Cortisone injections and Peyronie's disease

My doctor wants to put cortisone injections into my Peyronies scar, what do you think of that?

Will steroid injections reduce the inflammation and pain of my Peyronies?

My opinion is that it is risky to use cortisone injections as a Peyronie's treatment.  While a temporary and variable reduction of pain does occur in some cases, but not all, it is not worth the limited benefit that makes future Peyronies surgery more complicated and dangerous should it become necessary.  There is good reason to think twice about using steroid injections for this purpose.  This website has presented an earlier article about a closely related topic, Peyronie's disease treatment via direct drug injection.
It would be good to talk to your doctor about other treatment options or to consider using Alternative Medicine as a way to increase your natural ability to eliminate the Peyronies scar.  The PDI website explains how this can be done without the use of drugs and surgery.
In the 1960’s steroid (cortisone) injections were used as a Peyronie’s treatment under the theory that they would reduce plaque or scar formation because of the inhibitory effect cortisone has on fibroblast cell formation. Since fibroblasts are cells that make fibrin, and fibrin makes collagen in the body, with fewer fibrin cells the ideas was that this would result in less collagen produced during scar formation.
This treatment for Peyronie’s was used rather extensively until the mid-1980s when it became obvious that it did not consistently or greatly reduce collagen at the Peyronie’s plaque. And of equal concern was the observation that these steroid injections were causing penis tissue weakness (atrophy) of blood vessels, nerves, and all connective tissue of the corpora cavernosa and tunica albuginea of the at the site of the injections near the Peyronie’s plaque. These steroid injections resulted in weak and fragile tissue that would easily tear when a surgeon would try to sew it together during surgery, or worse yet would tear after surgery or heal slowly or not at all.

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It took a long time to notice and correlate this problem because virtually all of the studies of using cortisone injections in Peyronie’s disease did not use a placebo control, and they performed with only a small number of patients who reported their improvement subjectively without objective measurement of progress in terms of pain, plaque formation and deformity reduction.
Seldom did the steroid injections actually have a beneficial effect on the eventual Peyronie’s disease outcome, but had an undesirable side effect that made Peyronie’s surgery complicated and less effective. The problem was that the broad tissue destruction caused by the cortisone made the tissue so weak and compromised that a surgeon could not later go into that same area to suture the tissue closed at the site of a surgical incision, or expect the sutures to hold on the weakened tissue. If penis surgery was done it often resulted in frequent bleeding and repeated opening of surgical wounds. Once it was seen that cortisone injections made it difficult to do good surgery later, the practice began to fall out of general use.
In addition, the practice of using cortisone injections for treatment of Peyronie’s disease did not take into account the harmful effect of placing a series of multiple needle punctures into the scar material and the tunica albuginea tissue of the penis. Later clinical observations have shown that these frequent and repeated needle punctures act as additional trauma to tissue that has already shown itself capable of producing excess scar formation to repeated small injury. This has also proven to be the case when a series of multiple injections of other drugs like verapamil and interferon are used as Peyronie’s treatment. The clinical results of these other drug injections have not provided positive or encouraging clinical results that were any better than those of cortisone injections.

My husband has a curved penis, is this normal?

 Bent penis usually means Peyronie’s disease later in life

A curved penis can be normal for some men, or it can indicate the presence of a problem for other men.  Just because the penis is curved does not necessarily mean there is a problem.

For the most part, the fact that penile curvature exists at all in a man does not indicate a true abnormality or reason for concern; an abnormality is more so suggested if there is a change in the appearance and structure of the penis if it was previously straighter than it is now and only later became curved.

If a diagnosis of Peyronie’s disease has already been made to explain the bent penis you are asking about, you should consider using Alternative Medicine treatment to assist and support the body’s natural ability to heal and repair the Peyronie’s plaque that causes the curved penis and the various signs and symptoms that are a result.  Click here to find a good place to start learning about non-surgical and non-drug Peyronie’s treatment.

When did the bent penis begin?

