Peyronie’s disease causes painful curvature of the penis that can make intimate moments challenging and emotionally difficult. Understanding treatment options — from medications to surgery — can help affected men regain function, reduce pain, and improve their quality of life.

How to Approach Treatment for This Complex Condition

The goal of treating Peyronie’s disease focuses on reducing pain, correcting the curvature of the penis, and restoring sexual function so that men can engage in intercourse comfortably. Every person’s experience with this condition is unique, which means that the path forward must be tailored to each individual’s stage of disease and the severity of symptoms. Some men experience mild curvature that doesn’t interfere with sexual activity, while others face significant bending that makes penetration painful or impossible.^[1][2]

The condition progresses through two distinct phases. During the acute phase, which typically lasts between six and twelve months, scar tissue actively forms under the skin of the penis. This is often when pain is most pronounced, and the degree of curvature may change over time. Following this, the chronic phase begins when the scar tissue has stabilized and the curvature stops worsening. Pain usually decreases during this stage, though some men continue to experience discomfort, particularly during erections.^[2][9]

Treatment decisions depend significantly on which phase a man is experiencing and how much the condition interferes with daily life. Medical societies have developed guidelines to help doctors determine the best approach for each patient. These guidelines take into account the degree of curvature, the presence of pain, whether erectile function is preserved, and the impact on quality of life.^[8]

In addition to standard treatments that have been used for years, researchers continue to explore innovative therapies through clinical trials. These studies test new medications and techniques that may offer better outcomes or fewer side effects than current options. Understanding both established and emerging treatments can help men make informed decisions about their care.^[10]

Standard Treatment Approaches Used by Healthcare Providers

When the symptoms of Peyronie’s disease are mild and not interfering with sexual activity, doctors may recommend a period of observation without active treatment. This is sometimes called “watchful waiting.” During this time, the healthcare provider monitors the condition to see if it stabilizes or improves on its own. However, this is appropriate only when the curvature is slight, pain is minimal, and erectile function remains intact.^[12]

For men experiencing pain during erections, especially in the acute phase, anti-inflammatory medications called NSAIDs (nonsteroidal anti-inflammatory drugs) such as ibuprofen or naproxen are commonly prescribed. These medications help reduce inflammation and discomfort, making erections more tolerable. Pain management is often the first priority, as it allows men to maintain sexual activity and helps reduce anxiety associated with the condition.^[5][20]

Several oral medications have been used to try to slow down or reduce the formation of scar tissue in the penis. One such medication is pentoxifylline, which is thought to improve blood flow and potentially reduce inflammation in the affected tissue. Some doctors prescribe vitamin E in combination with an anti-inflammatory drug called colchicine, based on the theory that these agents might interfere with the scarring process. Another supplement sometimes used is carnitine, which some studies suggest may have beneficial effects on tissue healing.^[12][16]

It’s important to understand that the evidence supporting these oral medications is limited. Many studies have not shown strong or consistent benefits in reducing curvature or improving penile length. Nonetheless, some doctors prescribe them during the acute phase with the hope of slowing disease progression, particularly when other treatment options are not yet appropriate or desired.^[10]

Injectable treatments deliver medication directly into the scar tissue of the penis. One commonly used injectable is collagenase clostridium histolyticum, marketed under the brand name Xiaflex. This is the first and only medication approved by the United States Food and Drug Administration specifically for treating Peyronie’s disease in men with a curvature between 30 and 90 degrees. Collagenase is an enzyme that breaks down collagen, the main protein in scar tissue, helping to soften and reduce the plaque that causes the penis to curve.^[14]

Treatment with Xiaflex involves a series of cycles. Each cycle consists of two injections given a few days apart, followed by a technique called penile modeling, where the patient gently stretches the penis at home to help straighten it. This modeling is typically done three times daily for 30 seconds, starting two days after the second injection in each cycle. The full course usually includes four treatment cycles, with noticeable improvement in curvature reported in about 70% of men who complete the regimen.^[13][14]

Xiaflex treatment comes with specific precautions. Men must avoid sexual activity for four weeks after the second injection in each cycle to allow the tissue to heal and reduce the risk of complications. Side effects can include bruising, swelling, and pain at the injection site. In rare cases, serious complications such as bleeding within the penis (hematoma) or even a penile fracture can occur, which may require surgical repair. These risks are small but important to discuss with a healthcare provider before starting treatment.^[14]

