Peyronie’s Disease

A curved, painful erection is not only a physical problem. It hits confidence, intimacy, and how you feel about your body. Many men keep quiet about it for months or years, which adds stress on top of the physical change.

At Riverstone Urology Specialists,, Dr. Russell Libby evaluates and treats Peyronie’s disease for men from North Houston, Cypress, The Woodlands and nearby communities. His approach is private and practical. Understand the curve, protect function as much as possible, and choose a treatment plan that fits your goals.

What Is Peyronie’s Disease

Peyronie’s disease happens when scar tissue, often called plaque, forms in the tunica albuginea, the tough layer around the erectile bodies of the penis. This scar tissue stiffens one area of the shaft. During an erection, the stiff segment does not stretch like the surrounding tissue, so the penis bends toward the scarred side.

Key Points

Scar tissue forms in the tunica albuginea of one or more areas
The main result is curvature, indentation, or shortening during erection
Pain and weaker erections often appear, especially early in the process

The process is benign in the sense that the plaque is not cancer, yet the impact on sexual function and quality of life is real.

Rushing to or alway needing to be near a bathroom

Symptoms Men Often Notice

Peyronie’s Disease Shows Up In A Few Common Ways.

Bend or curve in the erect penis, in any direction
Indentation or “waisting” of the shaft during erection
Palpable lump or firm area in the shaft when soft or erect
Pain in the penis, often during erection in the early phase
Shortening or loss of length
Softer erections or trouble maintaining rigidity
Difficulty with penetration or intercourse

Some degree of natural curve exists in many men. Peyronie’s disease becomes a concern when the bend is new, getting worse, painful, or blocking sexual activity.

Why Peyronie’s Disease Develops

Research links Peyronie’s disease to scar formation after small injuries to the penis, often from sexual activity or other trauma. Many men do not remember any clear single injury, which fits the idea of repeated minor “micro trauma” over time.

Risk Factors Include

Age between about 40 and 70 years
Family history of Peyronie’s disease
Connective tissue disorders such as Dupuytren’s contracture in the hands
Diabetes and vascular disease
Low testosterone in some men
Prior prostate surgery or pelvic surgery that affects erections

Peyronie’s Disease Often Follows Two Phases

Active (acute) phase for roughly 6 to 12 months, with changing curvature and pain during erections

Stable (chronic) phase, where pain often fades and the curve levels off, while erectile dysfunction becomes more prominent for some men

Treatment decisions depend heavily on which phase you are in.

When To See Dr. Libby

You Do Not Need To Wait Until Sex Is Impossible. A Visit With Dr. Libby Makes Sense If You Notice

New bend or change in shape during erection
Pain in the penis, especially with erections
Shortening, narrowing, or “dent” in the shaft
Anxiety or relationship strain around sexual performance

Urgent evaluation is rarely needed for Peyronie’s disease itself, yet earlier input often leads to better planning and less stress.

How Dr. Libby Evaluates Peyronie’s Disease

Diagnosis Relies On A Focused History, Physical Exam, And Sometimes Imaging.

History

Timing and speed of symptom onset
Level of pain, both soft and erect
Direction and degree of curvature
Erectile firmness and consistency
Prior pelvic or prostate surgery, trauma, or injections
Impact on sexual activity and relationships

Physical Exam

Palpation of the penis in the non erect state to feel plaques and measure location
Assessment of length and any hourglass or hinge areas

Erection Assessment

Review of photos at home in private, taken from the side and from above, to document curvature and shape
In some cases, an in office induced erection with medication and ultrasound to map plaque, calcification, and blood flow

This information separates Peyronie’s disease from normal curvature and from other penile conditions and helps match you to the right level of treatment.

Treatment Goals

Peyronie’s Disease Has No Simple Cure. Treatment Focuses On Practical Goals

Reduce pain
Improve or preserve erectile function
Straighten the penis enough for comfortable intercourse
Lower anxiety and improve confidence

Not every man needs the same level of treatment. Some do best with education and monitoring. Others need medicines, traction, injections, or surgery.

Non Surgical Management

Observation And Support

In the early active phase, pain and curvature often change over time. Roughly half of men show progression of curvature over a year, while a smaller group improves or stays stable.

During this phase, Dr. Libby often emphasizes

Education on the natural course of the disease
Position changes and practical tips for intercourse
Pain control when needed
Parallel work on erectile function and metabolic health

Oral Medicines And Supplements

Multiple pills and vitamins have been tried for Peyronie’s disease, including vitamin E and other agents. Evidence for meaningful improvement from oral therapy alone remains weak.

Dr. Libby explains where current data stands so you do not waste time or money on approaches with low support.

Penile Traction And Mechanical Therapy

Traction devices gently stretch the penis for set periods each day. Over time, this can reduce curvature and help preserve or regain length in some men. Studies show the best results when traction is part of a structured program and when men commit to daily use.

Dr. Libby reviews realistic time requirements and expected gains before you choose this route.

Injectable Treatments

Injectable medicines target the plaque more directly. The only FDA approved drug for Peyronie’s disease is collagenase clostridium histolyticum, often known by the brand Xiaflex.

Collagenase (Xiaflex)

Injected directly into the plaque during office visits
Breaks down collagen fibers in the scar
Combined with a specific modeling protocol and often traction to reshape the shaft
Works best for stable disease, clear plaque, and curvature in a defined range

Other injectables such as verapamil or interferon have been used in some centers, with mixed evidence compared with collagenase.

Dr. Libby explains benefits, injection schedules, cost, and possible side effects such as bruising, swelling, and rare corporal rupture before any decision.

Surgical Options

Surgery enters the picture when Peyronie’s disease is stable, intercourse is difficult or impossible, and erections are strong enough or supported with other treatments.

Common Strategies Include

Plication Procedures

Shorten the longer side of the penis opposite the plaque
Improve straightness at the cost of some length
Often suited for moderate curves and good baseline length

Plaque Incision Or Excision With Grafting

Open or incise the plaque on the short side
Place a graft to fill the gap
Aims to straighten while preserving more length
Higher technical complexity and a higher risk of weaker erections in some men

Penile Prosthesis With Straightening Maneuvers

For men with Peyronie’s disease and significant erectile dysfunction
An inflatable penile prosthesis supports rigidity
Additional modeling or plaque work improves alignment

Choice depends on curvature severity, plaque location, erectile function, and personal priorities such as length preservation and recovery profile.

Dr. Libby discusses surgery only after curvature stops changing for a period, since operating during an active phase leads to higher revision risk.

Peyronie’s Disease, Erections, And Emotional Health

Peyronie’s Disease Sits At The Intersection Of Physical Structure And Emotional Wellbeing. Men Often Report

Worry about partner reactions
Avoidance of intimacy
Drop in self esteem
Symptoms of anxiety or depression

Dr. Libby addresses erection quality, hormonal status, and relationship concerns as part of a full men’s health visit. Partner involvement in discussions often helps both sides understand what is going on and what treatment might achieve.

Peyronie’s Disease Care At Riverstone Urology

Peyronie’s disease is common, under discussed, and highly individual. At Riverstone Urology, men from North Houston, Cypress, The Woodlands and nearby communities receive

Private, respectful evaluation
Clear explanation of disease stage and options
Stepwise treatment from education and traction to injections and advanced surgery when needed

If you notice a new curve, lump, pain, or shortening of your erections, reach out to schedule a visit with Dr. Libby. The first step is a straightforward conversation, a focused exam, and a plan that lines up your anatomy, your goals, and the best current evidence.