Usually the answer to the question, “When did the curved or bent penis begin?” will usually indicate if there is an actual problem to justify concern.

If your husband’s penis has been curved since childhood, or for as long as he can remember, then there is a very good chance that he has a normal variation of the shape of his penis.  This is called a normal penis curvature and is often simply due to a variation of the size of the internal chambers that make up the body of the penis.   In a congenital curve of the penis there is usually no pain associated with erection or intercourse.

Also, in regard to when the penis curvature occurred, it is not uncommon for Peyronie’s disease to develop after certain medical procedures or treatments:

  1. Use of Viagra, Cialis or Levitra (PDE5 inhibitor drugs) that have been known to cause damage to the internal tissue of the penis when an exaggerated or excessive erection occurs.  For some men this can happen after just one use of these drugs, or for other men after multiple uses that previously did not cause any unusual reaction.
  2. Use of beta-blocker heart medications that are used for chest pain and arrhythmia to name a few.  There are many beta-blockers used, but a few of the more popular are Lopressor LA, Sectral and Tenormin
  3. Use of some cholesterol lowering drugs (statin drug group) that have a long list of known side effects, but recently have been expanded to include Peyronie’s disease.  There are statin drugs in this category, but a few of the more popular are Crestor, Lipitor, Lisinopril and Lovastatin
  4. Having been catheterized as part of surgical procedure, especially when done while under anesthesia while in a hospital setting.  Many times greater force is used to pass the catheter tube through the urethra due to time constraints and urgency, resulting trauma to the penile tissue.

If your husband’s penis curvature started recently or sometime after his teen years when it had been previously straight, then this suggests a problem for which he should make an appointment with a urologist for an examination and diagnosis.  The most common cause of a curved penis that appears after it was previously straight, by far, is Peyronie’s disease.  Other less common causes can be:

  1. Trauma to the penis that causes simple swelling
  2. Trauma that causes penile fracture
  3. Penile cancer, although very rare

Diagnosis of Peyronie’s disease and the curved penis 

Typically, in cases of an adult onset curved penis, there are three primary findings that usually have to be met in order to establish a diagnosis of Peyronie’s disease:

1.    Presence of one or more nodules or areas of hardness located under the skin of the shaft.  These localized nodules are not seen on the surface, but a felt by digital examination below the skin; some can be so large that the surface of the skin is elevated from below by the nodule.

2.    Pain, from mild to severe, from occasional to constant, in some area of the penis while erect.  A small percentage of men experience penile pain while flaccid (non-erect), and an even smaller percentage experience pain during both states.

3.    Recent development of curved or bent penis, or some other similar distortion of the penis (bottleneck, hourglass, or indentation). 

A diagnosis of Peyronie’s disease can still be made without one of the above findings, if the other two are dominant and reliable.  Other findings of slightly less frequency and less importance seen during Peyronie’s disease, that are of some value in making a diagnosis  are:

  1. Loss of penis size in terms length and circumference (girth or diameter).
  2. Reduced erectile ability in either the entire shaft or a localized area of it.

The important thing is to not ignore the penile curvature and to do whatever you can to avoid Peyronie’s surgery whenever possible since the side effects can be devastating.

Is a penis extender the wrong thing to use for Peyronies?

Hi Dr.

I got Peyronie's disease about 5 years ago through intercourse with my wife. I saw an urologist who prescribed a 3 month dose of pills which failed to do anything so we tried it again. I was then told I could have surgery which made me go into denial. The curve has got worse over the last 2 years and I’m worried about having sex so it's become non existent between the two of us. I am now desperate and have been looking at the penis extender for Peyronies – is this a possible method along with your treatments, or is this the wrong move. I'd like to get started in the right direction.

Thanks R

Greetings R,

You need to do a little bit of reading.  There are many articles and posts I have written about using a mechanical penis stretcher, commonly called a penis extender.  Here are a few links for you to read: Penis stretcher:  Big problem as Peyronies treatment and Penis extender claims and Peyronie's disease and Peyronies treatment and the penis stretcher.

