Peyronie's Disease: What Curved Erections Are Telling You
By Dr. Leonard W. Liang, MD | Urology | Downtown Los Angeles
A curved erection is one of those symptoms men tend to sit on for a long time before mentioning it to anyone, let alone a doctor. That hesitation is understandable, but it’s also, according to the data, remarkably common, and remarkably fixable once someone actually brings it up.
What Peyronie's Disease Actually Is
Peyronie’s disease is a connective tissue disorder in which scar tissue, called plaque, forms inside the penis, most often along the upper or lower surface. As the Urology Care Foundation, the patient-education arm of the American Urological Association, explains, that scar tissue doesn’t stretch the way healthy tissue does, so when the penis becomes erect, the plaque pulls one side tighter than the other, producing a curve, an indentation, or sometimes a narrowing partway along the shaft. It’s generally believed to start after minor injury to the penis, often from ordinary sexual activity, followed by abnormal healing, though genetics, connective tissue conditions, and certain health conditions all appear to play a role.
It’s worth saying clearly: a mild, lifelong curve that’s never changed and causes no pain isn’t Peyronie’s disease. It’s just normal anatomy. Peyronie’s disease specifically involves a new curve, lump, or deformity that develops over time.
How Common It Actually Is
This is the part most patients get wrong, usually assuming it’s rare. A population-based U.S. survey of over 11,000 men, published in Advances in Urology, found that somewhere between 0.5% and 13% of men have Peyronie’s disease, depending on whether you count only formal diagnoses or also include men with clear symptoms who’ve never been diagnosed. A separate study of men presenting for routine prostate cancer screening, meaning they weren’t there because of a penile complaint, found a prevalence of 8.9%, with the condition significantly more common among men with hypertension and diabetes.
That second point matters. Like erectile dysfunction, Peyronie’s disease sometimes travels alongside cardiovascular and metabolic conditions, which is one more reason a curved erection is worth mentioning at a checkup rather than managing quietly.
The Underdiagnosis Problem
Here’s the statistic that should change how men think about bringing this up: in that same Advances in Urology study, among men who actually sought treatment for their symptoms, 73% saw a primary care physician first, and 92% of those men were not diagnosed with Peyronie’s disease at that visit. Thirty-six percent said their symptoms interfered with sexual activity. In other words, most men who do speak up still don’t get an accurate diagnosis on the first try, not because the condition is untreatable, but because it isn’t always top of mind for a general practitioner.
That gap is exactly why seeing a urologist specifically, rather than waiting it out or raising it only in passing, tends to get men to an accurate diagnosis and a real treatment plan faster.
What Treatment Can Look Like
Treatment depends heavily on how long someone has had symptoms and how much the curvature is affecting function. In the acute phase, when the curve is still changing and pain is often present, doctors frequently start with observation or oral and injectable medications aimed at limiting further scar formation. Once the condition stabilizes, usually after six to twelve months, more targeted treatments become options.
Collagenase clostridium histolyticum, sold as Xiaflex, is an FDA-approved injectable that breaks down the collagen in the plaque itself and has become a first-line option for men with significant curvature. A randomized trial published in The Journal of Urology directly compared collagenase injections against surgery and found that, at three months, surgery produced greater straightening, but collagenase preserved more penile length, caused fewer adverse effects, and had less impact on erectile function and sensation. Neither option is universally “better.” The right choice depends on the degree of curvature, how much it’s affecting function, and what a patient is prioritizing.
What a Conversation With Dr. Liang Looks Like
An evaluation typically starts with a history of when the curvature started and how it’s changed, followed by a physical exam to assess the plaque and degree of curve. From there, the conversation covers where a patient is in the disease course, acute or stable, and which treatment, whether medication, injection therapy, traction, or surgery, fits their specific anatomy and goals. Given how often Peyronie’s disease overlaps with erectile dysfunction, that side of things gets addressed in the same visit rather than treated as a separate issue.
Dr. Liang’s office is located at 1513 S Grand Ave, Suite 300, Downtown Los Angeles, CA 90015. Office hours are Monday through Friday, 9 AM to 5 PM. The office can be reached at (213) 749-0662, or an appointment can be booked directly online.
A new curve, a lump, or pain during erection isn’t something to just monitor on your own indefinitely. Given how often the condition gets missed on a first visit elsewhere, seeing someone who evaluates this regularly is worth the trip.
Related pages on this site: ViaSure for Erectile Dysfunction | About Dr. Liang | Contact & Appointments
