologists are recommending stretching devices or vacuum pumps to assist in this process. MG
A couple of years ago I thought I had a hernia. I had symptoms of my right testicle ascending into my scrotum. It also felt like my testicles were being squeezed. Anyway I went to a doctor a couple days later and he said I didn't have a hernia. However since this happened my penis now points to the right both when I'm erect and flaccid. Out use to point straight forward. It also looks like my right testicle is sitting a little behind my left testicle from a birds eye view. The doctor said I just pulled a muscle. However why do my genitals act in such a way since then. I also get a suttle pain in my lower abdomen on the right side, and I get a sensation of having to go number two. Is it possible for a two year long hernia?? And why the difference in appearance of my genitals? Other than that everything seems to be working right, and I have no pain during any usual body functions like laughing or coughing.
Hard to say what this is. Might be a good idea to have a specialist (general surgeon) check you for a hernia. MG
Hi, I'm twenty one years old and I've noticed a bend in my penis when erect and even when flacid. It occured quite suddenly and I think it could be the result of maybe gripping it too hard during masturbation. It's a relatively small bend and I was thinking I could have possibly bent the spongy chambers inside of the penis. If I refrain from sex and masturbation for a while is it likely to heal on it's own?
Yes I think that is quite likely. MG
I've had a noticeable cordlike bulge that runs (under the skin, not a lesion, not lumpy or bumpy) on the RIGHT of my penis in line with the dark brown line of my circumcision. When fully erect, it is still there to the touch but does not protrude, when pseudo erect or flaccid it is tender to the touch to the point where normal activity (e.g. walking) irritates it. The minor curvature I have to the LEFT is very pronounced (midway to the end of my penis bends to the left 35+degrees) when obtaining an erection but slight (<10degrees from the base not halfway down) when fully erect. The bulge has been there for 10 years and in the last two has become much more pronounced. In the last year I have developed a slight dent on the left, almost to the exact opposite of the bulge slightly lower on the 'shaft'. The dent seems consistent with PD but the bulge doesn't. No obvious plaque, no trauma of any kind in my history. Does this sound like PD, scarring from circumcision?, combination of issues? Grateful for your input. Thanks
To me this sounds more like a combination of the issues you mentioned than PD. MG
Hello, Thank you for your website - it's useful to be able to read other issues and ask for information. 57 year old male, reasonably fit (but probably should exercise more), lifelong non-smoker, low to moderate alcohol intake (1 large G&T and 1/2 bottle of wine and one beer per week, mostly at the weekend) not massively overweight (probably c. 15 lbs over my fighting weight - I'm 6' 4" and 200 lbs), no drugs apart from 40mg Simvastatin daily for cholesterol (level was 4.4 when last checked; HDL/LDL ratio 3.7) BP 120/75 when last checked last year. Eat reasonably healthily - no butter, not much saturated fats, little sugar, no added salt on food or in cooking, olive and rape seed oils in cooking and on salads, etc. Take 1000mg Vit C, a proprietary multivitamin tablet, 1000mg omega 3 fish oil and 400 mg Vit E daily with breakfast. Yesterday I noticed a pronounced "dent" in the left side of my penis when erect (well, it looked pronounced to me), about 1/3 the way from the root to the head. No pain, no noticeable curvature (I've always naturally curved slightly left anyway), no loss of firmness. I woke with an erection this morning and I could feel the dent in the side - again, no pain and firmness felt normal. When flaccid I can't feel any plaques, nodules or anything out of the ordinary. I'd say that the dent has appeared in the last week as it wasn't there the last time I looked at my erection. Obviously the first question is - does this sound like early PD? If yes, should I go to the doctor now or see if it resolves? If you don't think it is PD, any idea what it might be?
The appearance of a dent like this can be early PD, so it might be a good idea to consult a urologist. MG
have a question.may girlfriend and i discovered a lump suddenly in the muscle of my penis after sex.it went away and continue`s to do so,she call`s the damn thing a love bump though i`m scared to death!!!it hasn`t gotten any larger and goes away after sex.totally disappears. but the longer we have sex the longer it`s seem`s to stay.no pain and no discomfort and it comes out slowly.if it`s a short session like 20 min`s or so,it`s practically non exsistant,just,small,like pin needle head.anything over 35 min,it is pronounced,like tear a tiny coner of a piece of paper and wadd it up,there you go.but no pain.i`ve been smashed a few times as i`m a former amature boxer an low blow are part of the business.i do have a few on either side few boxing but this is just under the tip on the underside.even when i have sex the other bump`s have became pronounced.seem to come and go and get bigger and smaller.this one just scared the hell out of me. any idea what it is?? r.m.
This doesn't sound like PD so much as a small clot in a vein (also called Mondor's syndrome) which can get more swollen with more activity. With the passage of time it will usually subside on its own. MG
Woke with an erection. First the erection is only about 1/2 to 3/4. Definite Curvature to the left. Probably 30 degrees. Examined penis shaft and could see an area of slight discoloration on the bottom and left along the shaft of the organ. Also the erection almost feels as though it is broken at the base. No pain, probably because of lack of full erection. Not having sex so no big deal in the scheme of things. But I am still a man and not having the ablilty to stand up and salute is a real downer. Might Viagra help?
If there are no palpable firm areas or nodules and no pain, it is quite possible that with a more full and rigid erection the bending will be less. Viagra would definitely help to sort this out. MG
Hi......I am in my late 40's and in the last year or so my penis went from pretty striaght (when erected) to kind of a bend, not painful but it does have a bend, and having intercourse is not a problem, no pain at all, penetrates fine, I also have noticed that from the base to the middle of my penis there are maybe 4 or 5 rows of lines going around my penis....I know this is quite detailed, but I need some help and direction for this
I would not attach any significance to the lines, but the fact that you have developed a bend could mean you have PD - even without pain or problems with intercourse. It might be a good idea to be evaluated by a urologist. MG
About 2-3 months ago I noticed a thickened lump near the base of my penis (pea sized). It seems to be oriented more on the bottom side. My penis has always had a downward curve (sort of like a arch). It is not very pronounced but is noticeable in profile. Even when erect, it is not difficult to bend my penis downward. I have no memory of any trauma and I do not have any pain (nor have I ever had pain). I'm writing because it appears that the bend in my penis now appears to be more pronounced and it seems to be more in the area where I have the lump. I'd estimate that my bend overall is in the 40-45 degree range. I don't notice any shortening but I haven't really measured to tell. Intercourse is not really a problem and there is no pain. I'm taking Vitamin E and waiting it out but I don't want it to get any worse. I'm 48 yrs old. I also take beta blockers occasionally for public speaking anxiety have used them for many years (sometimes a few times a week, sometimes not for weeks: 10 mg usually). I've heard this can be related to PD. Should I stop taking beta blockers altogether? Does this sound like PD and should I see my urologist to be evaluated? The only other thing I notice is that I don't really ejaculate like I used to. At best I get a small dribble of semen and sometimes I need to "milk" it out. Maybe this is just a function of getting older but I wonder if it's related? I also take propecia. Thanks for this great resource.
Having a slight amount of pre existing (congenital) bend is not usually a problem, but it does expose the concave side of the curve (in your case, the underside) to increased mechanical stress during sex. This increases the chance of PD ocurring there, which would be accompanied by a firm bump and increased bending. There is some evidence that beta blockers can also contribute to PD, so I would definitely discontinue using them. Propecia can reduce the volume of ejaculate. MG
I am 17 and about 2 weeks ago i felt a small little knot under the skin in my penis. I do not know what this but it might be serious so i was wonder what it might be and what i can do about it.
At your age it is probably nothing but if it doesn't go away in a month or so, you should have someone check it. MG
I am 19 and about 8 months ago I first started noticing a curve to the left in my erect penis. This wasn't anything new except that I thought it was slightly more prominent than what I've always had. After palpating my penis, I found a very small, hard nodule down near the base on the left. I was starting to get pain during erections and as the months went on the curve started to increase to about 30-40degrees but no more, however with a palpable indent (small but it can be felt). The nodule has grown larger and I think has spread slightly further. I have had no traumatic injury to my penis that I know of, nor have I been rough during masturbation. I have not been in a sexual relationship. After fairly extensive research I am aware that I have Peyronies disease however my question is how much worse will it get over time? Will it ever plateau and not get worse or will it continue until there is a severe bend (e.g 90 degrees)? Also, how much curve can a woman's vagina take before there is pain?
Peyronies disease is more likely to improve in response to treament, or just to the passage of time in your age group - I would not expect this to progress significantly. It is rare to hear of any partner's complaint when the bend is less than 45 degrees. MG
Two years ago I was diagnosed by my GP with PD. Confirmed by a recommended urologist who proceeded to precribe a drug that wasn't manafactured anymore and told me that the FDA was on the verge of approving a drug that was highly succesful in clinical trials (name escapes me). The next urologist I attempted to see wanted 6 pictures and $200 before they would even make an appointment. The cash advance was because only surgery or injections were the only cure available, didn't make the appointment. My condition is more "Empire State Building" bigger on the base, smaller about half way up, than bent. No pain associated with or without erection. I just don't feel like making another appointment to have someone tell me what I already know. Is there anything on the FDA front or anything worth while happening out there?
Yes there is a promising drug (called Xiaflex) for Peyronies disease that was submitted to the FDA on November 7, 2012. It is possible it could be approved for use within about 6 months. MG
Hello, I'm 36 years old. First time I had hurt my penis was with aggressive intercourse penis came out and missed I heard a loud pop sound and penis went soft immediately. I couldn't get a erection for 3 weeks or so eventually it was hard enough to have intercourse again. Never was able to get a hard erection again maybe 80% at best. As time went on pretty much same thing occurred again. This time it popped and went soft immediately, and same thing took weeks to get and erection and now I found that any other position then her being on top of me would cause my penis to go soft. So we just used that position for some time. I would notice now that at the base of my penis at or just below scrotum I could feel my penis shift to one side when I would insert my now 80% hard penis if I'm lucky into my wife almost like it broke at that point. Time went on we made that work for a long while and then one night my penis wasn't very hard and seemed to go soft inside her and it came out and sure enough it pop'd again. Felt more pain then normal this time. After awhile I was able to have intercourse with wife on top and now I seem to go soft over time like it drains on me and need to stay at maximum arousal to keep penis hard. I'm really worried now even when masturbating I can't keep him hard unless maximum arousal. If I get a hard on and stand up it goes soft in 10 seconds. Now when I read forums etc it seems that when you damage your penis you need immediate medical attention. I was too scared to seek medical advice and was ok hiding problem as long as it was still semi functioning. What do you think is the problems I'm now facing and is it too late to do anything or what are my options Dr. Thanks in advance!
It sounds like you may have developed venous leakage secondary to the scarring caused by the traumatic episodes you recounted. Usually this responds quite well to phospodiesterase inhibitors (Cialis, Viagra, Levitra), so I would reccommend you see a urologist experienced in male sexual dysfunction who can do a penile duplex doppler utrasound and prescribe any indicated medications. MG
dear dr.gelbard - i have peyronies for 4 months now (i am 55) for the last 2 months, i am taking vitamin e, argenine l and pentoxifylline i also do the stretching daily - i have a few questions please: when is the final (or worst) shape of my "new" penis reached? is it helpful to take viagra, as part of the treatment? ( for more blood flow) for how long, do i have to take all the medications and for how long do i have to do the stretching? in the last two months, it has not gotten much worse, but definitely not better. (terrible erections, much smaller penis and harder to ejaculate, when masturbating) i almost lost my entire sex drive thank you SO very much for your kind replies, it is much easier talking to you, then my intimidating and super-busy urologist.
It usually takes a while for Peyronies to stabilize - up to 18 months in some cases. Most physicians like their patients to take the medications and use stretching for about 12 months. Erection medications can definitely help, with most urologists using low dose (5mg) cialis that is taken on a daily basis. MG
Hi Ian 17 years. My penis has hourglass shape when semi erected but get normal when fully erected. This has happened 2 weeks ago and still . Is there anything wrong , should I worry. Pls rrply
No to both of your questions. MG
A few years ago I was having sex with my girlfriend..she was on top and leaned back and I heard aa audible popping sound...there was no pain or problem continuining having sex at the time...but I have noticed a dull pain on left side from time to time but no pain while I have an erection...or during or after sex..there are no noticable nodules but there is a definite curvature to the left that has developed..I have always had a curvature up towards the navel...but since this incedent I have noticed a definite curve to the left..more so when flaccid then when erect...I wanted to know if this could be either PD or a fracture ??? I would really appreciate your opinion.
Since the episode did not cause you to loose the erection or have to stop having sex at the time, and was not followed by a lot of swelling and bruising, I don't think you had a fracture. If the direction of curvature has changed but is more severe when flaccid and the foregoing happened a few years ago, it is probable that you developed a mild case of PD that is probably stable at this point. MG
Hi I'm 46 yrs old and about 3 myths ago woke up with the most painful erection any way it seems now to have two lumps in the shaft of my penis I've been the docs and am awaiting a hos appointment but the question is I'm waking up 2 or 3 times a night with really bad pain in my erect penis clothing to do with sex but when I get a hard on the pain in unbearable any help would be appreciated no bends at all from my penis just two lumps and a hell of a lot of pain
The combination of bumps and pain sounds a lot like Peyronies, even if there is no bending. Fortunately the inflammatory phase that goes along with this type of pain is usually self limited. In the meantime, I would suggest taking 2 alleve (probably with some food) prior to bedtime. MG
I'm 18 and noticed that my penis was slightly less thick on the right side than the left. I googled some stuff and tried some methods similar to jelqing on one side. I was obviously a bit too rough with it because i noticed two little (less than a tic tac) nodules in the core of it about two weeks ago. They're not rock hard. I never noticeably hurt myself and my erections are as they were before the injury, with no pain. The nodules did cause my semi-erect penis to curve though. I've seen a doctor and a urologist and they dont think i have peyronies. One of their suggestions was that it could be hardened blood and that this will be re-absorbed. I just want some hope that this could actually be the cause of the nodules. Is it possible that they are only hardened blood and that they will go away with time?
Yes that is quite possible. The compression during "Jelqing" may traumatize blood vessels and cause small clots - which would be expected to resolve over a month or two. MG
about 7 months ago i was very aroused and decided on not having intercourse but to rather go to sleep on a futon. During the night my penis was erect during my entire sleep. as i was moving constantly trying to adjust. Once i finally got to a position that was comfortable i feel into deep sleep. i could feel my penis on a space at the edge of a support bar on the futon. i woke up the next morning and where i had been laying on my erect penis was very painful flaccid and more intense during erections. my penis was always very rigid during intercourse before the injury. i did not go see a doctor and the pain subsided in 4 -5 days. Now i feel as if my penis hasn't been as rigid since the incident where the pain occurred and my penis dosnt reach its s maximum potential. also there is a very noticable bend on the spot at which the beam was contacting. i am scared that i cause harm to myself that is irreversible.is there anything i can do to increase blood flow to my possibly damaged veins?
Low dose aspirin may help, and l-argenine (which is used for Peyronies disease) may be of benefit. MG
I am a Married man lately, I notice that my penis is not active enough during sex, it seem somehow reluctant, what mighty be the problem. thanks
Many possibilities here - you should see a urologist with an interest in treating ED. MG
Dear Dr. Today i visited urologist for treatment of ED. he performed penile doppler by injecting papavarine in the right shaft of penis. the flow was 26cm/sec. after some time(45-50 min) there was swelling/bulge and pain at the spot of injection. can this lead to PD in future. regards
No, a single injection followed by local bruising / swelling (hematoma) should not lead to PD. There is commonly a bit of local reaction for a while after one of these injections. MG
Good Morning; Can pentoxifylline useful in the treatment of Peyronie Disease. Can Sidenafil/Tadalafil can be used for erection if a person is having PD.
Pentoxyfilline is commonly used in the treatment of Peyronies. There is no good placebo-controlled data on its effectiveness. Sildenafil or Tadalafil can both safely be used by patients with PD. MG
Hi, I've had Peyronie's disease for several years now, and although there is moderate curvature, my main concern is thick plaque buildup on the left side of my penis that is very noticable when both erect and non-erect. I recently purchased Serracor-NK in hopes of at least reducing this thickness of the plaque and I was wondering if you had any other tips on ways to reduce the plaque. Also, Serracor-NK is not FDA regualted so if you have any knowledge of it being unsafe, I would really like to now. They recommend at least three pills a day. Thanks.
This is a proprietary mix of a variety of enzymes. As it is considered a nutritional supplement, it is not FDA regulated. The manufacturer does not publish any data on its results or side effects - probably because this work has never been done to the standards of a peer-reviewed journal. All I can say is I do not know it to be unsafe. MG
Hi, I’ve got a curvature to the left with nodule on the same side in about the top 1/3 of the shaft. I seen an urologist about this nodule about 7-8 years ago and he said not to bother with it and an operation was not necessary. Since that time the degree of bend has slightly worsened though the nodule is the same size. And I actually measured the curvature it and I think its around 7 degrees. There is pain with an erection and it lasts sometime afterwards but it’s only mild. What do you think, should I seek further treatment or is it OK as is.