Other medications that can be injected into the plaque include verapamil, a drug originally used for heart conditions, and interferon, a protein that plays a role in immune response. Verapamil is thought to help reduce the production of collagen and may improve blood flow in the area. Interferon may help break down scar tissue and reduce inflammation. These treatments are considered “off-label,” meaning they are not specifically approved for Peyronie’s disease by regulatory authorities, but some doctors use them based on clinical experience and research findings.^[13][16]

The results with intralesional verapamil are variable. Published research suggests that about 50% of patients see some improvement in curvature, though the change is often modest — perhaps a reduction of 10 to 15 degrees. The treatment typically involves a series of six injections given every two weeks. Side effects are generally mild and may include slight swelling or bruising. Unlike Xiaflex, there are usually no restrictions on sexual activity between treatments.^[13]

Non-Invasive Devices and Physical Therapy Options

Penile traction therapy involves wearing a device that gently stretches the penis in the direction opposite to the curvature. The concept is that sustained, gentle stretching encourages scar tissue to remodel into more normal, flexible tissue over time. This can potentially reduce curvature and may even restore some lost length. However, traction therapy requires consistent daily use over several months to see meaningful results, and it demands significant commitment from the patient.^[17]

Traction devices are typically worn for several hours each day. While this approach is non-invasive and does not carry the risks of medication or surgery, it can be cumbersome and uncomfortable. Some studies have shown modest improvements in curvature and penile length, but outcomes vary widely among individuals. Doctors may recommend traction therapy as an adjunct to other treatments rather than as a standalone solution.^[8]

Another non-invasive option is the use of sound waves to break down scar tissue, a technique called extracorporeal shockwave therapy. The sound waves are delivered through the skin to the area of the plaque. The theory is that these waves stimulate healing processes and help break up the rigid scar tissue. While some early studies have suggested potential benefits, the evidence for shockwave therapy in Peyronie’s disease is still evolving, and it is not widely available or recommended as a standard treatment.^[5][10]

Surgical Solutions for Severe or Stable Disease

Surgery is generally reserved for men who have severe curvature that makes intercourse difficult or impossible, or for those whose symptoms persist despite other treatments. It is important that the disease has reached the chronic phase and that the curvature has been stable for at least three to six months before considering surgery. Operating while the condition is still in the acute phase can lead to poor results because the scar tissue may continue to change afterward.^[8][15]

One common surgical technique is called penile plication. In this procedure, the surgeon places stitches on the side of the penis opposite the curvature. This effectively shortens the longer side, allowing the penis to straighten. Plication does not involve removing the scar tissue itself. The procedure can correct curvatures of approximately 60 to 65 degrees. One downside is that almost all men experience some degree of penile shortening, typically around three-quarters of an inch. However, most patients report satisfaction with the results, especially when they have realistic expectations.^[13]

Recovery from plication surgery involves abstaining from sexual activity for about six weeks. Risks include incomplete correction of the curvature, temporary or permanent changes in sensation (numbness or tingling), and a small risk of erectile dysfunction. This procedure is generally recommended for men who have good erectile function before surgery and who can accept the trade-off of some penile shortening in exchange for straighter erections.^[13]

For men with more severe curvature — typically over 70 degrees — a more complex operation may be needed. This involves making an incision in the plaque and placing a graft to fill the gap, allowing the penis to straighten. Various materials can be used for the graft, including tissues harvested from the patient’s own body or synthetic materials. This type of surgery is more involved and carries higher risks, including a greater chance of developing erectile dysfunction after the procedure. Estimates suggest that 10 to 50% of men may experience worsening erectile function, depending on their pre-operative condition and the extent of the surgery.^[13]

Sexual activity can usually resume six to eight weeks after graft surgery. Other risks include numbness or changes in sensation in the penis, incomplete straightening, and some shortening. This procedure is typically performed by urologists who specialize in reconstructive surgery or sexual medicine due to its complexity.^[13]

When Peyronie’s disease is accompanied by severe erectile dysfunction that does not respond to medications or other treatments, a penile prosthesis may be the best option. This is an implantable device that allows a man to achieve an erection suitable for intercourse. During the same surgery, the surgeon can address the curvature by manually straightening the penis or by performing additional procedures on the scar tissue. For men who cannot achieve adequate erections through other means, a prosthesis can restore both erectile function and penile straightness.^[13]

