Men who have Peyronies disease usually discover it as a small lump below the surface of the penis that is painful to the touch. In some instances patients are totally unaware of the disease until examined for erectile dysfunction. Distortion or lumps are not visible in the early stages of the disease. A painful erection is an indicator of the disease along with palpable scars or bending of the penis. Almost one third of patients present the disease with painless curvature.
Scar development is sometimes accompanied by pain and the severity varies from none at all to severe causing sleep disruptions. The pain can also show itself only when the area is touched, come and go on its own or even be constant without being touched. Pain that worsens is not generally from the disease worsening but from new injuries to the tunica albuginea that surrounds the penis.
There are generally two stages of Peyronies disease; acute and chronic. Neither stage suggests a set length of time, duration or intensity. The acute stage is considered an inflammation phase and is when the most scarring and bending occurs. In some cases the disease is restricted to the acute stage and will resolve itself without treatment. Doctors that witness this generally recommend that the patient wait to see what will happen while others recommend treatment as early and aggressively as possible.
Within the first 12-18 months distortion can occur which causes significant changes to the tunica albuginea. As the scar grows the curvature may worsen and in about one quarter of patients the scar actually becomes calcified. In another one quarter it may actually calcify into bone formation within the tunica albuginea. In cases such as these, it is unlikely that the condition of the tunica albuginea will be changed without surgery. However some doctors believe that treatment can still be used although it will most likely take longer to begin seeing any effect.
After the deformity from the initial formation of the scar, pain usually resolves itself and the process of the disease stabilizes within 12-18 months. This is when the chronic stage begins. It is believed that the onset of the chronic stage leaves no choice of treatment other than surgery. Sexual intercourse is affected by the deformity of the penis. This is due to two reasons; 1) curvature making penetration impossible and 2) pain to either or both partners.
The most severe deformities are described as a cane handle. A large donut like scar around the circumference of the penis is called a “bottle neck” deformity. This deformity can result in the penis being poorly filled during the erection process causing the distal portion of the penis, from the scar to the head, to stay flaccid. A corkscrew deformity occurs when there is a twist in the penis from the scar placement.
Peyronies disease can take its toll on an individual both mentally and emotionally. In addition it can be a source of stress for your partner as well. If this occurs, you should be open with your partner and discuss the possibilities. If there are still tensions and emotional problems, seeking medical advice is always a good idea. Many partners will see the distortion as a direct reflection on you. In some instances counseling is advised when the disease interferes with the relationship.