In the most recent clinical trial of Xiaflex for Peyronies disease, the protocol called for stopping further injections when the bend fell below 15 degrees. This was based on the consensus among investigators that up to 10 - 15 degrees of curvature with an erection is normal. So on that precedent, I would leave it alone if if is working OK. MG
I am 55 years old. I am glad to have found Peyronies.org. More information here than in a number of longer books I've looked through that seems to confirm my own suspicions that I probably have Peyronies, both congenital and probably exacerbated by injury during coitus. I always remember a slight bend to the left and perpendicular to upright posture. It has always been inflexible and extremely rigid, painfully so, but have gotten used to that. I am of the opinion that my penis is too long for the comfort of a number of my past partners who have complained that it hits them in their ovaries. Also in regard to its downward rigidity, my penis uncomfortably presses downward in their vagina, which doesn't feel good to them during face-to-face coitus. I think that perhaps during circumcision, too much tissue may have been removed on the left side (from my perspective, as I would look downward). It is resistant to upward and downward movement or flexibility when hard, but flexibility in upward direction has improved. Downward from perpendicular position has remained about the same. During intense coitus with a few heavy-set girlfriends (more than 30 years ago), while they were each straddling my waist, me on my back, I noticed with great pain a few times, my penis literally bending in half or in thirds under pressure of a missed stroke or partially inside their vaginas. In the latter instances, my rigid penis would have been forced into an “S” shape. On the concave side of the curve, looking down at my penis, which is more bent than the parenthesis here > ) , as I would be looking down on it, when it is from tumescent to turgid, there is an extremely taught cord-like structure that runs along the slight left side of the top base of the penis, to the slightly lower left topside behind the head of the penis. The cord is equal in thickness and hardness the entire length. Suspensory ligament injury/displacement? I am very embarrassed about this curvature, which has slowly but steadily gotten worse over the years. The injuries I discussed above happened a little over thirty years ago. Very intense pain occurs during ejaculation. This seems to be getting worse. The pressure inside my penis seems to be excessive to me. I wouldn't mind if it was a tad shorter and a tad softer on a regular basis during sexual activity. I think the pains regarding my penis have not reduced, or rather I have become desensitized over time. I don't remember what ejaculation feels like with out the sharp, intense pain. How much pain is there supposed to be during ejaculation? Perhaps some of this pain, which is in the muscular and skin areas of my penis, maybe in end of urethra, too, has little to do with Peyronies. Some type of neuralgia? Thanks c
That type of coital trauma you described with partner-on-top is fairly common, and can lead to PD. It sounds like you had some congenital downward curve to begin with, which makes sense. It is easier to miss a stroke or bend the penis during sex if it is curved, and in addition downward congenital curvature can be caused by overgrowth of the corpora cavernosa in relation to the urethra - the net result (besides curvature) being a longer penis. Ejaculation is supposed to feel intense, but not painful. If Xiaflex gets approved by the FDA, injection of this collagen-dissolving enzyme into the cord you describe may improve things considerably. MG
Now; I am experiencing rather unusual condition. when my penis is erect it seems that one side of the chamber is bulged (more inflated) and the other side is straight. after some time of erection the penis starts to bend to one side and then the erection is gone. the glans penis also looks small than used to be. When in flaccid stage; the penis is soft and no palpable node is identified. Sometimes in the flaccid stage the penis retracts towards the the pubic hair and feels hard. This started after i had rather rough masturbation. Does this indicate peyronie disease.
Not neccessarily - it may be responding to the temporary inflammation following trauma, which does not always lead to PD. MG
In a previous post you commented that I might have a slowly resolving trauma. Semi erect I have dented in on left side and a tiny bit on right when penis is filling up.. it never goes up straight like it used to but with some stimulation it gets perfectly straight and this are fills out normal.. maybe if you look very closely its a tad narrower. Never had nodules.. checked by 3 urologists they said I dont have a problem.. sometimes I still feel tenderness and a dull ache there after sexual activity just in that area.. can this still be resolving I dont understand, it has been the same for 24 months now! I thought with peyronies its increasinly curved the harder you get and I have the opposite.. really its hard when flaccid and thats the easiest time to see the slight band. No shortening or bend just narrower when flaccid. Its driving me crazy and please give me your opinion DR. Thank you
You are correct, with PD the harder the erection, the more noticeable the curve. After 24 months you may have developed some limited scarring in the erectile tissue that makes the penis slightly firm when flaccid, but I don't think you have PD. MG
I was wondering can depression and performance anxiety decrease the strength and rigidity of an erection?.
Yes. Depression can have a negative effect on libido and sexual perfomance, and one of the primary effects of anxiety is that it can cause release of catecholamines which constrict blood vessels - not good for erections. MG
Hey, i'm 23 and have Peyronie's disease. I believe I got it when I was having sex with my partner at the time. From memory I never noticed anything though. I do remember first noticing it though. I went to bed at my house and woke up and had a pain in my erection with the node noticeable in the morning. I just thought I injured it and it'd go away and at no point associated it with sex. I honestly thought it was because I slept with my jocks on a it was injured during the night. I never thought it was a a disease. I had no problems with my erections apart from the pain, which subsided after about a month I think. Everything was fine for a while... Anyway that was quite a long time ago, about 4-6 months if not longer. Just recently I noticed my erections weren't as hard as they had used to be. I literally just started dating a new girl that week so I thought it was psychological as we spent a while having sex to no avail as I could never maintain an erection but could by myself. I asked the doctor for Viagra so I could remove my brain from the equation and not have to think about the stress of having sex with this new girl for the first time and it was perfect. My penis was completely normal and back to what it used to be, rigidity and all. But still without the viagra it just doesn't feel 100% but I can't help but wonder when even by myself the stress of getting an erection is killing it. But even morning erections don't feel the same so I can only assume it's not. I was curious as to is this permanent? Will it get worse? Is there anything I can do to slow it down if so? I'm visiting a urologist in December but the wait is killing me.
Inflammation in the wall of the erection chambers (corpora cavernosa) may reduce the closure of veins that normally trap blood and contribute to hard erections. Inflammation may last for months after an injury, but it is not permanent. In the absence of palpable nodules, pain with erection, and curvature, there well may be no PD present. MG
Hi, I'm 17 years old and my penis has an extreme bend upward, there is no pain, but because my penis is so stiff there is no way to bend it straight outward. It has been this way forever and I worry that I won't be able to perform intercourse because of it, as well as the possible embarrassment. There are no lumps and on occasion some erections are straighter then others, is it possible to straighten my penis without seeing a doctor? Also, if I attempt to curve my penis manually could this be harmful to my health? I have been considering making a contraption to hold my penis straight out during my sleep because I sometimes wonder if the origin of my bend came from the fact that for the longest time I slept on my stomach causing my penis to go upward and run against my lower stomach.
Don't build the contraption, it might end up hurting you. Normally an up-pointing erection that cannot be forced down when really hard will not interfere with intercourse. Sometimes, the suspensory ligament that connects the top of the penis to the pubic bone may tether the penis and make intercourse uncomfortable, but this is unusual. MG
Okay so my 49 year old husband just found this name last night that seems to describe a lot of symptoms he's been having. The number one concern he has is what he describes as a big thick "knot" of some sort inside the very base of his penis that is very painful - especially after sex, but even when not having sex. This has been there for the last several months. (He drinks a lot of Pepsi and at first thought maybe it was from that, like women get knots in their breasts from caffeine. He hasn't had a Pepsi for almost 2 weeks and said he noticed that he can now push his urine out harder than he has been able to in awhile so maybe that could still be a contributing factor.) Both he and I have commented over the last month or two that his penis seems to be smaller both in length and girth, but it was fairly large to begin with so we thought maybe it was our imagination. He doesn't have erectile dysfunction, but he says it takes more to get hard than it used to. Just thought it was age before but now wondering if it's related. I haven't noticed a curvature but he says that he is noticing that it is "trying to" start curving (again this is all only a few months old) we're not into doctors practicing on something that they don't have a cure for, but would prefer to get started on a natural remedy if this indeed sounds like what he may have. I don't see as much about the painful internal "knot" listed on the peyronies sites so thought I would ask more about that. thank you!
That painful internal knot does sound a lot like early Peyronies. The pain will eventually go away, but in most cases the knot will coalesce into an area of scarring that can cause shortening, indenting, and or curvature of the penis. At this time taking L-argenine and low dose vitamin E may stabilize the process. Check this site for updates on the new medicationn (Xiaflex) that will soon be submitted to the FDA - it may not offer "cure" but if it becomes the first medication approved by the FDA for the treatment of PD it would be worth considering. MG
Doc...34 6'1 185lb male taking pexeva 20mg q.d. and adderall 20mg b.i.d (2nd dose as needed). I have noticed a decline in erections, probably due to stress and adderall. 3-4 months ago I noticed some bend in the shaft of my penis about 1inch below the glans. I definitely have engaged in rough masturbation with a strong firm grip. I noticed that depending on my grip or frequency of masturbation, the bend would become more pronounced. I estimate the bend to be 25% to 30%. I have noticed and indentation on the left side of the shaft and glans appears smaller during erections. I can feel what I would describe as scar tissue in the area of the bend. My questions are: 1. It is 1.5 months until appt with urologist. Should I be doing something in the meantime. 2. Have there been any real medical studies of the use of traction 3. I have access to a klaser and have utilized it to treat various injuries. my wife (physician) feels it cant hurt and could possibly assist in healing. 4. is there hope for reversal, or is stopping progression the best result to be expected. Already self-consious about penis size (around 6 inches) and might lose my mind if it gets shorter. any thoughts would be tremendously helpful.
There are a few studies on the use of traction devices in PD, but their scope and conclusions are limited. If the device can be worn for 2 hours per day or more, it may improve curvature and prevent shortening. Many urologists are employing stretching devices in the early treatment of PD. I am not familiar with data on the use of K laser for PD. MG
Can you eloborate on its use? Topical? I have just been diagnosed. I have about 45 degrees of bend to the left. I am looking to do the right things for twelve months before assessing any further treatment than an anti inflamatory and maybe vitamin E
Vitamin E in doses higher than 400 IU may have deleterious effect on heart / blood pressure. Topical vit E should be OK. Both of these remedies will at most help to stabilize the situation, not reverse curvature. MG
Hi Dr, I am 31 years old,circumcised, pretty healthy guy.I have pain on head part of my penis(about 1cm below the hole),around top of glans,for 1 year. About 10 months ago,when I had sex with my girlfriend(she was on top),my penis came off and hurt a bit.Next night after that, I could do sex,but it was uncomfortable and I couldn't be on top since then. I thought it may go a way but it didn't. I went to a doctor who refereed me to blood test work outs which every thing(STD,HIV,,...), seemed fine.She refereed me to an urologist who said to me after examination, he has no answer to me .He examined my penis flaccid and didn't discover any abnormalities . He also did Cystoscopy to check my bladder and said looks normal and cited having Peyronie disease chance is not or may be.He cited, I should seeing a sex consultant .My problem is I feel discomfort when I have sex especially when my girlfriend is on top(extremely pain).I feel dry and rigid(too hard)on my penis,when I have sex(I used lubrication.It didn't help). I don't seem to have erection issue,but my sex drive has been increased.I think, I had the feeling of my penis being too hard,and stiff before the sex trauma incident which I cited earlier.When my penis is hard, If I pressed against it from head, it hurts. My penis doesn't have an angle.My girlfriend and I both agree that my penis got a bit shorter and skinner.I take multivitamin daily,smoked cigarettes occasionally,weed 3 or4 times monthly.When I smoked weed ,head part of it is more sensitive.I use minoxidle5% for my hair about 7 months. And I have lost about 5 kilos during a year.Please let me know if my discomfort is PD?. and Thank you kindly.You are my last resort.
If you did develop a mild form of PD, the fact that you have no bending after 10 months is a very favorable sign. the discomfort will resolve eventually - in the usual case of PD pain takes 6 - 18 months to clear up. MG
I am 48 years old and am working with my urologist using three ideas for treatment of my PD. every two weeks I go in for direct injections, many of them right into the scar tissue. He has me taking CoQ10 as a supplement and using a manual vacuum pump 2x daily off ten minutes and especially after the injections. I believe he is using the Verpamil. I have an upright curvature near the head of the Penni's and I have noticed shortening a bit but right now there is not any pain and I am able to still have intercourse and no pain after orgasm. Tomorrow is my 6th injection in a series of 12. How does this sound to you and will I get the normal length of my penis back which was about 6 1/2 inches. Thank you for monitoring this site. My urologist also told me that the recent explosion in this arena he feels has to do with the craze of glucosamine/condroiton supplements that hit the market to help us aging guys with joint pain. I have not seen this mentioned in any of the sites I have been reading so I thought it may be helpful to get it out there. Makes sense to me and I was taking that before I noticed the change in my penis. I remember falling on my cross bar in earlier years and really hurting my penis. That is the only thing I can recall. Cheers!
The treatments you are receiving are very much in line with the state of the art at present, so I think you should continue under your Dr's care. Keep an eye out for Xiaflex, which if approved will add a very effective new option. I have seen a number of men who developed PD after glucosamine / chondroitin supplements, so I would tend to agree with your doctor. MG
I had a double hernia operation (laproscopic - I think that is the term) and had to also have a naval hernia (convential) as the finale... Things seemed fairly ok - except for the catheter that I was not informed was needed- and no sex followed for the next month... When the penile bruising went away, Mr Wiggly was again ready. Seemed ok. Within the next month, things felt different - like I had someone else's penis (I know - wierd). Shortly thereafter I noticed a slight curvature to my penis. Back towards my navel. NOTE: after the hernia surgery I think my penis stuck out further and seemed longer - but different. Definitely seeme longer. Now the curvature is more severe - approaching 30 to 40 degrees.. No pain. Still seems larger - or at least no size reduction - but sensation is different and the curvature is continuing to increase. I have ordered a ton of L Arginine and Vitamin E as it seems safe. I sense/feel a 'rigid' flat surface inside the flacid penis. I have made a call to my GP (I am 58 and rather good health). Prefer no surgery & think I am in early symptoms. Suggestions??? Would like suggestions as souther Indiana is limited for health attention...
PD occais develops after pelvic surgery and/or catheters. I think the supplements you are starting are OK but see the above on high dose vit E - to be avoided. Look at the doctor locator under links on this site in the peyronies association site, regarding specialists in your area. MG
ARE YOU AWARE OF ANY STUDIES LINKING THE USE OF EXTENZE TO THE ONSET OF PEYRONIES?
No, I have not heard of this association. MG
I'm 53, was diagnosed with Peyronies a couple of years ago. The plaque postage stamp sized growth in my penis over this time has moved from distal toward my body, making the curviture more difficult for sex, and I have also lost some of the "strength" of the erection. I was put on 800 mg of Vitamin E when first diagnosed (don't know if this is helping), but yesterday my doctor put me on a month trial of Pentoxifyll, 400 mg x's 3 per day. Anyone out there trying this? I will keep you updated if there is any changes, good or bad.
The pentoxyfilline is OK, but I would reccommend keeping the vit E dose at 400. MG
ok so i am 18 years old and i was having agressive sex and i missed then hole and bent my dick. I it hurt and i lost my erection. then i was fine and kept having sex again. when i got home i iced my balls for 20 mineuts, and now i have noticed that my balls are extreemly big and it hurts to touch or to shake...please help i am freaking out
You probably had a minor fracture, with blood accumulating in the scrotum. At your age this will probably heal ok but you should avoid sex for a couple of weeks and if the swelling doesn't come down by then see a urologist. MG
Thanks for starting such an forum. i had previously sent a query. my penis remains near the pubic hair and the shaft feels hard (same on both side). Cannot get erection as earlier used to get. when fully erect there is no sign of angulation or curve; but when going limp the penis always bends towards right and that side feels hard. i don't know i am able to explain my condition properly or not. i am very depressed at not getting erection. kindly advise on the curve of penis towards right. this started only after i masturbated while pressing my penis towards bed in sleeping position.
this doesn't really sound like PD, but you should see a urologist about your erectile problem. MG
I am 43 years old and literally just noticed about one month ago that my previously very straight 6/7ish penis had a horrible upward curve. it also feels less erect and look smaller. the other disturbing issue is the base of the penis almost (when erect feels disjointed from the above parts, it is like i can actualy wiggle it around) it it looks really odd and i do not recognise this as my penis. i have not had sex for a while (really have not been feeling horny at all, this was a total surprise, any advice?) thanks andrew
It certainly sounds like PD, which in many cases seems to appear without any preceeding trauma or other identifiable causes. At this point it would be a good idea to start on a nutritional supplement such as l-argenine and consult a knowlegeable urologist. Most authorities agree that if medication therapy is going to be effective in PD, the earlier it is started the better. MG
When measuring lying down my erection seems shorter than when standing up. Why is this?
I don't know if you are talking about angle or length, but if you are interested in tracking progress or response to treatment just make sure you use the same approach each time. MG
Can the acute phase continually reoccur over the years?.
I have seen the occaisional rare case where PD appears in a different site, years after the original site has developed then stabilized, with its own new acute phase in a new location but this is very unusual. MG
I have read several cases about vacuum therapy helping to correct curvature and it makes sense from a physical point of view - The suction stretches the tissue like an elastic and straightens it out simply due to the force of vacuum - I get that,but I'd like to know some opinions on the lasting effects of more basic vacuum pump models. I have read a change between 2-25 degree difference. Now part of my question is regarding the exact pump, some of these on medical websites are awfully expensive and being an older man I cannot afford such luxuries just to correct a curved penis. I came across this supply store http://penispumpwarehouse.com as I was researching related issues online and talked to the customer service rep, they said it should work but they are not medical professionals so they referred me back to my doctor. I understand they cannot give medical advice for legality reasons, most supply stores act the same way now-a-days. Tell me any professionals out there, what is your opinion on a manual vacuum device? Am I wasting money or will it work? Thanks in advance. Jean T
Physical stretching is being increasingly used in the management of PD - either via vacuum device or traction device. There is some evidence that if these are used regularly they can reduce angulation. If the investment is not too great for you, it would probably be worth a try. Evidence suggests a traction or stretching device needs to be used about 2 hours per day to be effective. Vacuum pumps on the other hand can only be used for about 5 -10 minutesa at a time. MG
Hello, I'm 30, I have MAYBE a 10 degree downward curve when erect. Is this normal? Common? Should I be concerned. My erections are painful.
