Symptoms and Associated Conditions
Symptoms of Peyronie's Disease can include any of the following and are present in the percentages listed among men who are coming to a doctor. Note, the numbers vary because different studies report differing rates.(1-4)
- Penile curvature (80-91%)
- Penile nodule or plaque (15%)
- Penile pain (3-22%)
- Erectile dysfunction (15-28%)
- Penile shortening (14%)
- Prior penile trauma (8-9%)
References: (1) Kadioglu, et al: 2002 J Urol; (2) Rhoden EL, et al: 2010 J Sex Med; (3) Kadioglu A, et al: 2004 IJIR; (4) Chung E, et al: 2012 BJUI.
By the time men present to their physicians, their average curve is 41-45°. You can see from the figure below, that 20-43% of men will have <30°, 39-61% of men will have 30-60°, and 19-25% will have >60°.
For direction, up (dorsal) or up and to the side (dorsolateral) are the most common directions of curvature, with 46-72% of men having this type of curvature at the time of their evaluation by a physician. In contrast, only 11-29% have lateral only curvature and 11-17% have downward (ventral) curves.
References: (1) Kadioglu A, et al: 2002 J Urol; (2) Mulhall JP, et al: 2006 J Sex Med; (3) Kadioglu A, et al: 2004 IJIR; (4) Grasso M, et al: 2007 Arch Esp Urol.
Pain is present in 3-22% of men with Peyronie's Disease at the time of their presentation.(1-4) Although it is not fully known how many men will experience pain at any time during their disease, it is clear that a percentage of men will never have pain, a percentage will have a brief course of pain, and a percentage will have chronic, smoldering pain that may take years to resolve. Some men experience pain only with erections (more common), while others have pain even with a flaccid penis (less common).
Pain is thought to resolve in all men over time and without treatment. However, the time course for pain resolution varies significantly. There are some therapies which may help to speed up the resolution of pain, but the pain will resolve with or without treatment. It is therefore important to recognize that any treatment which purports to improve pain in men with Peyronie's Disease should be viewed skeptically unless it is part of a randomized, controlled trial, where pain was a primary or secondary endpoint (main objective of study).
Among men who went to their doctor within the first 6 months of disease onset and who had pain, 89% had pain resolution at an average of 18 months after disease onset, and all men had improvements in their pain.(5)
References: (1) Kadioglu A, et al: 2002 J Urol; (2) Rhoden EL, et al: 2010 J Sex Med; (3) Kadioglu A, et al: 2004 IJIR; (4) Chung E, et al: 2012 BJUI. (5) Mulhall JP, et al: 2006 J Urol.
Indentations, hourglass, or other similar deformities are relatively common with Peyronie's disease. In a study of 128 men presenting to a physician for treatment, 39% of men were found to have indentations on one side, 23% with hourglass (narrowing on both sides), and 13% with tapering towards the end of the penis.(1) Surprisingly, men with any of these deformities were nearly 3x more likely to have psychological distress and decreased sexual activity compared to those who did not have these conditions.
References: (1) Margolin EJ, et al: 2018 Sex Med.
Dupuytren's disease is the most commonly associated condition with Peyronie's Disease and is thought to occur in approximately 6-11% of men who present to a physician.(1-2) Ledderhose's disease is also thought to occur with increasing frequency, however, this is not commonly assessed during physical exam and is therefore likely under reported.
There are several other conditions that have also been associated including erectile dysfunction, hyperlipidemia, diabetes, and hypertension.(3-7) However, there are also contradictory studies suggesting that these conditions do not occur at a higher rate among men with Peyronie's Disease.
At the present time, there is inadequate evidence to suggest that Peyronie's Disease is linked to any type of cancer.
References: (1) Rhoden EL, et al: 2010 J Sex Med; (2) Grasso M, et al: 2007 Arch Esp Urol; (3) Kadioglu A, et al: 2002 J Urol; (4) Mulhall JP, et al: 2006 J Urol; (5) Kadioglu A, et al: 2004 IJIR; (6) La Pera G, et al: 2001 Eur Urol; (7) Chung E, et al: 2012 BJUI.
Peyronie's Disease is linked with several psychological conditions. Specifically, men with Peyronie's Disease are nearly 7x more likely to have emotional distress and 8x more likely to have relationship distress.(1) Depression is also common, with 48% of men having this condition at the time of their Peyronie's evaluation, and 77% report negative psychological effects from the condition.(2-3)
Predictors of emotional distress include loss of penile length, existing relationship issues, inability to have intercourse, and the extent of penile curvature.(1-4)
References: (1) Smith JF, et al: 2008 J Sex Med; (2) Gelbard MK, et al: 1990 J urol; (3) Nelson CJ, et al: 2008 J Sex Med; (4) Gelbard M, et al: 2012 J urol.