How to Treat Peyronie’s Disease

It’s surprisingly common for middle-aged men to have painful lumps or bends in their penis, though most don’t tell their doctors. But you can beat this.

Bent, painful penises aren’t rare — up to 10 percent of men between the ages of 40 and 70 get Peyronie’s disease, named for a French surgeon who described it in the 1700s. A hard lump appears under the skin on the shaft, usually on the top. As it grows bigger and harder, you may feel pain. Your penis begins to bend. Eventually erections become painful or aren’t complete.

Within a year to a year and a half, the lump stops growing and erections aren’t painful, but the penis keeps the bent shape (as you can see in this picture), and it may also be shorter. Most of the time you can have intercourse. However, if you get anxious about the problem, it’s easy to develop ongoing erectile dysfunction (ED).

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Peyronie’s may be triggered by an injury or possibly a genetic vulnerability.

According to Ajay Nehra, a senior urologic surgeon at Massachusetts General Hospital who led a panel that published a 2015 Peyronie’s treatment protocol for the American Urology Association, men don’t tend to report this problem. That’s too bad, as early treatment makes a difference. It’s usually a wife who gives men a push, he says, if the curve is noticeably increasing, or intercourse becomes uncomfortable or impossible.

How to treat Peyronie’s disease

For men who have a 30-degree curvature, the Food and Drug Administration has approved injections of a drug that can reduce the bend. You’ll need eight injections of collagenase clostridium histolyticum (Xiaflex) over 32 weeks, and the protocol includes stretching exercises. You run the risk of swelling, bruising, or, rarely, a rupture that will need a surgical fix.

Research suggests this treatment will shift the bend around 33 percent over 52 weeks if you also do the exercises. It’s important to note that men who got a placebo injection and did the exercises improved from 18 to 22 percent. You can see what a 33 percent improvement looks like here at the Xiaflex manufacturer’s website.

Another option is a painless traction device, Restorex, which researchers have found restores lost length in nearly all men with Peyronie’s . Some 77 percent of the participants had a shift in the curve, on average by 28 percent. Among men who couldn’t have intercourse at the beginning of the trial, 80 percent could afterwards. You’ll need to use the device every day in half-hour sessions over at least three months.

There’s evidence that combining Restorex with Iaflex works best of all. In a small study at the Mayo Clinic in Rochester, men who did both had, on average, a 49 percent improvement in the curve and were 3.5 times more likely to get a 50 percent improvement or greater than men who used Xiaflex alone or with a different traction device.

If that doesn’t work, there are surgical options. A procedure that cuts out the lump and inserts a graft instead may sound good — but it may make the penis less sensitive and aggravate ED. Another surgical option is to straighten out your penis by shortening the longer side, but you’ll end up 1 to 2 cm shorter. If you have severe ED and Peyronie’s, you might get an implant.

Stay away from these remedies

In the past, men were told to rub creams on the sore hard area, or were offered a number of pills that didn’t work well. Among the failures: Vitamin E, Potaba, tamoxifen (Soltamox), and carnitine. Colchicine (Colcrys) can cut pain but won’t change the course of the illness. Injections of interferon, a hepatitis and cancer treatment, may slow the growth of the lump, but you’re likely to feel like you have a flu.

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