Ten degrees of curvature is generally regarded as normal. If however this causes pain during sex, a corrective procedure (nesbit plication) may be a consideration. MG
I am a 57 year old who recently (6 months ago) asked for and received an Rx of Cialis (20mg)to assist in sustaining an erection during intercourse. The side effects of the 20mg were evident (headache, stuffiness, vision disturbances) so I initially discontinued. I then used a pill splitter to lessen the dose to 10mg and and side effects diminished. However, around this time I developed the first symptoms of possible Peyronies Disease (slight indentation on left side, with slight pain associated at the bend site). My question is, "any association between cialis and PD?" The website references PD as one of the conditions to be considered prior to taking cialis but beyond that there isn't any mention. In fact, that is what brought me to your website today. Thank you in advance for your advise. I will start on vitamin E and L-arganine today
I know of no association between the use of any of the phospodiesterase inhibitors (viagra, cialis, or levitra) and PD. The product literature includes a caution regarding PD, the reason being that a study involving a specific group of PD patients was not included in the material submitted to the FDA for their approval. MG
Hello Dr. Thanks for the reply to the post(09/19/2012 - 17:39 ). I have few more queries - Presently i am taking homeopathic medicine and feeling somewhat fine; my concerns are - 1. I do not get erection if i want to masturbate. 2. After a certain time of erection my penis bends towards right (at that time my penis is semi-erect). 3. in standing position my flaccid penis always remains near the pubic hair and remains hard; while lying it goes soft with no sign of hardness or plaque. 4. When semi erect feel like my penis is experiencing pull towards right. Is it possible that PD manifests itself without occurrence of plaque.
Yes, in some cases scarring due to PD can only be felt as a tight cord that can be felt only when the flaccid penis is stretched. MG
Several years ago, my husband had emergency surgery because he became ruptured and now he cannot get an erection at all. Is there any help for him?
Yes, if he had a rupture of the corpora he may respond to medications such as viagra, levitra, or cialis. If not, implant surgery is capable of completely restoring function. MG
I posted about a year ago concerning the diagnosis of Peyronies I have been given. The symptoms fit perfectly. 40 – 45 degree upward bend when fully erect. I'm now 32 months into this condition and I'm constantly in pain. In fact the pain has got worse and I'm getting referred pain elsewhere. I have full dose of pain control medications. When it really wants to hurt no drug will prevent the pain. The dents on my penis (hour glassing) have pretty much cleared up and are not apparent when erect. My erections have got stronger and my penis bigger since having PD. No palpable plaque has been found in spite of five examinations. Two GP's not sure if it is PD, one Uro said definitely not, two (one of whom didn't examine me) said it is PD. Pain consultant says nerve damage present and thinks the nerves that control circulation may be effected. Here's the tricky bit that I don't get, I've had two times when I've got 90 percent better over night. I've woken with a completely straight full erection bigger than before this condition started but with a small dorsal dent. There has been lots of pain when erect and straight. After five days penis slowly returned to being bend when erect. This has happened twice. I have also been sure I've felt blockages tearing and clearing with a rush of blood in my penis. I can see visible bumps on the surface. My right testicle is often nearly black in colour presumably due to blood sitting there. Testicles often tender. Any idea why I should get better briefly then get worse again? Is there anything I can do to try to hold on to or encourage a lasting recovery. I'm unable to have sex as it puts pressure on the bend which huts me. Ejaculating leaves me in pain for 24 – 36 hours afterwards.
After 32 weeks I would consider graft surgery for disabling bend, but with your recurring "90%" recovery episodes, that would be a bad idea. I am not sure why the severity of the bend changes to such a degree, other than perhaps there is variation in the fullness of erections. MG
To all fellow sufferers. As there is little understanding of the cause/s of Peyronie's Disease I have been considering creating a questionnaire to be filled in by sufferers who wish to take part. The purpose of the questionnaire would be to see if there is a common link amongst sufferers which could point to a cause. Whilst certain types of medication may cause Peyronie's (Beta blockers), we have to remember that the disease has been around for a long time, before such medicines were available. This suggests that any link between Peyronie's causing medications and the disease itself must be a trigger for another process. We need to understand the process, so it is vital that we identify triggers. The questionnaire I propose to write would consist of a set of questions relating to such things as diet, smoking and drinking habits, exercise, sleep, medications etc. It would also include questions relating to the participant's PD, duration, type and degree of deformity, amount of pain etc and whether or not the sufferer was aware of an injury prior to the onset of PD. If enough people participate in this we might find clues as to the cause of the disease. This would be extremely useful as it would offer a starting point in the search for ways to halt or even cure the disease. I would be happy for an administrator of Peyronies.org to take this up on my behalf as there will be a need for confidentiality and perhaps anonimity. Perhaps the site could produce an online form? I look forward to hearing people's views on this. Kindest regards MH
I like your idea but unfortunately there is no administrator of peyronies.org, only me! As it is I have some difficulty keeping up with forum posts due to all the crazy machine spam that comes in. MG
Hello. I live in Australia and yesterday I was diagnosed with Peyronie's disease. I originally noted minor discomfort that did not interfere with sexual activity. A few days later I noticed a small lump in the inside of my penis, that felt like a small descent when I had an erection. The GP that initially examined me, said he would feel the lump and that the descent was caused by a tear in the corpora cavernosa. This sounded to me like partial penile fracture. But he suggested I could still have sex, but to take it easy. Anxious as I am, I ended up in an Emergency Department, hoping I would get to see an Urologist on the day. Lucky for me I saw a Consultant Urologist, who gave me the diagnosis. He suggested I visit in three months. Did not start me on anything. Said there is no clear evidence. At this stage, I don't really care about scientific evidence. He also said I could continue to have sex. The registrar actually said that some professionals are in favour of continuing to have erection as a means to improve blood circulation. Since I read on the net about this medical condition, I have bought Vitamin E 1000UI and have been using this twice a day. I have read through: https://www.andrologyaustralia.org/wp-content/uploads/Factsheet_Peyronie... Never having really payed much attention to the natural bend of my penis, I have now noticed a bend 3/4 down my penis well marked, but not profound (I think). This is higher then the lump that I felt around two weeks ago. So I am not sure if I have had previous episodes. I have never had any problems with sex. But in this last ten years being with my partner, there have been occasions when she has come down wrong and there has been some pain, though nothing big. Because I am a person that needs to do everything possible if and when I encounter a problem, I am looking at what I can do. I have not really felt strong pain when having an erection, but I am now sensitive, with some pain, when flaccid. I have no problems with erection, or ejaculation. I don’t have any problems passing urine. I can’t remember seeing bruising. I never noticed anything until I felt the strong erection and later the lump three/four weeks ago. Now… How do I keep my penis as healthy as possible? What can I do to prevent scaring? (Hence prevent bending) Of all the oral medication, what should I try? (Do I need a prescription for these options?) I am not really looking for "evidence based". I feel I don’t have time for this. If I am in the active phase, then now is the time to tackle any possible treatment (s) that might help prevent any further deterioration. Your advice is critically sought.
As we don't have any great evidence for effectiveness among oral medications, the best guideline is safety. L-argenine has a good track record in this regard, and may interfere with scar proliferation. Many urologist are employing stretching or traction devices to retard scarring and contracture. Other urologists reccommend an prescription medication called pentoxyfilline. MG
When someone has Peyronie's Disease, how much length can they lose?. One of the urologists that I went to said you only could lose up to a couple of centimeters in length. However I have read in blogs that men can lose an inch or more.
Yes, length loss in some cases of PD can exceed an inch. MG
When I was a kid I was racked real hard play fighting due to being backed against the wall and kneed it was not cool and I turned green and sweaty and had to drag myself to the bathroom and my penis temporarily turned black and blue but I never told my parents about it. Long story short Im pretty sure thats why its so hard for me to keep an erection and i have semi hard erections at that unless less ive been abstaining from sex for a couple of weeks and still have to use a ring, or take pills that you get at sex shops to achieve an erection in which stiff nights really work. I had read in a magazine article years ago on the mechanics of an erection and that what i have can be fixed through surgery but the mechanism that locks the penis off after it fills with blood is not locking down or shutting the flow off so Im constantly having to do a pelvic lunge to fill the penis and use a ring to keep it up. About six months ago I finally got circumcised which was a great improvement but still didnt fix it but is helping alot due to my penis was so sensitive before so it was hard to achieve an erection and then it was so sensitive that i would ejaculate too quickly so I never got the good sex life like many of my peers did and remained a virgin for a long time but now that im older and have insurance i can try to address but is there any hope to improve keeping an erection and is there a physical way to massage or manipulate the mechanisms that keep an erection? I do recommend to anyone out there to get circumcised I was alway self conscience due to everybody else being circumcised so no hitting the showers for me in gym class but im glad its done now and my wife is too. Gravity is my friend on keeping my erection as well but it would be nice if there was a fix.
It sounds like the trauma you experienced was a tear of the corpus cavernosum. While this doesn't neccessarily pertain to Peyronies disease, I am running your post because the result of this injury sounds like venous leakage - a condition that is not uncommon among men with PD. It can make it very difficult to maintain an erection. MG
I had the Nesbit Procedure for a 30 degree curvature inwards about five months ago. I can obtain an erection, though not at the previous rigidity. While there is some discomfort during sex, I have no sensation whatsoever. I am very worried that he damaged a nerve or that this is permanent. Is this normal or does it take some time to regain feeling in the penis? Also, my penis now has a bend about 10 or 15 degrees to the right, but the doctor who performed the surgery says it was just a slight over correction. I went to a reputable hospital for the procedure but I would like to know if over corrections are common or did the doctor fail me. I feel horrible that I went through this terrible procedure just to have a curve in a different direction.
After 5 months, there will probably not be much more change in the correction you have. If it is bending opposite to the original direction, there may be some degree of over correction. Sensory loss can take cosiderably longer to recover, so there is definitely hope your sensation may improve. MG
In my last post you told me that my inflammation comes from the mechanical stress put on my penis. This firmness has not gone away for three months. Is there any way to reduce this inflammation?. I was also wondering that because peyronie's starts with an area of unusual firmness that this could be the disease in the acute phase.
It is possible that this is early PD. Although conventional medications and anti inflammatories don't usually change PD much, the best response is early on so it might be a good idea to see a urologist and be fully evaluated. MG
Im 18 never had problems getting hard. However within the last week it takes awhile for me to get comptletly hard. The other problem is bottom of my penis gets hard but at the middle it like pinches and it takes me a little bit to get fully hard to do anything. I also feel like its not as big. What is going on? Should i get it checked out?
If this is a change from your previous condition, it might be a good idea to get checked by a urologist. MG
My penis when flaccid feels firm and sometimes after I masterbate I get the sensation of a dull ache occasionally. I have examined my penis and i feel no such lump or nodule. I have gotten this inflammation for over a year. This has also caused some loss of erectile length. I want to know why and I also want to know if I should abstain from masterbation.
I'm not sure you need to do that. At any rate, this does not sound like PD to me. MG
I'm a 71 year old man who has and still is sexually active...My problem is my penis has always been straight no curvature at all left or right up or down, about 6 weeks ago I was with a lady friend and got an erection but I was really amzed to see my penis was now curved at about a 45% angle as if it had been snapped in half and was stuck at that position, it was also a lot smaller than it usually is....Is this something to do with my age or a medical thing? I mean it looks ridiculous just like a fat hook Please can you tell me whats happened and if there is a remedy...
Yes it is a medical thing, but it does not go along with any other internal disorders or health risks. That is why Peyronies Disease is not really a "disease". Regarding medicine to help it straighten out, the most promising remedy appears to be Xiaflex. This is an enzyme that partly dissolves the distorting scar tissue, and it is being submitted for FDA approval some time this fall. MG
I'm 23 yrs old and recently had my nesbit operation a 1 week ago for congenitile penile curvature - around 60 degrees during erections. While my erections seem to be come and go, i've noticed less sensitivity on the top half of my penis and my penis forehead is non extistent, even during an erection and looks crushed. Foreskin has firmly covered the top. Is this normal? and will by penis forehead come back in time? Kindly note that i have almost no pain and that i am not circumcized. Also can u suggest activities that will speed up the healing process?
If you had a nesbit procedure for downward bending, the nerves on top of the penis had to be mobilized to create the tucks along the top. This can create some sensory loss, which usually resolves after a few months. I don't know of any way to speed up the healing process. MG
I am 36 years old and have a 30 degree bend to the left, which a urologist thought was a congenital curve. It feels weaker than the right side and have been taking Cialis for about 7 years with great results at 5 mg. I went to check out other ED options and the clinic I went to injected my right side (Stronger side) with a single trmix shot. They assured me it would not cause a scar, but I got a bruise for a couple days and have been freaking out because my right side seems weaker than before and does not stay firm even with Cialis now. It's been 6 days since the injection and the bruise went away in 3 days but my erections won't stand up on their own because both sides seem weak now. The right side also hangs differently now as it has straightened out my left curve somewhat when semi erect. Will this cause the dreaded hourglass peyronies condition and possibly complete ED since my erection won't stand up on it's own with Cialis anymore? I have been using a lot of Vitamin E oil. I have been worried sick about this. Thanks for any feedback.
A small hematoma (blood accumulation) in the wall of the right corpus cavernosa would temporarily restrict its expansion, which could cause diameter reduction and corresponding loss of rigidity on this side for a couple of weeks. I think any permanent damage from a single trimix injection is extremely unlikely. MG
Hello. I'm a 22 year old male and I've been having issues with a lump on my penis. About a year and a half ago, after I was nicked by someone's tooth during oral sex, I developed a small lump about a centimetre and a half under my glans, top side and slightly to the left that swells with my erection and subsides when I am flaccid. The lump itself is the issue, as I had an episode in the bath where I became erect and then naturally lost the erection, only to find after getting out that the lump was connected to a thick vein like structure travelling around and to the tip of my penis. While massaging this structure I felt a pop and the vein disappeared but the lump remained. I assumed that the lump was a lymphocele because of this. However, now i'm not so sure. When I feel the lump, it feels like there is a hard immobile lump that the vein comes from. The only way I can explain is is to show it like this ===() where = is the soft vein and () is the lump. It's changed very little over the year and a half, perhaps growing slightly, and while I experience some pain on the skin around that area it moves with my foreskin and isn't fixed. Most literature that i've read suggests that lymphoceles vanish with a few weeks. Do I have scarring involved or potential to develop PD, or should I not be worried?
This may be the residual of minor local trauma to a superficial vein. I don't think it exposes you to any risk of PD. MG
HI Dr, I am 19 and have been sexually active for about a year and a half. My issue today is that my penis when flaccid, tends to show an hourglass shape , pretty much looking normal and healthy from the base to a little above the middle of the shaft, from the middle to the head, the penis is less wide (clearly) than the shaft. Pretty much i think it would hang lower if it wasnt all scrunched up. sometimes though it hangs normal, when im in the shower or whatever. some days its worse than others and ill have to pull the skin around the base downwards and use pressure as if to pee, for the rest of the penis to widen up again. When erect, there is a slight difference in width from bottom to top but i do notice that where it is scrunched up flaccid, it tends to not be as hard there when i am erect. Now, i have witnessed my penis functioning normally and blood flowed all the way through and my penis was around 7 1/2, but usually its around 6 1/2 or 7. im wondering what has caused this, if i should go to the doctor, and if there are any cures? I'm guessing it may be either from sleeping on my chest or when masturbating i may have squeezed to hard for too many times on the middle of the shaft and now its forming that way? hopefully not the case..but please help!
I don't think you have peyronies disease (fortunately) nor do I think there is anything wrong with your penis based on what you have written. MG
thank you so very much for taking the time to answer our questions, doctor! here is a follow-up question : i did see an urologist and i was right with my self- diagnosis of PD - he prescribed Pentoxifylline for my PD, i am not sure, whether this urologist is as experienced as you are - and since it is mentioned, that in the beginning phase of the disease there can be a lot of positive things done towards "healing"... (i am in the 2nd month of noticing the disease) and everywhere is mentioned, that Pentoxifylline is a very conservative approach - with other words, is my urologist playing it too safe? and therefore the results might be minimal too? thank you so very much again, for your kind reply in advance! i am 55 and somewhat devastated, since i am single...
pentoxyfilline is commonly used in the early stages of PD, so this seems like a reasonable approach. You may wish to add an over the counter supplement called l-argenine, which is taken as a 1,000 mg capsule twice daily. MG
Hello, I am quite young as I am only 18 and I believe this issue started when I was 12. My problem began with curvature on the underside of my penis and penile shortening. For several years it was difficult to gain an erection and I only could achieve one through masterbation. The problem around 2 years ago seemed to resolve as I was gaining strong erections. This lasted about a year until my penis became firm and gradually shortening by a couple centimeters. It seemed like it was going through an inflammation process. I can only theorize this problem arose from sleeping face down. This resulted in my penis bending down. This process lasted about 3 months until the firmness went away. This problem has come back every 5-6 months since then. I notice each time this problem occurs it shortens a 1 or 2 centimeters. My full erection 2 years ago was about 5 3/4. It is now about 5.5 or sometimes smaller depending on the day at full erection length. Last year I went to 2 different urologists who said I seemed to have no lumps or scar tissue, yet I know from evaluating my penis that I seem to have a mild case of peyronie's disease. Currently I seem to undergoing an inflammation process that hasn't really resolved much. It seems masterbation makes the firm area worse. I have no idea if the shortening can be reversed or if I should go see a urologist again. Peyronie's is not a well understood disease and from what I have read there is no effective treatment. I would appreciate it if you could give me some of your advice.
