Spongy spaces inside the penis called corpora cavernosa fill with blood to cause an erection. Damage to the elastic tissue surrounding the corpora cavernosa usually heals with no lingering effects, but in Peyronie's disease, permanent scar tissue, or plaque, develop. Scarring shortens connective tissue in the penis so that an erection bends, sometimes causing pain. Anxiety over the appearance of the penis, pain with an erection or during sexual intercourse, or scarring that extends into the corpora cavernosa can cause impotence or prevent an affected man from having a satisfying sexual relationship.
Medication
In some cases of Peyronie's disease, the symptoms resolve themselves over time without treatment. Treatment is indicated if the patient has painful erections, if there is a severe bend in the penis with erection or if the bend worsens, or if the condition prevents sex. The Mayo Clinic mentions that several oral drugs have been tested for treating Peyronie's disease, but so far none have been proven useful. The Merck Manual reports that the use of oral vitamin E and vitamin K para-aminobenzoate has shown some success in treating Peyronie's disease. While corticosteroid injections directly into scar tissue might be effective, oral corticosteroids are not, states the Merck Manual.
Penile Injections
According to the Mayo Clinic, limited evidence supports the usefulness of multiple direct injection of medications into the scar tissue of the penis over the course of a few months to treat Peyronie's disease. Options include verapamil, a drug normally used for high blood pressure, which disrupts the connective tissue protein collagen to minimize scarring in the penis; interferon, to disrupt collagen and promote its breakdown; and collagenase, an enzyme that degrades collagen.
Surgery
Several outpatient surgical approaches can straighten the penis and eliminate painful erections. According to the Mayo Clinic, surgery must wait until the degree of bend stabilizes and erections have been pain-free for six months. To remove the bend, the surgeon can either shorten the elastic tissue on the side opposite the scars, or lengthen the side with the scars. For men with normal penis length and only a moderate bend, the surgeon might recommend the former approach, which will slightly shorten the overall length of the penis. For men with a shorter penis, a severe bend or other complications, the surgeon might lengthen the scarred side by cutting several notches in the scar tissue to let it stretch, and cover it with transplanted or artificial graft tissue. With lengthening, the man has a higher risk of post-surgical erectile dysfunction as compared to the shortening procedure. In cases where the patient suffers from erectile dysfunction and Peyronie's, the surgeon might insert penile implants during the shortening or lengthening procedure. The implants can allow a man to have an erection firm enough for sex.