Emerging Treatments Being Tested in Clinical Trials

Researchers around the world are investigating new approaches to treat Peyronie’s disease more effectively and with fewer side effects. Clinical trials are studies that test whether new treatments are safe and how well they work compared to existing options. Participation in a clinical trial can give patients access to cutting-edge therapies that are not yet widely available.^[10]

Platelet-rich plasma (PRP) therapy is one such experimental treatment. PRP is prepared by taking a sample of the patient’s own blood, processing it to concentrate the platelets and growth factors, and then injecting this concentrated mixture into the scar tissue. The theory is that the growth factors in PRP can stimulate tissue healing and regeneration, potentially reducing scar formation and improving penile function. Early studies have shown some promise, but more research is needed to determine whether PRP is truly effective and safe for Peyronie’s disease.^[6][10]

Stem cell therapy is another area of active investigation. Stem cells have the ability to develop into different types of cells and may help repair damaged tissue. Researchers are exploring whether injecting stem cells into the penis can promote healing of the tunica albuginea — the fibrous sheath surrounding the erectile tissue — and reduce the scarring that causes curvature. This approach is still in the early stages of research, and its safety and effectiveness have not yet been established through large-scale clinical trials.^[6]

Various forms of extracorporeal shockwave therapy are being studied in clinical trials to better understand their potential benefits. Different protocols involving varying intensities and frequencies of shockwave application are being tested to see if they can effectively break down scar tissue and improve symptoms. While some preliminary results have been encouraging, these treatments are not yet part of standard clinical practice.^[10]

Some trials are investigating combinations of treatments, such as using shockwave therapy together with PRP injections or pairing traction devices with injectable medications. The idea is that a multi-pronged approach might be more effective than any single treatment alone. These studies often aim to identify the optimal timing and sequence of different therapies to maximize benefits for patients.^[10]

New formulations of existing medications are also being tested. For example, researchers are exploring topical gels containing verapamil or other agents that could be applied directly to the skin of the penis. This would be a more convenient and less invasive alternative to injections. Early trials are assessing whether enough of the medication can penetrate the skin to reach the scar tissue and produce a therapeutic effect.^[16]

Clinical trials for Peyronie’s disease are conducted in different phases. Phase I trials focus on testing the safety of a new treatment in a small group of people. Researchers look for side effects and determine safe dosing ranges. Phase II trials involve a larger group of participants and aim to evaluate whether the treatment is effective and to further assess its safety. Phase III trials compare the new treatment to the current standard of care in large groups of patients to confirm effectiveness, monitor side effects, and gather information that will help determine how the treatment can be used safely and effectively.^[10]

Eligibility for clinical trials varies depending on the specific study. Common criteria include the stage of Peyronie’s disease, the degree of curvature, whether erectile function is preserved, and the patient’s overall health. Some trials are conducted in specific regions, such as the United States or Europe, while others may be available internationally. Interested patients should discuss clinical trial options with their healthcare provider or search for trials through registries and databases maintained by medical institutions and government health agencies.

Most common treatment methods

• Oral medications
  • Pentoxifylline to improve blood flow and reduce inflammation.
  • Vitamin E combined with colchicine to potentially slow scar tissue formation.
  • Carnitine supplements, which may support tissue healing.
  • NSAIDs such as ibuprofen or naproxen to manage pain during the acute phase.
• Injectable medications
  • Collagenase clostridium histolyticum (Xiaflex), an FDA-approved enzyme that breaks down collagen in scar tissue.
  • Verapamil injections, used off-label to reduce collagen production and improve blood flow.
  • Interferon injections, which may help break down scar tissue and reduce inflammation.
  • Corticosteroid injections to reduce inflammation and pain in the affected area.
• Physical therapy and devices
  • Penile traction therapy using devices that gently stretch the penis over several months.
  • Penile modeling exercises performed at home, often in conjunction with injectable treatments.
  • Extracorporeal shockwave therapy to break down scar tissue using sound waves.
• Surgical procedures
  • Penile plication surgery to straighten the penis by placing stitches on the side opposite the curvature.
  • Incision and grafting procedures for severe curvature, where the plaque is cut and a graft is used to fill the gap.
  • Penile prosthesis implantation for men with both Peyronie’s disease and severe erectile dysfunction.
• Experimental and emerging treatments
  • Platelet-rich plasma (PRP) injections to promote tissue healing using the patient’s own blood components.
  • Stem cell therapy aimed at regenerating damaged tissue in the penis.
  • Topical verapamil gels being tested as a less invasive alternative to injections.
  • Combination therapies pairing medications with physical treatments for enhanced effectiveness.