The downward bending noted at adolescence is not Peyronies, but congenital curvature. In some young patients I have seen this associated with mild venous leakage, a condtion that can make maintaining a rigid erection for a prolonged time difficult. In addition, the downward bend makes the concave underside subject to more mechanical stress than the rest of the penis during sexual activity - which can result in episodes of inflammation. A nesbit procedure to straighten the congenital curvature may address some of these problems. MG
Please help! I am a 26 yr old, perfect health, no allergies, always had a 6 inch penis which bent a bit to the left. After some rough drunk sex, i assume my GF came down hard on my erect penis, missed the hole, and caused it to bend hard to the left. Symptoms: Blue/purple balls, shorter penis, more pronounced bend to the left, with an accumulation of hard tissue at the base. No pain while peeing, or when experiencing pleasure. Swelling has started to come down, but the bend is still very pronounced. Please help !
sounds like you had a mild penile fracture, which might require a surgical repair - if you had a lot of swelling and now severe bending. You should see a urologist experienced in reconstructive surgery. MG
I am 29. Everything started about 3 months ago, during prolonged and aggressive sex, I bent my penis, it was a little bit painful and I lost erection, than within couple of minutes everything was fine again and continued to have sex. In about 24 hour I discovered small bruising on penis shaft, did not think about it much as it disappeared within 2 days. In about 3 weeks started noticing that my flaccid penis hangs to the left... within month or so I think it started curving a lot to the left when semi erect, when it's erect it is straight or maybe curved 5 degrees to the left, not sure. Also I noticed hard vain like pencil on my penile shaft that moves left and right and I have feeling as it is too short and it pulls my penis to the left side when flaccid. Not sure but after reading about dents, there might be small dent on the left side, don't know if it was there before. I don have pain during erection or when flaccid. I could not find any lumps also. Have not visited doctor yet, not sure what to do. Please help as it drives me crazy
It is not clear that this is PD - may be just slowly resolving trauma. I would suggest supplements like l-argenine and vitamin E, then a checkup with a urologist if it does not resolve in a couple of months. MG
Hi Dr, a few months ago my partner began to complain of pain in his penis during intercourse, very soon after he noticed what he called a bend in his penis. Since this time I have noticed what I can only describe as a hard ring around the shaft of his penis. He has become less and less reluctant to have sex in the past few months and says it is getting more painful and really doesnt like me to mention it when all I want to do is help and understand. We have a really good relationship otherwise and I want to reassure him. He is only 47, in very good health and is quite fit but wont see a doctor about it. Could you tell me what the long term outcome may be with this condition.
If this is a mild case of PD, there will usually be some persistant bend or constriction over time. For that reason, and since mild PD responds best to medical (non-surgical) treatment early on, it would be a good idea for him to see a urologist. MG
i am 55 and i first thought, i have ED due to my age - but now i can see, that i have almost all the symptoms of PD, except a hard lump - i am single now and just met someone - worst timing possible! - how can i perform sexually with a shortened and softer and slightly curved penis, and the additional pain during the erection? (i do have a few hard bumps on the palm of my left hand for a few years now) would viagra restore the hardness and length? thank you for your answer in advance...
Viagra will probably restore the hardness and help you with sex, though it may not bring back the length. MG
First, thank you for this forum, it has been very interesting, but also has unfortunately confirmed in my mind that in addition to Peyronies Disease my husband also has Dupuytren Contracture as well as Plantar Fibromatosis. He has been seeing a urologist who basically has advised him there is not much that can be done for his Peyronies other than surgery. He is also seeing a podiatrist for his foot problem, but now with the problems with his hands I hate to have to see another doctor. By chance are you aware of a doctor in the Chicago area that may be able to handle all three conditions?
Although these problems are related, unfortunately one doctor will not be able to handle all of them. For the Peyronies I would reccommend Dr. Laurence Levine who is with Rush medical college in Chicago. MG
Hi, I wrote you another e-mail yesterday regarding the progression of my Peyronie's, but I realized I have another question. Around the same time I developed PD (about 7 months ago) I began having bloody ejaculates. I have had a thorough work-up for the blood (MRI, cystoscopy, ultrasound, PSA, etc.) Nothing was found except that my prostate bleeds easily. My urologist believes that I have varicose veins around my prostate. I have had the bloody ejaculates unabated for the last seven months. I have been told that there is no connection to the Peyronie's but it all seems so odd. Do you think there's a connection? Can these bloody ejaculates worsen my PD? As of now, I have been told that my treatment options for the blood are either Proscar or a surgical cauterization, both of which run the risk of importence. My instinct is to just live with the blood for now. What are your thoughts?
I believe your doctor is correct; I know of no connection between bloody ejaculate and PD. MG
I'm a 49 year old. Diagnosed w / peyronies. Had ultrasound and confirmed. Probrably 8 months, noticeably into my condition. My curve is more sideways to the right . Able to have erection, and orgasm. My Urologist said to wait, no treatment, till it runs it's course. I have appt w/ the Dr you recommended in Sloan, Dr Mulhal, in early Nov. 2015 . Since I have caclificatiin do you think that new drug you spoke about that may be FDA certified in 2013 would help me ( Xiaflax ). I feel that I / we should be doing or trying something in the developmental stage???
Xiaflex may be helpful if calcification is limited or spotty. With extensive calcification, this drug probably will not offer a lot of improvement. MG
Hi, I have had Peyronie's for a little over six months. I present with mild curvature (13 degrees), a dent midway through the shaft and flattening on the top side of the penis. I am luckily sexually functional. During this time I have been treated with six rounds of Verapamil injections. I am also in my fifth month of using the Fast Size traction device. I initially had one small, pea size scar. During the course of injections, about 2 and a half months ago, a new scar appeared on the left side of my penis. I also now have a twinge sensation near the new scar when I pull on the penis, even gently. As of now, my deformity seems largely unchanged despite the new scar. My question is as follows. I still feel tremendous fear and anxiety. When can I relax? Given the treatment I have received and the fact that the deformity appears basically unchanged in six months, what are my odds? Am I out of the woods? Also, what do you make of the "twinge" sensation? Thank you.
These twinges are pretty common and I wouldn't make too much of them. If your condition is stable at 6 months there is a good chance you will see no further progression. MG
Dear Dr. I am 31 year old; unmarried. One night in February(2012) i masturbated with my penis supported against bed. on the following morning i noticed the the following condition - 1. Pain on the tip of the penis. 2. Glans Penis seemed dried/wrinkled. 3. Penis was stiff even when flaccid. 4. The veins had become prominent (on the top) and the blood vessels were prominently visible after sliding the skin. 5.Sometimes pain at the base of penis. I was diagnosed with prostritis by Urologist and took the medication for the same. the pain subsided but i am facing the following problem - 1. I am unable to get erection if i want to masturbate again. 2. My penis remains stiff even in flaccid stage. 3. Penis is slightly twisted towards right. 3. Recently 4-5 times i observed that my penis bends right side when semi erect. though i am unable to find any difference between both side of my penis. Kindly advice. Do i have PD; if so how can i identify the plaque; will it resolve with time.
PD will cause increased bending with increased erection - if you see angulation with semi erection that straightens out when it gets hard, this is probably not PD. MG
Hi, I am 24 year old male. I've been masturbating once a day since i was 17. Now my penis is bent 45 degrees downward during erection. Is it due to masturbation ? Should I stop ?
this is probably congenital curvature. no need to stop masturbating. MG
I am 65 years old. Six months ago I had what looked like a fungal infection on the glans which was finally diagnosed as lichen planus (skin condition elsewhere on my body and inside my mouth confirmed this) which was successfully treated by corticosteroids in less than six weeks. A few weeks later I noticed that my penis had an abnormal bend in it and I suspected it to be PD. I have been experiencing an aching pain for about a year whenever I had an erection. I had not had sexual intercourse since the first onset of the symptoms appearing in case it might have been an infection. After discovering the bend I visited my General practitioner who has made a referral to an urologist. I have attempted intercourse once since but I found it was extremely difficult to achieve penetration due to the misalignment and I suspect to the difficulty of achieving a sustained erection. I have never had ED and I suspect this problem to be psychological as I am embarrassed. I have not yet been diagnosed by a medical professional but my condition seems consistent with PD. Because the bend seemed to appear so suddenly I was anxious that the distortion might continue, so I monitored its condition. Over the last three months I have found no change in the bend which is downwards. My penis curves 10 degrees to the right from halfway along the shaft at a radius of about3inches (viewed from above), and bends downwards about ¾ of the way along the shaft at 40 degrees sharply at an internal radius of 1 ½ inches (as viewed from its right side). (I think) my wife is unaware of my condition despite our difficult sex and I am too embarrassed to talk about it as I feel inadequate until I see a specialist. I cannot contemplate having sex because of the. I am concerned that I have waited about four months for an appointment to see the urologist and I would appreciate your opinion whether a long wait might worsen the problem and chances of successful treatment. Could my condition be associated with Lichen Planus and the use of the steroid ointment, or do you think this might be just coincidence?
The association with lichen planus is probably coincidental. Usually, the earlier medical (non surgical) treatments are started, the better the result. MG
I had a nerve sparing prostectomy 12 months ago, and ED is still a significant problem. The "therapy" has been injections into the penis 3x week. The result of these injections appears to be peyronies. Half way up, there is an hour glass indent on the left side. Also my penis points up, between 55-65 degrees from midshaft. Should I seek additional help about the peyronies, or wait to see if it things self heal? Is peyronies hurting my recovery with ED? Or conversly, will trying to fix the peyronies hurt my recovery with the ED problem? It was extremely painful to have an erection months ago, but now is less painful. Thanks, CW
PD is more common after radical prostatectomy, and after the use of injections. It may be better to adopt a vacuum device to help with erections at this point, rather than injections. You might want to talk to your urologist about the curvature you have developed. MG
I am a 47 year old male. I started taking an ACE Inhibitor blood pressure medication 6 months ago and have since developed PD and Dupuytren's in my right hand. I feel strongly that there was some relationship there between the start of my medication and the onset of these two conditions. Do you know of any such relationship?
The only drug-based relationship to PD that I know of would be with beta blockers - could the medication you're taking possibly be a combination of the two? MG
I am 60 and have had peyronie's for 5 years. I have a 45 degree upward curve which has been stable the last two years. My doctor prescribed cialis 20mg to improve my erections which are not as firm as before. He told me I would probably benefit greatly from xiaflex, should it get approval later this year. At my next appointment I'm going to have the full workup, ultrasound etc. If the tests show calcification, do you feel xiaflex would still be a viable treatment option?
In the clinical trials, patients with extensive or contiguous plates of calcification were excluded, but not patients with punctate or small calcifications. I think the same thinking will hold true in clinical practice. MG
Hello, I'm writting for my huband who has tried research but hasn't gotten anywhere. So Ithought id try for him. He's scared of doctors. I'm the first who's really noticed it very clearly. When he is soft its on the underside of his penis and to me it just looks like a raised bump and skin has kindof bult around it. He was born with it. Its embaressing for him to say but it gives himextreem pleasure durring sex. He discribes it as though what it would feel like as a clitorus to me. Its more sensitive than the head of his penis. He loves it and so do i, we are just curious as to what it could be? And also there is a thin line that goes straight up from that to under the tip of his head. Its all sensitive like crazy. I thought at first it was how he was circomsized? But the bu an inchss under the head confuses me. Never any pain, discomfort or change in color. Just extreem pleast ure. Do you thave any suggestions as to what it may be. He's stuborn and embaressed to go in for it. Thank you for any answers we haven't found any he gave up monthsz ago, not me! Lol
This bump does not sound like Peyronies. If it has been present lifelong, is not changing in size, and it works for the two of you, leave it be. MG
My boyfriend of 6 years has experienced gradual loss of erections, sensation and libido. He has diabetes type 2 and is 59. He used to be able to get semi-hard erections without much help, though has been taking viagra for about 3 years. The effect of the viagra is lessening, even though he is on the maximum dose. I noticed his penis started to bend downwards a little and there is now noticeable plaque along one side and a more severe bend to the side, which has worsened in recent months and an erection is now almost impossible. He has also lost length and experiences a lot of pain if we try and have sex. He is struggling with not being able to have sex and we very rarely do anything now, which I am finding very difficult. He won't go and see a doctor as he thinks there is nothing which can be done and the diabetes has basically caused it which is not going to get any better. I also wonder whether he has low testosterone levels which is also causing the lack of libido and sensation. When we first met, we had really great sex. I enjoy times of intimacy with him which do not lead to intercourse, but they are getting less too as he does not want to think about how he used to be good at sex and now he isn't (or so he thinks) Is there anything I can suggest?
This is obviously a very difficult situation but you do need to influence him to see a urologist experienced in the treatment of PD. He also should have a testosterone level checked. As you know, Diabetes itself can have deleterious effects on male sexual function, and when combined with downward - bending PD (which usually causes more difficulty than the usual upward bend), the effects can be particularly difficult. Intercouse is not everything but intimacy is. The big problem in this scenario is the gradual erosion of intimacy, which will compromise the relationship and incur psychological costs. It would be a good idea to address and deal with the treatable physical issues before this happens. MG
Recently I noticed my penis has a dent at the base on the left side. I'm a 57 yer old who recently had back surgery and had a catheter. Could the catheter have caused damage to a blood vessel? I've also noticed my volume of ejaculate has decreased and sometimes I there is the feeling of orgasm but very little or no ejaculate is present. I'm on pain meds but have been on these for the last 3 years due to multiple back surgeries. My left testicle is also somewhat tender at times and slightly drawn up. My testicles use to hang somewhat evenly now my right one hangs much lower than the left. Seeing a urologist next week but wondering what some of these causes may be in your opinion. Thanks
The dent at the base on the left side could be early PD, which can sometimes come on after a period of catheter use. The other symptoms are probably not related. MG
Doctor, 56 a couple years ago I started to get a pinching about a third of the way up the shaft. Now pinching is servere and texture feels hard around the pinch. Shortning and unable to get fully erect. Peyronies?
Yes that sounds to me to be the case. In some cases of PD, there is more pinching in of diameter and less bending. Both forms cause loss of length and may contribute to the erectile issues. MG
Great forum, thanks. 38 yr old in general good health. About 6 weeks ago i experienced trauma during sex. The pain was moderate, but no bruising or swelling. About 2 weeks ago i started getting a mild pain/discomfort on the base and bottom side of penis during masturbation. Also the erection has not been as full. I haven't noticed any lumps or curvature, other than a very slight curvature which i've always had. Nevertheless i've never experienced a pain like this before and it's continued for the past few weeks. Does this sound like mild peyronies related to healing which will subside? Or something that will continue to worsen?
No it does not sound like PD, which takes a lot longer than 6 wks to develop. There is probably some residual inflammation which will take a while to clear up. MG
Doctor Gelbard - I just sent a message a few minutes ago and wanted to add - I have taken Trental/Pentoxifylline, Natural Vit E, L-Arginine, Cialis - all with no improvement in pain or progression. thank you
thank you see below. MG
Hello Doctor, I was diagnosed with Peyronies several years ago, it started with a small lump and pain while flaccid, and has evolved to several areas of plaque - lumps, bands, small chunks - and pain. I was stable for a period of about 6-7 months once, while I still had pain, the deformity did not progress during this time. Have you ever known of a case that progressed for this long - 4.5 years? Is there anything that can be done? At this point I would seriously consider having my entire penis removed to take the pain away. thank you
low dose radiation is no longer used to treat PD, but in those very rare cases with perisisting pain it may be worth considering. MG
Hi Dr, I was diagnosed with PD about six month ago and I wonder if it' s bad for the desease to mastubate every day, can the lumps/indentations get worse? I'm afraid that I will make the disease progress to worse. I also wonder about the lump that I have. Some times I can feel the lump very well and some times I can almost not feel the lump, It's like it shrinks sometimes why is that? I have no bend but indentations were the lump is. When can I relax and stop worrie about this getting wors, bend or bigger indentations. Thank you!
Masturbation will not be harmful, and it is normal for the bumps to change their configuration. MG
I'm a 57 year old male. I had a normal sex life until I was recently diagnosed with PD. I have an issue with curvature, but no problems with errections. Everything feels quite normal,except for the curved penis. No pain at all. My doctor prescribed vitamin E along with cialis and he recommended an Andropenis, which I find uncomfortable. I did some research and came across another recommedation that treats PD and the associated curvature. It is Serranex-Ft and Nattolizyme combined with Vitamin D. This supposedly treats the PD and curvature. Is this a viable option? Thank you SA
This is an enzyme preparation that to my knowlege has never been evaluated critically or scientifically for its effectiveness in treating PD. MG
Hello, I am 47 years old. Does PD happen instantly? My penis head started curving to the left about a week ago. My penis has always favored the left since a youth but , literally the head area wants to go to the left. My wife commented last night when did this happen? There is no pain and I dont feel any bumps or scaring? I dont recall any injury. Any comments would be appreciated.
In some cases PD seems to come on "over night". That is probably not the case as the process may be developing and escape notice for a long time. At any rate, we do hear this history from a number of patients, that it just "suddenly appeared". MG
I noticed pain down right side of shaft about six months ago and now have a curvature at the end of my penis upwards and to the left. All the signs are of PD but I cannot detect a lumpat all. Is this possible or is a lump a prerequisite of the condition?
