Telling the active and stable phases apart
In the active (inflammatory) phase the degree of curvature fluctuates and pain during erection is common. This period usually continues for a span measured in months, and the picture has not yet settled.
In the stable phase the pain lessens or passes and the degree of curvature has not changed for some time. Surgical correction is considered only in this phase; a procedure carried out during the active phase can lead to curvature returning, because the process is still under way.
Assessment
The history covers when the curvature began, whether there is pain, whether the curvature prevents intercourse, and the quality of erections. At examination the plaque is assessed by hand.
For an objective measurement of the degree of curvature, images taken during erection or an assessment under controlled conditions may be used. Whether erectile dysfunction accompanies it is examined separately, because it directly affects the choice of treatment; where needed, a penile colour Doppler ultrasound is performed.
Treatment options
The approach is set by the phase and by the severity of the complaint:
- In the active phase the priority is managing pain and observing; in some cases the disease settles of its own accord.
- The effect of oral medication in correcting curvature is limited; expectations are discussed within that frame.
- Injection treatments into the plaque may be considered in selected cases.
- Traction devices are a supporting option requiring regular use, under a physician’s guidance.
- In the stable phase, and where curvature prevents intercourse, surgical correction comes into play; the method is chosen according to the degree of curvature and the state of erectile function.
- Where advanced erectile dysfunction accompanies the curvature, correction together with a penile implant may be considered.
Frequently asked questions
Does penile curvature resolve on its own?
In some cases the disease settles over time and the pain passes; complete resolution of the curvature, however, is not common. The decision to observe is therefore also made through a physician’s assessment.
How long must I wait before surgery?
Surgical correction is planned in the stable phase, once the curvature has not changed for some time and the pain has passed. A procedure carried out during the active phase can lead to curvature returning.
Is every curvature Peyronie’s disease?
No. Congenital curvature occurs without plaque formation or pain and is assessed under a different heading. The distinction is made by examination and history.
Does curvature cause shortening?
Because the plaque can create tension on the affected side, a sense of shortening may be reported. This is one of the points taken into account in surgical planning.