Peyronie’s disease results from a dense fibrous plaque that forms on the tunica albuginea, causing a curvature of the erect penis. Although the precise etiology of the fibrous plaque is unknown, it is believed that the plaque represents scar tissue resulting from microscopic tears of the tunica albuginea that form during intercourse.

Very dense plaques may be appreciated on physical exam. However, in most patients, the flaccid penis is normal on examination and the penile curvature is only noted in the erect penis.Peyronie’s disease has an acute phase and a chronic phase. The acute phase is associated with pain and inflammation as the plaque is forming. During the acute phase, medical therapy with p-aminobenzoic acid, vitamin E, colchicines, or tamoxifen may be modestly successful. Once the pain subsides and the plaque is stable, patients with mild curvatures that do not interfere with intercourse should be observed.

Surgical correction should be considered if the penile curvature interferes with sexual intercourse. Patients with Peyronie’s disease and erectile dysfunction can be treated with a penile implant. Patients with normal erection can be treated either by plicating the tunica albuginea on the outside of the Peyronie’s curvature or by grafting a patch onto the inside of the Peyronie’s curvature.