This definitely sounds like Peyronies to me. A lump or plaque is not always present - sometime it can be a band of scar that can only be felt on stretch. MG
Hi Doc, I was diagnosed about 15 months ago. Dr. M. from Memorial Sloan said I had very mild case less than 10 degree curve, have indent top left side, when erect left side is smaller erections are not as firm, when flaccid lays completely on left side and is smaller, shrinks when play sports. Has affected my confidence being single man and active but have found when erect it is almost 100percent but I have to be really erect. My big concern is when flaccid or before erect left side is unstable and not firm because of indent, it doesn't hang like it used to at all when flaccid. I did traction for many months which helped with curve. I now consulted with urologist in Alabama and am using VED 20 mins/day plus ultrasound 2x 10 mins/day and Verapamil cream 2x day plus VitE, L-arginine. Main question is left side instability feels like this side has been shaved away a bit, indentation where break or fracture took place is obvious small improvement. No lumps, possibly a chord I can feel! Any suggestions. Thank You Much! Jerry
Dr. M at Memorial is one of the best. The Vacuum therapy may help, though I have little confidence in the benefits of topical verapamil. MG
Although not officially diagnosed with PD, I have most symptoms: over age 55, curvature, shortening of penis, semi-rigid, noticeable lump, and over the years there have been incidences of trauma to the penis. My question concerns my erections, although not nearly as rigid as they once were, they are always downward. I can no longer get it perpendicular to my body as it once was. Is this also a symptom of PD?
Yes, if PD occurs on the underside of the penis, it will cause downward bending. MG
Has anyone tryed a heated back massager for PD the heat for healing and the vibrating to increase blood flow to the area?
I'll put this out to the readership - I know of no studies examining this method. MG
I have been contemplating coming to see you. I noticed about six months ago a hard lump inside the shaft of my penis. It is most noticeable when flaccid. There are no noticeable external signs except that erections are slightly painful and length has been slightly effected (shortened). There is now another one of these masses a little further down the shaft away from the head and needless to say all of this is quite disconcerting. Is this PD even without bends or curves or is this something else?
The combination of palpable bumps, discomfort with erection, and shortening sounds suspicious for PD to me. MG
I developed Peyronie's symptoms suddenly in September, 2011. After several unsuccessful verapamil injection treatments, I underwent an excision/grafting procedure in April, 2012. I was told i required a "large" graft of approx. 8 cm. After a couple of weeks, i began taking daily Cialis. Not long thereafter, my penis became swollen, particularly around the sutured area near the glans. I stopped taking the Cialis. For several days, I squeezed substantial amounts of blood out of the penis through suture openings that had not yet healed. Eventually things seemed to normalize. I was cleared to have intercourse approximately in late May, 2012, about 5 or 6 weeks after the surgery. My first erections were straight, although length and girth were clearly lost. Nonetheless, I was extremely pleased to be straight. I had sex twice in late May, 2012, though was not able to ejaculate. A few days later, I contracted a high fever of 104. I was given fluids, and tested negative for any viruses at the ER. My fever broke and I was released from the ER. A few days later, my fever returned, and this time was accompanied by swelling in my penis (I had resumed the daily Cialis for a while). I was able to discharge some fluid from the same area. However, at first, the fluid was yellow this time. Later it became rust colored, and then blood red. I contacted the surgeon and was quickly admitted to the hospital where i was administered some powerful antibiotics and kept overnight. I was released the next day and got progressively better thereafter. The swelling was gone as well. However, ever since, my penis has had a substantial upward curve when erect. There is a noticeable narrowing on the shaft where the curve begins. I do not believe there is any plaque. My surgeon believes that the graft he gave me has tightened. The length and girth of my penis have diminished distressingly. Now the curve is back as well. I am extremely disappointed. I have not been able to have intercourse, both because of the size and shape, as well as my distress when i see or feel it. Can a non-plaque caused curve be corrected? Was the graft placed improperly? My surgeon is recommending a prothesis, which I simply am not ready for. I feel i am too young. I am at the point where i want to propose to my girlfriend, but this is a serious concern. We want children and i want her to be happy and fulfilled. Needless to say, my life changed dramatically and without warning that day about one year ago. I want to be normal again. I've lost some confidence in my surgeon, who is a very reputable urologist in a major city. I don't know what to do, but will do anything to avoid a prothesis.
My question is regarding the nature of the graft - it sounds like it became infected, which is unusual in a graft taken from your own body. If this was not an autologous graft (tissue from your own body), it may be possible to revise the curvature while removing the foreign graft material and subsituting autologous tissue. MG
I think my boyfriend suffers from this condition, I have been researching for some time now(I'm a biologist) and I'm convince the cause of his bent upwards penis and the fact that he can only get one erection a day is Peyronie's disease. I love him to death and this has never been an issue for me, but Im afraid in the long run it will translate into impotence. We have a great communication but I don't know how to approach the subject without making him feel belittled. Can you guys give me some pointers? Thanks in advance.
That is a difficult question. Your communication skills seem great, perhaps you should cc the email that you sent me, with the comment that concern for a loved one is never belittleing. BTW if he is functional now this condition is not likely to lead to impotence. MG
I am interested in determining what insurance might be most likely to cover the Xiaflex treatments should it become available in near future.
This of course will have to wait for FDA approval. My opinion is if approval is granted and Xiaflex becomes standard first line therapy for Peyronies Disease, insurance carriers will be obliged to cover it. MG
Dr. I was diagnosed with peyronies in Sept. 2008 Since that diagnosis I was taking Vit. E 400mg twice daily. Since the diagnosis my PSA have been rising from 3 before diagnsis to 6.47 now. Is this a coinsidence or something related to peyronies?
Peyronies Disease has no interaction with or effect on PSA. You should have the rise in PSA checked out without too much delay. MG
My husband developed Peyronies a few years ago and had the Nesbit procedure after 16 months. We were aware that the procedure reduces length but we were not prepared for how much (two and half inches). This has a dramatic effect on our sex life. Having known my husband’s penis for 20 years I don’t believe that they put the sheath of his penis back correctly and there seems to be quite a lot of penile tissue retracted into the body. I believe that they cut too much foreskin away and re attached higher up reducing the usable length. Can this be rectified?
When a Nesbit procedure is done for severe bending, the resulting shortening can present problems. You may wish to consult with an experienced reconstructive surgeon, though this issue can be difficult to resolve. MG
I'm currently 30 years old going through an absolutely devastating divorce. I've not had an erection or any sexual contact etc for the past 2-3 months, lack erections due to stress no doubt. Is there a risk of penile shortening etc from lack of use here?
No, fortunately you don't have to worry about that. MG
Hi, I am unsure if I hve peyroines or not, and unsure if my curvature has always been natural. I have about 20-30 degrees curvature on erection and a tight sheet-spot on left side of penis base. The right side of the base feels weak in comparison so I wonder if this is just more developed tissue on the left base. The curve goes to the left and isn't so much of a curve as it just points that way. The left base tightness does not hurt and feels basically like a stronger muscle, almost rock hard. While flaccid this area feels tougher in comparison to the right side and is basically the tissue that connects penis to pubic boen or something. When i flex my PC muscles it pulls on my penis from this area. Is this a plaque?
I don't think so, from your description. Some men have thicker fibrous tissue around the suspensory ligament, which connects the base of the penis to the pubic bone. This can have the effect of pointing the penis off to one direction or other with a really hard erection and is not usually a problem. MG
Dear Dr Martin Gelbard I just want to express my gratitude to you for the time you dedicated to answer our questions. Please keep up the good work. In my case, the condition I had turned out -as you have suspected- to be a thrombised vein. I am almost completely recovered now. Thanks a lot again... Sincerely yours ... MMW
Thank you - I appreciate your taking time to give us some followup. MG
Hi, 3 weeks ago I bent my penis when I was dancing at the club. It hurt pretty bad - no bleeding, erections are ok, and no pain while urinating. However there was some bruising, and there still is some discoloration today. 2 or 3 days later I noticed a bit of a curvature. My penis already curved a little bit to the left but now it does more so. Anyways, the injury is on the right side of my penis. The area is still a bit discolored and looks a little inflamed with broken blood vessels, there is a very slight indentation where the injury was - not noticeable while errect, and I have some pain that goes on and off. I went to the urologist a week and a half ago and he said that I dont have pd and that I should rest it until today so it can heal. I have no plague and I thought it was sort of weird that the injury is on the right side but curve is to the left. Should I get a second opinion about pd or just give it time?
Just give it a rest, it doesn't sound like PD to me either. MG
Hi, looking though your forum comments it seems that I have this problem. I am living in what some call the third world so treatment or even an authoritative diagnoses is not all that easy. However a few answers to questions may assist. It is mentioned that those suffering from Dupuytren’s contracture may be prone to Peyronies?? It is mentioned that there can be a loss of length (penile)as a result of the condition??Is this permanent?? I seem to have contracted two other conditions in the same period as I realized the Peyronies. 1, a large lump on the ball of my left foot, different from the lump associated to Dupuytren’s. 2, pain in the first three fingers of each hand. All sounds like just a coincidence however it would be good to understand that to be the case and not somehow linked. Like all of you other correspondents I feel that I am healthy. Details Male 65 years old Totally active in all areas, Running, biking, Sex (young 37 year old wife) Take no medication other than beer. Have had both hands operated on for Dupuytren’s contracture, so far no recurrence. Not vastly over weight, 1m 95cm tall 107 KG no beer gut.
What you are describing is all part of one picture. Dupuytrens and Peyronies are closely related, as well as plantar fibromatosis (bumps on the soles of the feet). Yes Peyronies often causes shortening of the penis and in some cases this can be permanent - particularly in a man who also has dupuytrens contracture and a plantar fibroma. MG
I am a 57 year old male with no medical issues. About a year ago, I begin to notice that my penis was beginning to curve upwards. It continued and I finally saw a Urologist a few weeks ago. As I suspected, I was diagnosed with PD. He suscribed a combination of L-Arginine, Vitamin E and Cialis. This along with purchasing an Andropenis. I am concerned about the Cialis and it's side effects. Plus the fact that I don't have any problems with a sustained errection, nor do I have any pain at all as a result of the PD. In other words, everything has continued to feel quite normal during sex except for the fact that I don't have enough to work with as a reslult of the curvature. I do not suffer from ED, which is what I thought that Cialis treated. At this point I am very confused! I continued to research options. One option was a combination of Serranex-Ft and Nattolizyme, along with Vitamin D10. Do you have any thoughts on this combination? Do you agree with the original recommendation that I stated above? Thanks for your input. AS
The use of low dose cialis is a common reccomendation, as this class of drug seems to have some anti - fibrotic (anti - scarring) effects. However there is really no good peer-reviewed double blind study data confirming it helps, so if you don't have ED, it's sort of an expensive "maybe". The use of an extender device such as andropenis and the supplements / enzymes is a reasonable course of action at present. The topline phase III data on Xiaflex (collagenase) that was released earlier this year shows great promise in my opinion, and I believe it will be submitted for FDA approval by the end of this year. If that drug becomes available, it may prove to be a very compelling option for many men. I will post updates on that in the future. MG
Hello Dr, I'm a 31yr old male, in good health. 2 or 3 months ago i had the impression that my penis was becoming 'stiffer' when in flaccid state. Also, the superficial veins in the foreskin, the dorsal vein and the branches on the side became swollen and more visible. The foreskin and the glans penis are irritated and show redness. I have problems getting erections, and experience a slight burning pain after erections (sometimes lasting 1 or 2 days). There is no bending of the penis upon erection, but it does not become fully erected as before. Also the tip of the penis does not get as stiff as before. Yesterday, my urologist presumed Peyronie's disease (in an early stage), after palpation. Is it possible to get Peyronie's from vasculitis? (If vasculitis is the cause) His plan is to culture a semen and a urine sample, and i can come back in 2 weeks for the results and an echo of the prostate and the scrotum. I don't like to wait for 2 weeks without doing anything. My question is: can i start some kind of therapy on my own? Like: Antibiotics? (against a possible bacterial infection) (4yrs ago i was treated for an infected prostate). If yes, which kind of antibiotics? Corticosteroid creme? (to break the inflammation chain and build-up of connective tissue) Hirudoid creme? Against intravascular clotting. Cooling? Thanks! Regards from Holland PS: keep up the good work on this site! It is really helpful.
I'm not sure this is PD. If the superficial veins themselves are prominent and firm, it may be something called Mondor's Syndrome. This is thrombophlebitis of these veins, which is a benign and self-limited condition that often responds to aspirin 325mg 3 to 4 times per day over about 10 days. If you have a history of prostatitis I believe a course of antibiotics might be helpful as prostatits often causes pain referred to the glans and can temporarily inhibit erections. Pathologists have noted that there is a vasculitis component to early PD, which is limited to the areas involved by palpable plaque. Systemic vasculitis is a rare and serious illness that to my knowlege has no relationship to PD. MG
Hi Dr I have a problem I think I have a micro penis I Have not had sex for seven yr because Iam ashamed of the size when soft it about 2half inches I've had women walk out on me so I gave up is there anything I can do I've heard of these stretching devises dont know what to do and Iam losing weight was 300 pounds thank you
Normally I don't respond to inquiries about condtions unrelated to PD. In your case I would suggest you consult with a urologist experienced in reconstructive surgery. You may wish to try a traction or stretching device. MG
Hi dr I have had like a small white lump on the shaft of my penis for about six months it wasn't affecting me and didn't notice it that much but a few days ago it started to feel quite painful so I had look at it and it had turned into a realy big lump and realy red but it sort of popped and a bit of white stuff like what you get from a whit head came out and then blood so I stopped and thort it might go down now but it felt like ther was a realy hard bit of something in the skin under this spot but then tonight I got back from work and it was painful so had a look and there was white stuff coming out so squeezed and when it was out it was hard don't no how to describe realy like a grain of rice but more round and a bit bigger would you have any advice
This is an infected sebaceous cyst. You should see a urologist to get it cleared up. MG
Hi I am 36 year old healthy man. I think I just developed a PD. the story is as follow less than a week ago, after having sex with my wife, I immediately felt minimal pain in the penis (which happens to me sometimes if I have a lot of sex). Few hours later, my penis became mildly swollen and tender. My pubic area was also very tend to touch. This was associated with one day fever. About 24 hours, I started myself on Amoxi-calv ( i am an MD) sine my wife turned out to have mild cervical infection. So I thought this was cellulitis of the skin of the penis. The swelling and tenderness both on the pubic area and the penis decrease but, On the 3rd or 4th day, I noticed a hard band-like structure around the tip of the penis (c-shaped). This band is still mildly tender. The tip of my penis is slightly itchy and some of the skin still sloughs away. My penis is not bent when erect although the erection is not as hard af before. I did not have sex with my wife since then waiting for her infection to improve and my itchiness and tenderness to improve too. My questions are as follow 1- is this a Peyronie's disease? 2- if it is, can I do anything about in this very early stage? 3- what is the prognosis in my situation? Thanks a lot
Please see my response to the question about vasculitis. The c - shaped structure is probably a superficial vein, and this sounds to me like Mondor's Syndrome as well. Peyronies doesn't usually start off this way. If it comes on after traumatic sex, it takes months to develop unless there is a frank rupture of the tunica albuginea with bruising and dramatic "eggplant" swelling etc. I would consider a course of aspririn, to hasten the recovery of the thrombosed superficial vein. MG
I had the Nesbit procedure done 10 weeks ago. I have pain while having sex. Is this normal? If so how long should this last?
Normally patients can resume sex about 5 - 6 weeks after a Nesbit procedure. If it was done for severe curvature (>50 or 60 degrees), it may take longer to feel comfortable. MG
I am 54 Male, Have 6" long curved Penis which is curved towards upward. Penis is very weak if we see ring thickness and look of the penis is not in proper shape.I can not go for sexual intercourse with my wife. I feel helpless and desperate in this situation. Please see erection is there but not so satisfactory and up to need of action. Erection does not sustain till the ejaculation.When it is penetrated with difficulty it becomes loose and not do its Job. S C, India.
You should see a urologist who could start you out on injection therapy (with papaverine / phentolamine, which is not expensive) or perhaps you would be a candidate for implant surgery. Dr. Krishnamurti in Hyderabad has experience in treating your problem. MG
Hello, Thank you for your previous response to my post about a week ago (23 year old who bent penis while having sex). I've gone to two urologists now who both agree that I will heal and be fine. They also prescribed me Naproxen for two weeks. My concern is about the indentation that I mentioned in my last post though. It is on the right side of my corpus spongiosum. It is most noticeable when I have an erection and that portion of the spongiosum seems to not "inflate" with the rest of my penis. This causes it to appear to be slightly sunken in. I mentioned it to the second urologist that I saw and they said that it was more than likely due to the healing process. Does the tissue just require more time to heal? If so, should I try to avoid having erections? Thank you again for your help.
Proper healing may take months. There is no need to avoid erections, in fact the use of a vacuum device may help to expand and correct the indented area. MG
Dear Doc, I recently noticed a hard spot maybe 1 cm in the very centre of my penis shaft, what feels like right above my urethra (have to squeeze pretty and deep to feel it) when I was urinating. This has led me here and I am curious if I could have PD without having any symptoms (pain/viable lumps) while erect. I have masturbated more than usual for the past couple weeks but just noticed about 4 days ago. My penis feels semi sore while it is in the stage of getting hard but once it is hard there is no pain. Does this sound like PD or anything else I should consider looking at. Thanks
This little lump and the soreness you feel could be early PD. Consider having an examination by a urologist. MG
hiiiii dr. i m viki from India my question is my penis round shape. for top side. i m very confuse. i m engaged newly what i do? what i do for my penis? shall do beeter sex?
I presume you mean it is round on the top because it is curving downward. This is the most common form of congenital curvature, which can be corrected with a nesbit procedure if it is causing a problem with sex. MG
Hello, I am 23 and about 5 weeks ago I bent my penis some while having sex. The dull, achy pain lasted for about 4 days and then went away, even when I had an erection. The pain came back a week or so later after I had sex again. The sex was not vigorous nor did I bend my penis, but the dull, achy pain came back for a few days again. I noticed a slight indention that was quite small on my penis. Just to be safe, I went to a urologist a week ago who listened to what happened and then examined my penis, checking for plaque. I also told him about the slight indentation, and he checked that as well. He said that he found no plaque and that I don't have peyronies. I have no curvature at all, but every now and then I get a slight sensation in the side of my penis that feels like inflammation. I can still get regular, rigid erections that have no curve. My question is whether or not I can have non-vigorous sex with my girlfriend, and also if there is a good possibility that with the absence of curvature and plaque that this will just take some time to heal. How much time should I give it to heal?..sorry for all the questions. Thank you for your help!
I would agree with you Urologist - you don't have PD. A sore spot from bending the penis (and a little indent from the associated inflammation) may take several weeks to resolve. In the meantime, gentle sex should be OK . MG
Hi Dr. Is there a medical website or a reliable place I could buy a stretching device from? I want to make sure I'm not wasting my money on something thats not going to work.
The two reasonable devices I know of are called Fastsize and Andropenis - I think they are both available on line. MG
07/31/2012 - 13:46 Thank you Dr for your answer and this exelent web site. So if I understand you right: I don't have to worrie about this getting any worse but probably the lump or/and the change of shape across the penis will stay as it is? Thanks again!
Hi Dr, I´m 46 yers old and I was diagnosed by a urologist with peyronies disease six month ago. He did´t tell me much about the diagnose exept that It´s not dangerus. I have a small lump on my penis right side half way upp. It´s 4-5 millimeters, I have no bend but i have a small change of shape across the penis at that area. Lately I feel a mild pain sometimes but no problem with erection and often the pain goes away with full erection. The only change I can feel is that the lump is a bit wider and flat now compared to six month ago. At the beguining I could feel the edges very well. My question is: Do you think this will get any worse, I worries me because I also have a mild form of dupuytren's contracture in one of my hands (just lumps, no bending fingers). Thanks!
The discomfort will almost certainly go away on its own eventually. The fact that you've had this for 6 months without progression to severe curvature is a good sign, though you should know that the presence of Dupuytren's contractures makes this situation more likely to persist in some form. MG
Hi, I was diagnosed with PD and am taking Pentoxifylli and not seeing much of a change. I heard about a streching device, do these work? If they do could the device be covered by insurance?
Please see the response below. In some cases these may produce enough extension to lessen the bend. I don't think most insurance carriers cover stretching devices, but that is something to check with your particular policy. MG
To avoid a surgery procedure for fixing Peyronies. May a Penis Traction be a substitution for minor cases?
Current experience suggests that traction devices may offer mild improvement in curvature if used regularly for several hours daily. Surgery is generally reserved for more severe cases which will not respond as well to stretching. MG
Hi Dr, I am a 55 year old who has been diagnosed by a urologist with peyronies disease. His clinical examination showed that there is a palpable dorsal plaque in the penile shaft and he reckons I have a dorsal angulation of about 25 degrees on erection from a digital image I showed him on camera. I had began noticing the curvature and experiencing pain on erection for the past 7-8 months. Prior to that I had also had at times had some E.D problems over the previous 12 months but this was put down down to stress through a family bereavement. He did some routine blood tests, testoterone, liver and kidney function tests which all came back normal and has informed me that the peyronies disease needs a period of observation for the condition to stabilise before the he considers intervention. He reckoned a period of 18 months would give the penis enough time to reach stabilty at which point he would then consider surgery to rectify the problem. He did offer to prescribe something to assist with any E.D. problems I was still having but I declined as I told him this was no longer a major issue. What I would like to know after reading everything about peyronies is whether I am doing the right thing in taking his advice and waiting so long before I receive treatment. As the days go by I can see that the curvature in my penis is worsening and intercourse is becoming more difficult with my wife. I am afraid that by the time I do go back to see the urologist the curvature in my penis may be too great to correct. Your advice would be much appreciated.
Your Doctor is correct in waiting 12 - 18 months before intervening surgically, as the disease often takes that long to stabilize and the optimal surgical results are in patients with stable disease. Unfortunately the non surgical options (oral medications, plaque injections of verapamil, stretching devices) are not always that helpful. The recently released topline phase III results with Xiaflex, an enzyme that dissolves scar, are promising enough that you may want to wait for this (Possible FDA approval early in 2013) prior to electing surgery. If not, and your condition is progressing, it would be reasonable to opt for surgery at the 12 month point. MG
A little over a year ago I began to notice a slight change in the size and intensity of my erections during sex with my wife. My penis seemed to be getting slightly shorter when erect and for a few months I had trouble getting and maintaining an erection. I was finally diagnoised with chronic lyme disease about 5 years ago after several years of chronic exhaustion, joint pain, as well numerous other symtoms. I had 3 doctor confirmed tick bites about 1994 and was treated with a 10 day course of antibiotics at that time that apparantly didnt do the job. In the same year as that diagnoises, I also had a LAD blockage that was corrected with a stent and a few months later, I had my gall bladder removed. In my early twenties, was diagnoised with erratic blood sugar that would come and go, sometimes there were years between the symtoms, but the doctors who diagnoised it told me that I would be a diabetic later in life. In 2002, this was confirmed, I was diagnoised with type 2 diabetes that I still controll with medication and diet. In 1986, I had my chest crushed to the sternum along with numerous other injuries when I was hit broad side by a drunk driver who had ran a red light. I will be 57 years old later this year and despite health problems, my wife and I have continued a reasonably good sex life until the problems that started last year. Earlier this year I quit taking Effexor-XR that I had been taking for the last 8 or 9 years and my ED symtoms began to ease. However, I noticed my erections that all my life had a slight bend upward now bend downwards 45 to 50 degrees even though they seem to be just as hard as before. After a while I began to experience pain on the bottom side of my penis during and sometimes after sex and it seems to be increasing. I have also found that I experiece the same pain if I try to force my penis straight during an erection. After recently combing the internet for answers I found some information about PD. After reading up on PD, I checked my penis while in it's usually state and I feel a small mass that feels thicker and denser just past midlength. Now I am convinced that I have Peyronies Disease. I plan to make an appointment with my doctor and discuss it with him, but I am worried that he might not know much about it. My questions are: Does this sound like PD? If so, what are my options?
This does sound like PD to me, and downward bending due to this disorder can be a problem when it exceeds 30 or 40 degrees. Your doctor may want to start you on some of the usual medications such as the supplements mentioned in this forum, colchicine, pentoxyfilline, and intralesional verapamil. If the bend does not respond and the duration of the PD if > 1 year, you may want to consider a dorsal plication procedure - though this will shorten the penis a little bit. MG
I am 26 and I noticed a lump on the right side of my penis that goes from the top to bottom of the penis. There is no pain and sometimes it more visible than others, usually after an erection. I am very sexually active with the same person. This has been visible for around 5 months and it seems to be less noticeable at times. Does this sound like PD? the urologist said he thinks it is the early stages and prescribed vitamin e and transdermal verapamil 15% gel. I also started to take Aceyl L-Carnitine. Does this sound like PD? should I try other meds?
This may be PD. I think the meds you mentioned are reasonable, though the experience of my patients using topical verapamil has not shown it to be very effective. MG
Hi Dr, I am 14, and I have been wondering what I can do about my curvature problem. it bends to the left, but when you straighten it out, the left side of the penis is straight, but on the right, below the head, the right side seems to not be as straight as the left and merges left. It's confusing because the penis curves left when there is more skin on the left. Can you help figure this one out?
This type of congenital curvature is due to a mild disparity in size between the right and left corpus cavernosum, and does not usually cause any problems. If in the future it becomes difficult to deal with, it can easily be corrected by an experienced surgeon using the nesbit technique. MG
Hello Dr. I am suffering from PD with mild to moderate ED. My uro suggest Viagra 50mg during sex so that I can have firm erection. I also find in othe forum as they suggest low dose Calis/viagra daily basis to maintain penile health. My question now: 1. Will viagra 50mg use of 2 or 3 time in weak make me dependent on it? 2. Will low dose daily use of such medicine loose it's efficiency in long time?
Daily low dose treatment usually employs Cialis at 2.5 or 5 mg daily, as it has a long duration of action. The long term effectiveness of this in helping erections is good. Using 50 mg of Viagra a few times per week should not make you dependent - in some cases as the acute effects of the PD resolve, you may find you don't need to use it any longer. MG
Doctor, Thank for taking the time to open up this forum for individuals who may have peyronies desease. I am a 29 year old male in otherwise excellent health, I am not on any medications and I don't have any known medical issues. About 5 months ago I first began to notice some slight pain when I had an erection in my upper right hand side of my penis. I didn't think much of it. I don't recall any trama to my penis and hadn't had sexual intercourse for 4 months pior to notices the pain. The pain came and went and really wasn't to concerned about it till about a week ago I woke up with an erection and noticed I had a slight right side bend in my penis near the top. I immediately check my penis for abnormalities. I discovered a lump inside my penis about 2/3 of the up on the right hand side. It's about the size of a small pea. It is not completely calcified and but is fairly dense. I immediately fell into internet search mode and discovered Peyronies Disease. Needless to say I am concerned about my chances of developing a significant Penis distortion. I have not made an appointment to see my primary phyisican because I am out the country on work till mid September. I plan on making an appointment when I return. Meanwhile I am considering suppliments as a intern step to seeing a urologist. I am considering Vitman E and Neprenol. Honestly, I because of my youth and health I'm hoping the lump will subside over time. The bend in my penis at this point would not cause significant sexual disability but I am very concern it will develop even further into a major issue. I have no trouble with maintaining and sufficient erection and have not notices changes beyound the lump and bend towards the end of my penis to the right. I now have a dull ach in ny penis but no significant pain during and erection. I have been researching spontanious recovery from this abnormality. My feeling is generally men have this occurance, it gets a little better stablizes and they move on. Honestly, I know there is no way to predict the outcome of any disease with certainity but what are feeling on my situtation. I live in upstart New York. Is there doctor you know how has experience with this desease outside the NYC area. If I had to and my insurance carrier accepts it I would travel to NYC to see a specialist. Thanks.
This does sound like a mild case of PD. You are correct in feeling comfortable that at your age it will resolve - that is often the case. Supplements are not a bad idea - the usual combination is vitamin E 400 units daily and L-Argenine 2,000 mg daily. Albany Med Center may be able to direct you to someone upstate; if not I would reccommend Dr. John Mulhall in NYC at Memorial Sloan Kettering. MG
About a 10 days ago I went to the ER for an enlarged vein on my penis, also my penis hole seems to be darker. The doctor in the ER told me I had urethatitus and did an STD test which came back negative they gave me antibotics & sent me on my way. I did some research and what came up was thrombosed vein. Im concered that something is wrong. About 2 weeks ago my wife and i was having sex consistanly for about 2 weeks and thats when all this happened, ive had slight burning when i ejaculated. What should i do?
A thrombosed (clotted) vein under the penile skin, or Mondor's Syndrome, can be mistaken for Peyronies because it causes a palpable bump in the penis. It will resolve on its own - aspirin may help speed up the process. MG
Hi Doctor, I have PD with a plaque on tunica causing a tapped shape for last 2 years. I want to have arginie, but I can only find here in my country as intregated with lysine and ornithine. Is that Ok of I take this?
Yes, I know of no problems with that combination. MG
Hi Dr, I noticed the other day in the shower a lump directly below the head, slightly smaller than a marble and another directly under it the size of a pea. Almost directly in the center. My penis is strait when erect however if feels like on the left side towards the head is almost dented in slightly and possibly slightly bent down when erecet. After feeling the lumps enough some irritation is felt but for the most part there is no pain. I can remember one night of sex about two weeks ago where my fiance and I were having rigorous sex and from going out to back in I jabbed into her skin painfully but no pop or what not. I am concerned although both lumps appear to have shrunken slightly. Many thanks for any insight. I am a 31 year old male.
These lumps or inflammed areas are probably the result of the trauma you describe, and in most cases they will eventually resolve without leading to further scarring or PD. It would probably be wise to "give it a rest" for a couple of weeks. MG
Hello doctor thank you for the forum I am 21 years old not really sexually active but I do masturbate a lot a couple of days ago I noticed a small dent right underneath the head is this a sign of peryiones disease not seeing any curvature yet nor pain during erection I'm starting to get worried...
This does not sound like PD, which is extremely rare in your age group. MG
Dr. Gelbard I'm 29, I have a ventral curvature of about 10 to 15 degrees. Is this unusual? It seems like most all penises curve up, now I'm paranoid that I'm biologically malformed. I have 2 children, and I'm married, but I wish my penis curved the right direction. Will this condition worsen as I age?
This is not terribly unusual. Downward curvature does not commonly produce any functional problems unless it exceeds the 30 to 40 degree range. It will probably not worsen as you age, though congenital curvature in any direction exposes the concave side to increased stress during sexual activity - it is important to avoid traumatizing the penis as this can occaisionally lead to Peyronies disease. If the bend is a bother to you, a Nesbit procedure to correct your degree of curvature is not a complicated affair - in experienced hands. MG
First, the most sincere thanks are in order, to Dr. Martin Gelbard. I have had PD for over 6 years now, it is at an advanced stage. I may be put on a course of Isotretinoin for my acne. Will it make my PD worse? If there is no established link, based on the already known mechanisms of operation of Isotretinoin, is it likely that there would be any worsening? To sum up, taking only acne and PD into consideration - will the Isotretinoin be worth the risk? Many, many, thanks.
I have seen no problems in my patients using isotretinoin in the presence of PD, and my search of the literature does not show any direct contraindications or warnings specific to the PD patient. To my knowlege, there has been no prospective scientific study regarding the effects of this drug on PD, but based on its mechanism of action (supresssing sebaceous gland secretion) I would consider it reasonable if the acne itself is severe enough to warrant treatment. MG
Hi, First of all, I can't thank you enough for starting this forum and helping people out. I am 26 and for almost a year now due to extremely busy work life have not had the time for a personal life that lead to occassional bouts of masturbation. The only problem is that the duration of such activity became longer and longer, as well as the wear and tear on the skin. One day, during a particularly rough session, as I looked at my penis, there was a reddish lump beneath the head, a bit to the side. The lump was soft and painless yet scared the living daylights out of me. I managed to keep the first erection up for around 3 hours, and ejaculated twice after that as well, the third time lead to the lump. I immediately went online and read around and concluded that this must be thrombosis or scelerosing lymphangitis and gave everything a rest for 4 to 5 weeks even though the lump was considerably reduced on the 4th or 5th day. Then just to see if things worked properly, I masturbated to see if the plumbing worked again. Everything was fine. Then, a few days later, trying to push the limits, I managed to get another lump, around the same place. I am now certain that the abuse I have been putting on my penis has probably lead to Peyronies. Because the skin where the lumps were now looks more damaged (wrinkled) and of a lighter color. If this is the onset of Peyronie's, can early action save me? I wish to avoid going to a urologist till it becomes absolutely necessary. If, on the other hand this is penile thrombosis and/or Mondor's disease, can they also lead to Peyronie's? Any help would be greatly appreciated. Thank you in advance.
Peyronies will not cause any changes in the overlying skin, nor does it usually present in this fashion. I think you probably have Mondor's syndrome (thrombosis or clotting in superficial veins) which is usually self-limited, and will not lead to Peyronies disease. Some authorities prescribe a week or two of low dose aspirin for this. MG
This is a great site, thank you!! Had a great sex life, pulled out during a thrust in and heard a pop, bothered me a bit for a few months but nothing serious. Then I noticed my erection felt odd and I lost sensitivity. From highly sensitive to barely sensitive. My wife started to feel pain from my penis bending up and me taking so long to ejaculate. The extra time and friction caused her discomfort and for the first time, I would roll over and give up. My Urologist diagnosed Peyronies and said the calcification seems to be limited to the base of the penis, which makes the penis point up against my stomach, but it can be pushed down, but will take a hard turn right at that point. Pushing down and to the left seems to make it go back to the upright position. The erection feels too hard at the head and not hard enough at the base. The sensation at the head is a bit of stiffness where it doesn’t belong. I tied the verapimil cream for a while, it helped (or so I thought) a little, but plateaued real fast. I am 62 years old, over weight, take paroxitine 40 mg a day, Bayer 81 mg per day, metropol ( 130/80 BP ). I can have an erection and ejaculate, but it takes a long time to get to ejaculation. Any suggestions would be much appreciated. Thanks very much
It is not clear how long you have had the severe bend. If Xiaflex (collagenase) is approved by the FDA sometime in 2013 this may help your cuvature considerably, if it is not calcified on x-ray or ultrasound. If it is heavily calcified, surgery may be a consideration - you need to make sure the surgeon has plenty of experience with PD. You may know that paroxetine is used to delay orgasm in men with premature ejaculation - I assume you are taking it for depression. It is probably contributing to your problem in coming to a climax. MG
I have had PD for about two years and am 62. I am otherwise in excellent health and condition. After I doubled my dosage of vitamen E I thought I saw slight improvement but no longer. IF anything I think I am worsening and in just the last 6 months have had trouble with intercourse. Entry is difficult and once accomplised, I have so little to work with it is difficult to thrust. I find this very depressing. Is it worth it to talk to my uroligist (actually I have only seem him once) to explore either/both taking COLLAGENAS or Pntoxifylline? The data for either of these drug is at best luke warm. Frankly I am a bit desperate. Thanks in advance
It would definitely be worth discussing this with your urologist. Pentoxyfilline is commonly used in PD, though there is no good controlled data on its effectiveness. Collagenase (Xiaflex) has shown quite a bit of promise in phase II and Phase III studies, so it may be an attractive alternative within a year - if it gets FDA approval. MG
Hi, I was wondering how much of a curve is too much. Mine curves to the left, about 35 degrees. At what point is a curve too big, assuming it were to curve to the left? Also, does Peyronies cause pain during sex, as I'm a virgin, and I'm wondering if it will cause me or my partner pain. Thanks for your time, John Doe
That degree of curvature will probably not cause pain for your or your partner. MG
I'm curious why therer is no mention in the forum or TREATMENT section about this drug. I was just prescribed it by my urologist but only found sopmething opn the web from 2006 where it states the drug "may have efficacy in the treatment of PD". Until I asked my urologist about my problem I didn't even know there was a name for it and the reason I'm questioning the drug therapy is that I don't like the associated side effects such a dizzyness, headache & some anxiety. In any case, after two days of Pentoxifylline I rather live with the erectile bend than suffer with the waking side effects of this drug.
The treatment section needs updating in this regard, as pentoxyfilline is prescribed by many physicians for the treatment of PD. Unfortunately there is no peer reviewed placebo controlled clinical trial data confirming its effectiveness. MG
Hi, Dr. Gelbard, great site. I'm 31, I have a ventral curvature of possibly 10 degrees, I'm not 100% positive but think it might have resulted from an old injury, however I'm concerned, the length of my penis as is already bothers me, and concerned if the condition progresses surgery might be the only option, in that possible eventuality, can a ventral plaque be grafted so as to reduce loss of length? These issues are highly frustrating, a man walked on the moon in 1969, it boggles my mind these issues are so difficult to treat.
It is possible to incise & graft a ventral plaque that is causing downward bending. Extensive ventral grafting can lessen erectile rigidity, however. In the ongoing research with collagenase for PD, patients with ventral bending have been excluded from clinical trials. If it gains FDA approval in the future, the indications may be widened to include patients with ventral bending. MG
Is there any risk of vasectomy resulting in Peyronie's disease or makes an existing condition worse as would be the case? I'm quite paranoid about having this done.
There is no data to suggest vasectomy could cause PD or make an existing case worse. MG
Hello. I have peyroni plaque about 2 cm dorsal for 4 months. I wonder if the disease is an inflammatoric or autoimmun reaction why not try a oral prednisolon treatment to dimish the inflammation and pains? Ex prednisolon 25 mg fore one or two weeks, dimishing to 12,5 for one or two weeks more? What is your knowledge, or experience about this kind of treatment? Greetings from a Danish doctor..
Your reasoning is excellent - others have made this observation and incorporated corticosteroids (oral medrol dose pack, intralesional decadron or trimancinolone) into treatment regimens over the years. Unfortunately the results have been disappointing. I prescribe a limited course of corticosteroids for my own patients only in those rare cases where pain is unremitting and disabling. MG
This may seem an odd thing to ask, but I'm 31, and occasionally I get erections while wearing shorts or blue jeans if I'm thinking of sexual things. I normally have a slight downward curvature, but if I have an erection where my penis penis is pointing upwards while confined within my pants will this cause peyronie's disease? I don't think I ever become fully erect when this happens simply because it has no where to go.
No I don't think you need to worry that this will cause PD. However, congenital curvature may make you slightly more likely to develop Peyronies as it exposes the concave side of the bend to increased mechanical forces during intercourse. This would really only be an issue in response to repeated rough sex. MG
Hi! I had a few questions about Peyronies. Peyronies is often described as a a curvature of the penis. How is this angle of curvature measured? When I measured my curve, I measured from the center of the base of my penis to the center of the tip, is this the correct method of measurement, assuming the penis curves to the left? Also, how large does a curve have to be in order for penetration to be impossible (when I measured mine, I get results between 30-40 degrees to the left)? Thanks for your time, John Doe
Some degree of curvature is normal - having a bit of a bend does not mean you have Peyronie's. Generally the overall angle is measured from the part of the shaft joining the body to the direction of the shaft at the far end of the penis. Usually an angle of > 50 degrees up or >35 degrees down starts to interfere physically with intercourse. MG
I have PD for sure, i diagnosed it via web sites, and have been to the clinic where im now awaiting ultrasound, to confirm this. I noticed i had this lump half way down my penis when i was going to the loo, which scared the hell out of me, as i thought cancer, then when i got an erection i noticed slight shortening, an hour glass shape with a bend up wards and painful to maintain and erection.. it looks like a boomerang and it has knocked my self confidence for six. i didnt do anything for months to see what would happen, also after reading various sites i decided its PD, months later i then had sex with this matter and it seems i damaged it further during sex due to it popping out and basically it hurt and i felt/heard a popping sound and now i feel 2 lumps practically on top of each other within my penis. At this point was when i went to the clinic and saw a doctor who confirmed it is possibly PD and hence im now awaiting ultrasound, im worried this is the end for my sexual life im only 31, im worried and stressed as a result i don't even know how or what i can do .... nothings changed over time even from the first lump it hadn't changed,my love life has become none resistant as getting an erection proves painful and i feel its not worth the risk of even more damage... what will i do if this is how it will be for the rest of my life ? there must be a cure .... or does every option come with a possible negative consequence? sorry in advance for negativeness but i feel pretty useless as a man and for my future as a man.
At age 31, there is no chance this will end your sex life. But it will take a while to recover. Usually the inflammatory or painful part takes 6 months or more to settle down. Though the lumps ("plaques") may go down, some degree of curvature may persist. If the work with collagenase continues to make progress, the drug xiaflex may become available next year - in clinical trials the results appear reasonable. Even in a worse case scenario, if you have severe curvature or dense calcification, the results of surgery are quite good in your age group. But the chances you will ever need surgery are slim. MG
I have been depressed over an unwanted divorce, I live in a new town and have been masturbating a lot more than normal. I have always had normal erections and noticed no injury. One day going to masturbate i noticed an uneven erection and a bit softer than normal.when aroused, The base stays soft and pretty bendable with a small diameter as the rest grows like normal, kind of like filling a water balloon but normal diameter at top. I can still climax but it hurts a bit with tingly sensations that can go to my toes. It is only an issue during erection, It is scary. I don't have the money for any major doctor trips and don't have insurance. Does that sound familiar?
Fortunately, this does not sound like PD. MG
I was diagnosed with Peyronies a little over a year ago. In that time the hard patch (calcium? Fibroids?) under the skin has gone from near the tip of my penis to close to my abdomen. Because of this the curve went from close to the tip to now the whole penis is trying to curve making intercourse difficult. The erection is not as strong as it used to be, and sometimes the penis wants to fold backward - in half- curing sex...this hurts! What are my options for treatment? Thanks. Tim
With severe bending that causes the penis to double back, and duration of PD> 1 year, you may wish to consider plaque incision and grafting - by someone who does this on a regular basis. Plication surgery, or "nesbit" would cause unacceptable shortening with this type of severe bend. If you can deal with the current situation for another year and you don't have plaque calcification, it is possible that xiaflex might be an option if it gets FDA approval. MG
I recently had exploratory abdominal surgery and an appendectomy due to a necrotic piece of tissue between appendix and intestine. The next day when trying to urinate I had to strain immensely and could not go at all the first couple of times trying. The nurse offered to catherize me but I decided I would continue to try on my own. Eventually, I was able to get started and it was fine. That same day I noticed that my penis felt strange in my own hand. It just didn't feel like mine. Upon further inspection I was noticeing that it was like it was broken. At the top of the shaft it was able to bend like a joint would and more towards the base, it felt like this also. The back side was swollen just below the head. As the days went on, I noticed it starting to bend upwards when erect and the head not swelling as much as usual. There was/is a discomfort near the tip when erect. I went to an uroligist and he diagnosed PD. There is a lump of plaque now growing slowly near the head. I have not had any trauma other than the surgery. Could this have triggered the PD ? This is strange that it happened the very next day. The only other thing different in my daily routine is that I have been taking Lamisil for about 3 months for toenail fungus. I have had gout and was on colchicine and allupurinal for a few years and have stopped the colchicne about 1 year ago. I continue to take allupurinol. Can you find any coorelation between any of this? Do you know anything about Neprinol? Would it be benificial ?
Peyronies Disease can be associated with some surgical procedures, such as radical prostatectomy or urinary tract endoscopic operations. These all directly involve penile anatomy in one way or another. I am unaware of any cases coming on after an appendectomy - the association among the events you described is really a mystery to me. Neprinol has its adherents, though there is no peer-reviewed controlled clinical trial data on this supplement. MG
Dr. Gelbard, I am 51 years old. After using Glucosamine/chondroitin at recommended doses for about 3 weeks, I noticed I was getting painful erections. After reading about a possible connection to PD, I stopped using the supplement immediately. I noticed that I now have a "hard nodule" on the shaft of my penis near the start of the glans. There is no curvature yet. It has been about a month since I stopped the supplement but the pain and nodule are still there. Do you think this will clear up? I have doctor appointment scheduled but it is not for a few weeks and I am concerned. I never had any erection pain before taking the supplement. Thank you.
It is likely that this will clear up. Since there has been so little time elapsed since it started, I would reccommend some type of anti inflammatory regimen such as oral colchicine 0.6 mg two or three times a day for several months if you Doctor agrees. I have heard of others who developed similar problems after taking glucosamine / chondroitin supplements, though to my knowlege there has been no well controlled scientific study of this observation. MG
I am 54 and have had PD for about 5 years now. I was going through the treaments of Colchecine, and verapamill- external application and shots. It didn't help much. I have about 70 - 80 degrees upward curve.I never suffered from pain (my wife does) and the curve is not worsening. I lost about 1/3 of legnth. I have 2 questions: What do you think about enzyme treatments and what is the percentage of ED suffered with the nesbit procedure. just found your website and want to thank you for it.
Regarding the enzyme treatments (Xiaflex or collagenase clostridium histolyticum, which is being developed by Auxilium Pharmceuticals Inc) I would refer you to our article that just appeared in the June issue of the Journal of Urology. You can probably get the abstract through the Pub Med website (national library of medicine). Based on that data I would say it is promising. In a man with good erections, the likelihood of developing ED from a Nesbit procedure is quite low - probably 5% or less. MG
I have had peyronies for almost 2 years I discovered it about 2 weeks after my son committed suicide. I masturbate very rarely and have not been with a woman in over 12 years. I had ED problems a few years prior to the peyronies. I started using Verapamil cream and Potaba pills. for 1 month now with no results! Really Doc. does any of this stuff really work? Injections included which is the next step Verapamil as well. I havent in your forum heard anyone say that anything has worked! Is surgery or implants really the only way to go? I havent heard any one even say that that was all that successful either. Would you by chance tell us here what you think is the best way to fix this problem. The ones with the highest success rates ? Their is a girl I'm now intrested in and she is probably wondering why I haven't made a move ya know? Due to my peyronies Their is no way intercourse is going to happen in my condition!
The treatment decisions are complicated, as they depend on how well the erection works in addition to what type of curvature / deformity there is. For the most part, the conventional oral or topical medical therapies such as potaba or verapamil cream are not very effective. Injectable verapamil will help some patients but not all. The research recently published in the June issue of the Journal of Urology suggest there is promise to the new drug Xiaflex, though it has yet to be submitted and approved by the FDA. In those patients with longstanding problems where medications haven't worked, plication surgery is effective for minor bends, grafting for more significant deformity (in those with good hard erections) and implant surgery can be very restorative in those patients with PD and very poor or soft erections. MG
Sir, Thank you very much for your immediate reply. Whats the exact cost of Nesbit Plication procedure? Is it for life time or temporary process? Does the procedure lead to any problems or difficulties during sex? Sir, I have recently come to know about varicocele.... I have my testis a little bit hanging when penis is erect. However,when penis is not erect,the testis are normal i.e. not hanging or streched downwards..... Am I suffering from varicocele?How to ensure this? If yes then what are remedies? Are Peyronies and Varicocele both genetic? Thank you.
Nesbit surgical fees are in the $1800 to $2,000 range, with facility fees (to hospital or surgery center) of about $3,000. Varicocele feels like "a bag of worms" due to varicose veins in the scrotum, and usually occurs on the left side. MG
Hello I m 24 yrs old and have some questions. Firstly,thanks to u Dr Gelbard tht this forum has cleared lot of doubts. I have bend to the left side from the base of shaft of penis wch is more than 45 degrees; and increasing. Also the black outline to the outer side of shaft of penis is askewed and not straight. I have no pain in my penis. It also seems to me that... I dont have any plaque. Is it Peyronie's disease? If not then what is it? Is it serious? Still I am very concerned about this bend to the left side.Because I am sure it has been increasing for years. Earlier 7-8 yrs ago it was not severe left. But I findit increasing...... Wht should be done to stop this curvature? Sir what should I do?The bend is going to increase for sure.Should I use devices to get the curve right? Should I use supplements?
If you have congenital curvature, the concave side is exposed to greater mechanical tensile stress, which can lead to scarring on that side. This is turn can increase the bend, and may be the reason some men born with moderate curvature will find it gets worse over the years. If this is indeed happening, you may want to consider undergoing a nesbit plication procedure which will even out the stresses, straighten the penis, and probably help to prevent future progression. I don't think supplements will do much, as you probably don't have PD. MG
Hi! I have a 30 degree curve to the left in my penis. There are no hard spots and it doesn't have an hour glass shape. I don't have any pain with erections either. I noticed it when I was about 10, and am 18 now. The curve only shows up when I get hard. Is this Peyronies and will a 30 degree curve be to much for penetration, as I'm a virgin and haven't found out for myself? Also, can the way I masturbated for years (I was in my bed leaning the left, the same way as my curve) cause my curve? Thanks, John Doe
No, this is not Peyronies and a 30 deg lateral curve will not interfere in anyway with intercourse. You have congenital corporal dysproportion, which is a fancy way of saying you were born with the right corpus being slightly larger than the left. With erection, this causes a slight curve to the left. This is not the result of masturbation technique. MG
I'm 37 years old and about 6 years ago I was diagnosed with prostatitis by my urologist (I found him simply due to the pain in testicles and general genital area). It has come and gone... It comes back with a vengeance when I'm under stress, and pain varies from general bladder/prostate area to back, testicles and sometimes penis. Nonetheless, OTC anti-inflammatories and a couple of weeks without caffeine tend to resolve it. I've never been prescribed antibiotics for it, despite reading that this is common. Anyway, recently I felt like maybe I had a urethral infection or UTI of some sort. The opening of the urethra and glans of the penis were swollen one day, and following that it seemed to get slowly better, with slightly blotchy or red glans. I wasn't too worried until I had an erection one morning and noticed it was leaning to the left and the head/glans seemed slightly twisted (turned), along with slight pain in the one side up near where the glans meets the shaft (pain from shaft, not glans). It freaked me out. Erections are strong and I have had sex with my wife several times, and sometimes it seems the angle to the left reduces, but the twist of the penis head doesn't change, it's there when I'm erect and even slightly when not. I went to my urologist. He looked at me for about 10 seconds and said I had PD, and to take a low dose of ibuprofen for 3 months and come back. I had not much pain at that time, but after the exam pain went through the roof.... it ranges from a dull ache to a shooting pain, and now I have what is maybe prostatitis symptoms, including pain near the anus, and up in my "pelvic floor" muscles, testicles, a slightly hard flaccid penis at times (comes and goes), along with a feeling of either pressure, pain (shooting or dull), or "itchy" feeling, much like when I have a partial erection, resolved by bringing myself to full erection, but inconvenient throughout the work day or while driving. I have very little pain when fully erect, and my wife and I have had sex, and in fact it seems to relieve pain. My wife and I have had sex even more often since having this (6 weeks?), because it seems to relieve pain, although it may hurt more afterward if we are not as careful about the one tender area.... If I get a really full erection (with partner, strongest mental stimulation), I see very little angle to the penis, but the head-twist is there. Although the urologist says he could feel something on there, it's in the area just below the head, where my foreskin bunches up and even when I pull it back, I can really barely feel any sort of bump or anything there.... I do feel the soreness or pain if I am too rough right in that tiny spot. Is this really PD? I have an appt with a specialist at a research hospital clinic in Houston (where I live), because I want a second opinion and I want to know why my prostatitis has come back with a horrific vengeance. I haven't had a flare-up this bad in years.... Other items of note: Severe work stress (changing jobs, and major turmoil at work, plus concern over penis problems??).... Also, the idea of a shortened or problematic penis terrifies me. As it is, my penis is only about 4.5 inches fully erect, so the idea of it shortening, as a relatively young man (37), and affecting my sex life with my wife makes me very anxious (I'm already susceptible to anxiety and have taken meds for that, but I'm out...).. I also had adhesions of my foreskin to glans that were only resolved by surgery 8 years ago (I was a virgin until I was married 6 years ago), and I wonder if I already had this scarring and an infection has inflamed it, causing the slight angle to the left? I know anxiety and stress flare up prostatitis, but does this sound like a typical case of PD? A serious one? Will it get worse or better, stay the same? Will the pain subside, and if I can resolve the prostate flare-up, will that help? I know that's a lot to throw out there, and I do have a second opinion coming, but a third opinion from an expert is very welcomed.
I'm not even sure this is PD, but I know that with painful early PD, erections and intercourse make the pain a whole lot worse and this doesn't sound like your case to me. Furthermore, PD will not cause pain in the anus, pelvic floor, etc. - that sounds more like prostatitis. MG
I have been on Bystolic for about 4 to 5 years, after suffering a heart attack. I am now 59 and have recently been dignosed with PD by a nurologist. My question is, if my PD was in part caused by taking a beta blocker, would changing the medication now possibilty help correct the problem, or is the damage already done? The PD started about 4 months ago. In other words, would you suggest talking to my heart doctor about changing the medication or is it to late to help? Thanks so much for this form...
We don't have any definitive evidence that beta blockers cause PD, but they do seem to aggravate it. As the PD process can go on developing for well over a year, it would be a good idea to get off the Bystolic even if you have had the PD symptoms for only 4 months. That is, of course, if your cardiologist thinks there is a safe and effective alternative drug. MG
Hello. I first noticed a small "dimple" or small dent just beneath the tip of my penis. I thought nothing of it. About 7 months ago, I think I might have sustained a injury to my penis during sex. It didn't hurt or pop or anything, just felt bad for a fleeting moment. Today, I have maybe a 5-10 degree bend (it really is almost straight), one half of my penis fills up all the way, the right side does not. The head of my penis doesn't seem to fill up as much. It used to hurt during intercourse with my girlfriend, but not anymore. There is never any pain anymore. I can feel a small lump at the base of my penis. I am taking Vitamin E, L-Cartinine, and L-Arginine. I don't really know what to ask, Dr, just looking for general advice. I dont even know if I have peyronie's - in fact when I went to see my primary care physician 6 months ago, he told me not to worry about it (that if i had damaged my corpus cavernosum i would have known due to the pain)
There is a wide range of those scarring responses we call "Peyronies disease". From the dimpling, assymetric inflation, transient pain and slight bend, I would suspect you have a very mild case which has stabilized and will probably never get any worse. I think it would be good to stay on the supplement you are taking for about a year. MG
Hi! I have an angulation at the base, about 60 degrees upwards, that is only present when the erection is really hard, since a little more than a year. The thing is that my urologist seems to think this angulation is the same thing as 60 degree bending of the penis, but I find that strange because the penis itself does not have much of a bend -- it is only that the angulation at the base is upwards, which to me seems different and less troublesome. I've had an ultrasound and they think I have some diffuse type of peyronies or somethings similiar. I have some other symptoms, like a little band of raised penile tissue on the left side, increased sensitivity, hard flaccid, less flexibility when erect (too rigid/worried it might break if I have intercourse)and sometimes prolonged erections and hourglassing when becoming erect. The first symptoms appeared about 16 months ago and it hasn't changed much since last summer. The size is the same as before. Do I really have a peyronies plaque at the base or is this more likely to be some diffuse scarring of the entire tunica? And, do you think intercourse is possible/unwise when it's like this. It's really rigid and inflexible so I'm a bit worried I might fracture it if I try. Thanks for a great web page!
I suspect with the way a rigid erection is pinned upward at 60 degrees and feels so fixed in that position that you are worried it may be injured with sex, that you do have a peyronies plaque at the base of the penis where the suspensory ligament attaches it to the pubic bone. Remember that the plaque is nothing more than scarring in the tunica albuginea (the wall of the corpus cavernosum), and this may have come on as the result of some past trauma. If it has been stable for 16 months I doubt it will progress. Fortunately, as long as you avoid levering down on the erection, there would be little functional impairment to expect from having the (straight) erect penis be at a 60 degree angle to the body axis. MG
Hello Dr, I want to begin by saying that reading through this forum has helped tremendously. However I a still not convinced whether I have peyronies or not. Let me start from the beginning, October of 2010 I used propecia for about a month. I don't recall any traumatic injuries except I slipped out one time during intercourse which has happened a handful of times with some slight burning feeling but no ache. I was on top so it wasn't that hard.BTW this was way earlier, long time before. Anyway within 10 days of dropping the drug I started getting incomplete erections which dents in right below the head and slightly lean to theright. This only happens when semi erect incriminating achieve a full erection it is perfectly straight but I do feel occasionally soreness at the site where I get the renting. I never have pain fully erect nor do I have any plaques or knots. 2 urologists one being a specialist examined and said he couldn't feel anything at all. Now I know something has happened and its not in my head because it takes a little massaging and manipulation to get the dented area to fill out which it does. But this cause ls me not to I've any solid rigid erections just by thought it has to be "adjusted". The doc said I probably have a little scar tissue in there but it had been nearly 17 months and I still feel some stinging in there occasionally but ONLY when flaccid. I got this at 29 I have been taking pentoxifylline 3x a day but urologists don't seem convinced I have peyronies because there's no sort of hardening just something obstructing bloodflow right under the head. When I wear warm pants it fills out easier as well. What your take on this I can mostly tell where the weird hourglassing is when I'm flaccid.
This sounds more like some type of local reaction to trauma (which has not progressed) than the scarring we usually call "Peyronies Disease" - which is to say your chances of this resolving are better. MG
Hi I'm 30 years old, mild PD from injury in years past, married 2 kids, and recently my wife had issues associated with her IUD, and so we've had to resort to condom use for the time being. I have difficulty with them, putting them on is painful from just the sheer tightness and during a recent sexual encounter it was difficult for me to even roll it on, so obvious I need to try another size, however is there much risk of injury to the tunica from using the ones I already have. Even though putting them on at times can be painful (too tight) and difficult, I'm mindful not to cause much if any bending of the shaft.
You might want to try switching to another brand. I am unaware of any significant problems occurring in Peyronie's patients due to tight or constricting condoms. MG
Hi, Doctor Gelbard. I am 33. I apologize for the long (and graphic) story, but I want to be thorough. 2 weeks ago, I was masturbating. I had already ejaculated twice this particular day and for whatever reason, I tried to go for a 3rd. I was only able to achieve a semi-erection, so in a stupid attempt to achieve a more solid erection, I gripped my penis with my thumb and index finger and performed what I have now learned to be a motion called "jelquing". It is a technique in which some men use to try to enlarge their penis. After a few strokes, I did not achieve any more of an erection, and I found what I did to be rather uncomfortable, so I gave up and went to sleep. Over the next few days, I noticed that I was unable to achieve erections and that I had an ache at the base of my penis. I also noticed that my penis was stiff even when flaccid (this was attributed to anxiety by my doctor). I decided to see a urologist. He examined me and recommended that I "rest" for about a week. I did so and within a few days I noticed that I was getting erections again, but they were very weak. I noticed that sitting up made my erection harder, but it would quickly soften again if I lied back down. Then a couple days ago, I was having testicular pain so I went back to my doctor. He said that I had "blue balls" and recommended that I very gently masturbate to "clean the pipes". The next morning I used my slight morning erection to my advantage, and was able to bring myself to climax by simply massaging my testicles. The next morning I also experienced a "wet dream". I awoke with a mild erection and ejaculated almost immediately without any stimulation... Here's where my Peyronie's question comes in: Since all of this, my erect penis has taken on a seemingly slightly different shape. It hasn't been anything major, until last night. I was urinating and upon completion felt my penis begin the erection process. However, when I looked at it, there was a rather severe (but gradual, not sharp) curve to the left. I quickly did a mental "de-arousal" and left the bathroom. This happened again later in the night. My urologist said that my penis seemed normal, but this was before this curve appeared... This "curving" incident is 2 weeks to the day from the "jelquing" masturbation incident. I intend to follow up with my urologist again, but do you think it's possible that I have caused some kind of injury that is resulting in development of Peyronie's? Thank you.
No I don't think you have developed PD over the last 2 weeks. I believe you may have temporarily traumatized the cavernous erectile tissue within the penis by the pressurizing manuever you described, and this can result in temporary firmness of the flaccid penis and changes in shape. MG
I am 52 years old and about a month a go I started experiencing a little pain during intercourse and then noticed a hard spot along the top of my shaft near the base. I have been way from my wife for about a 10 day period and when I returned home yesterday and we had sex I noticed that I had a bend near the base of my penis to the left. I have also noticed that sometimes I am not as hard as I use to be but I thought this was just due to age. Anyway, my question is weather or not I should continue to have intercourse right now. I have an appointment with my Dr. soon to diagnose and begin treatment but by my explanation by phone he is pretty sure that I have Payronies. Are there any other does and Dont's that I should be aware of. Also could you recommend the best clinics to go to and the best treatment at this early stage. Thank You.
If you do have PD, there is no need to avoid sex, as long as you avoid activities that are painful or put a great deal of mechanical stress on the erection. In fact one of the challenges for men dealing with PD is to remain sexually active to some degree, rather than retreating from it and suffering loss of intimacy in your relationship etc. There are no restrictions on diet or medications, with the exception of beta blockers (usually for blood pressure) that may aggravate peyronies, or large doses of glucosamine / chondroitin supplements (for arthritis and joint health) as there are anecdotal reports of problems with these products. Try using the finder in our links section to identify physicians with special interest / training in treating PD, listed geographicallly. MG
I am 18 and pretty sure I have peyronie's disease. I began to feel pain after having masturbated 3-4 months ago. I have always had a slight curve to the left, however now when I get an erection it curves even more to the left and I have a couple hard cord-like lesions(which i assume is the plaque) going two different directions from the base of my penis to close to the top. When I am lying down the curve with an erection is hardly noticeable, however when I stand up my penis seems to hang much more to the left. I also notice what appears to be a vein when flaccid, and in the coming days after masturbating I'll sometimes have pain on the right side at the base of my penis when flaccid. Does this sound like Peyronie's disease to you? If so is the curavture likely to greatly worsen over the coming months? I have not consulted a physician.
If you really had the scarring and plaque that characterize Peyronie's, I think the curvature with erection would be pretty similar lying down or standing up. Also, PD does not seem to be associated with dilated or inflammed veins. This sounds to me more like some kind of delayed response to trauma, which at your age is likely to resolve with a temporary reduction in the intensity of sexual activity. Note that pre-existing or congenital curvature to a given side will make that (concave) side more vulnerable to trauma. MG
Dr. Gelbard, I am 29, and I *may* possibly have mild Peyronie's from an injury several years ago. For fitness I lift weights and to maintain/build muscle mass I take 2 -3 scoops of Whey protein powder. Should I worry about this protein supplementation causing the condition again, making the condition worse, etc???
There is no reason to worry about the effects of protein supplement on PD - as far as I know there are none. The only association of PD with supplement use that I have heard of is glucosamine / chondroitin (used for arthitis). I should emphasize strongly that this relationship is unproven at present, though I have a had a few patients where this seemed to be an issue. MG
I Noticed about a year ago that my penis was distincly shorter and with a much sharper upward bend. Much like the Wikipedia photo. It has an hourglass shape and is about a 1/3 shorter. My Doctor and I had discussed my borderline highblood pressure but when he suggested that the cause of my shortned penis might be a blood pressure issue I immediately folled his suggestion and went on Bystolic. While my blood pressure is now perfect this did not improve my Penis. Researched, discovered Peyronies and asked him about it. He recomended a urologist. I went to him but I may have poisend the well in that I basically announced my diagnosis. He examined me briefly and commented "I don't even feel a lump". So my question is: If there is no lump do I have peyronies?
I believe the answer to you question is yes. In many cases Peyronies can cause linear scarring which produces deformity but not any palpable "lumps" bumps or plaques. In light of the new onset of upward bending, hourglass, and length loss I would say you do have Peyronies. Based on this I would talk to your primary doctor about switching you to a different high blood pressure drug. Bystolic is a very good drug for blood pressure, but it is a beta blocker and this class of drug may be associated with aggravating Peyronies disease. MG
About 6 months ago my opthamologist doubled my dosage of timolol eye drops to control glaucoma, and probably about 4 months ago I noticed about a 15-degree curve to the left, with a depressed area in the tunica about 1cm causing the curve. The timolol info sheet lists PD as a potential side effect - is this rare and might it be reversable with the discontinuation of timolol?
timolol is a beta blocker, and these drugs have been associated with PD. I would recommend your have your eye doctor give you a different medication, if that is possible. This is likely to be reversible if the time span is short. MG
I am 57 years old and about 3-4 years ago I was having Erectile Dysfunction. I was taking Lopressor for hypertension which is a Beta Blocker. It was very difficult for me to get an erection and when I did it would go limp when I went to penetrate my wife. Sometime my penis would not get hard. My erections were soft and I could not penetrate my wife's vagina because my penis was not hard enough. My wife stimulated my penis by rubbing it with oil, masturbating me, etc. but nothing worked. After getting my Blood pressure under control without medications I started to get better erections sometimes. But when I did my penis had a slight curve to the left side and it had a upward curve along the shaft toward the head of the penis. My penis was straight with no curvature prior to this. I went to a Urologist and he diagnosed me with Peyronie's Disease.I never had pain but he felt 2 small lumps in my penis. He prescribed 100 mg of Viagra to take prior to sex so I could have more firmer erections. My erections now are very hard within 30-45 minutes after taking Viagra. I now enjoy a very fulfilling sex life. My wife always has an orgasm and I am able to ejaculate in her vagina. I have intercourse once every week with no pain or discomfort. Is it possible that I got Peyronie's Disese from the Blood Pressure medication? I read that Beta Blockers list Peyronie's Disease as a side effect.
Please see the forum entry adjacent - there does seem to be a relationship between beta blocker use and peyronies disease. It is good to hear that you remain fully functional, which is often the case in PD. MG
Background: I'm a 28 year old male and about 4 weeks ago, I noticed my penis had a noticeable indentation about a 1/2 inch above the base. It looked as if an elastic band had been wrapped around the shaft in a slightly diagonal direction. The indetation on the right side was much more pronounced and only slight on the left side. Seems to be consistent with what this site calls the diameter reducing hourglass shape. I was completely horrified and made an appointment with my doctor who referred me to a urologist. After examination, I was told I had Peyronie's plaques (actually a few) throughout the penis) and that they had probably been there for a while, but only just gotten bad enough to cause noticeable distortion. Questions: 1. I have been on Toprol (beta blocker) 25mg for about 4 years. Peyronnie's is listed as a possible side effect, but my urolgist doesn't think it's related. What do you think? 2. I strength train 5x a week and take a Glutamine supplement for muscle recovery (5 grams of L-Glutamine immediately after workouts in 12 oz of water). Do you think this could have contributed to my development of PD? 2. My urologist prescribed a vitamin E treatment (200 IU x3 daily) for 4 months leading up to my follow up with him. I noticed 400 IU seems to be the suggested amount, am I taking too much? I've heard of additional health risks associated with higher than upper limit vitamin E doses. 4. I have difficulty maintaining an erection during intercourse, but not during masturbation. I think this is all mental and due to PD-related anxiety. Is there anything I can do to mitigate this other than trying to ignore it? I'm married so my wife is understanding but it is nontheless embarassing, plus I shouldn't be having this sort of issue at 28.
Although there is no convincing proof, many reports suggest there is a relationship between beta blockers and peyronies disease. It is not know whether it contributes to causing this problem, or making a mild (sub clinical case) that would otherwise escape detection show up. 400 IU is the standard dose for Vitamin E - taking more than this is not recommended. Even if your current erectile problems are due to anxiety, it would help you if you used one of the phosphodiesterase inhibitors (viagra, cialis or levitra) for a while. MG
Can taking propecia cause peyronies?
There is no evidence to suggest this. MG
I am 18 years old and have a curved penis. It has always been this way but it has recently become a lot worse. I first had sex with my girlfriend when we were 15, and despite the curve, everything worked fine. We were away from each other for about a year when we were 17, so were not able to have sex. I am not sure if it developed during that time. Now we are together again, and when we do have sex I have to be extremely careful so as to not hurt her. I think the curve is a lot worse then it used to be. When I was younger, I was always really rough with the way I masturbated, so I am not sure if this could have caused it or not. I do not think I ever had an lumps or scars that they say are signs of Peryonie's disease being developed. Any help would be greatly appreciated. Thanks.
You do not have Peyronies Disease, but congenital curvature of the penis. This is a benign condition which is a slight variation of normal anatomy - the two erection chambers are of slightly different size, which causes bending. It the bend is severe enough to cause problems with sex, it should be corrected surgically by one experienced in this type of reconstructive work. MG
I have recently had trauma three four months ago. I have a hard plaque on the left side and curvature. Also, the vein on top seems to be hardened. My urologist has prescribed vitamin e and L-Carnitine. I have read that Acetyl L-Carnitine should be used. Is there a difference? The head of the penis seems to have restricted blood flow. I have also read that Cialis or Viagra can further damage the tissues. What is your opinion? I have also read about using DHEA and arginine to allow blood flow to the area. I am so confused about what is correct and what is not. Vitamin E, L-Carnitin, DHEA, Arginine. Can you shed any light? Does anyone else have any truthful experience of turning this around?
Acetyl-l-carnetine, l-argenine, and vitamin E are all safe nutritional supplements used in the management of PD. Unfortunately there is little in the way of evidence-based guidelines for supplements or oral medication in Peyronies. Most authorities feel there is no significant risk using cialis or viagra, if the erection itself is soft. There is no well-established role for the use of DHEA in PD. MG
42 yr. about six months ago was told i have PD, this after 3 wait and see follow ups. No bend but "tic tac" size lump in lower third of penis. Can get erection but at site has indent and pretty much can bend at section when erect. Can not maintain erection during sex, i think mostly because its on my mind. Does diagnosis sound correct? Is the vitamin e that i read about the same as over the counter or is it prescribed? Any thoughts? Should i get a second opinion? Thanks for your help
This does sound like PD to me. The vitamin E that is used is the standard over-the-counter version. You should talk to your doctor about getting some pills (viagra, levitra, cialis) to help with the erection temporarily, and possibly some medications for the Peyronies itself, beyond vitamin E. The possibilities would be colchicine pills, pentoxtfilline pills, and/or verapamil or interferon injections. MG