Peyronie's surgery is always something that is proposed when other medical treatment eventually fails.  I would caution you to consider that if your penis has already demonstrated the ability to develop too much scar after a small injury, there is a stronger possibility of an even greater amount of scar occurring as a result of the surgical incisions associated with common penis surgery techniques.  This is the reason that men find their PD worse after having surgery to correct their curved penis.     

From my experience many couples who live with Peyronie's disease in their lives will limit or stop sexual intimacy when it is not necessary to do so.  The problem often is that their medical doctor does not know about or does not take time time to explain, some basic information that would enable a couple to safely engage in intercourse.  I can assure you that within a brief time you would feel a lot more comfortable about resuming sexual relations once a few things have been explained to you. My wife, who is an RN, and I have counseled with many hundreds of couples and helped them to regain that part of their lives by simply sharing some simple information. Contact me if you are interested in learning more.  Additionally, you can get a book that wrote, "Peyronie's Disease and Sex" from the PDI website.       

Getting Peyronie's treatment started in the right direction is easy if you are prepared to spend some time educating yourself on the PDI about Alternative Medicine methods to increase your ability to remove the PD scar naturally.  I did it, and I get emails every week from men who are doing it.  I have come to realize that when the average man even after five years of dealing with Peyronies if he uses a large and diverse program of care and works aggressively will see positive change in 2-4 months in about 80% of cases.

Let me know if I can help you in any way to get your life together.  TRH

Will this surgery work to correct my Peyronie’s disease?

I have peyronies a year and a half now with a 45 degree bend when erect.i have consulted my doctor.i have seen a surgeon and I am not satisfied with his straightening method.he just wants to put a slit in it and sew it back.i don't believe this would would work.i need a second opinion.i am on medical card and live in county roscommon in the west region of Ireland. i need a surgeon who is prepared to carry out the full and proper treatment I would be very thankful for your assistance doctor and advice.i am only 39 and this is ruining my relationships and I am depressed. please help me.


Are you sure you heard and understood everything that was told to you about this penis surgery?

I cannot directly comment about what your surgeon explained about the Peyronie's surgery he or she proposed because I was not there to hear the explanation you were given, and you were. However, as I understand penis surgery to correct a penile curvature caused by PD, the typical procedure is much more complex than simply putting a slit in the shaft and closing it up.  

If you are positive you were given this exact explanation, I suggest you contact another urology surgeon who will take your case more seriously for a second opinion.  Using the information that follows I propose that this next time around you be prepared to ask many questions and demand answers.  You should fully understand what is being proposed to you so you can make an intelligent and informed decision.  I also suggest that you spend some time on the Peyronie's Disease Institute website to learn about the possibility of using non-drug and non-surgical treatment to increase your ability to eliminate the Peyronie's plaque naturally.

I am sensitive to what you are asking and I understand your concern about penis surgery.  However, I have no way to know what is the full and proper surgical treatment for your particular problem, and frankly neither do you.  Something as vitally important and final as surgery requires a great deal of trust in the skill and competence of the surgeon in an area that a layperson does not have enough knowledge or skill to judge what needs to be done. Having said that, I think you might be correct to want to talk to another surgeon if only because it is not correct or proper that you were allowed to leave that office without a better understanding of the proposed surgery.  In my opinion, a half-hearted explanation is no explanation, and does not bode well for the kind of surgery that a doctor like that would provide.

There is always the possibility you misunderstood what was explained to you, but it is still the responsibility of the doctor to make sure you do fully understand so you can give informed consent to a surgical procedure.  There is also the possibility the doctor did not want to give you all the (somewhat gruesome) details of the surgery, since it might scare off someone with a squeamish stomach. Another possibility is that the doctor simply did not want to take the time from a busy office schedule to explain what would happen in the proposed surgery.  It has been my observation that many times a surgeon will greatly limit or modify the truth about some aspect of a proposed surgery (risks, chances for recurrence, changes for failure, degree or frequency of complications or side effects) so that the patient is more inclined to accept the idea of the surgery, and agree to have the surgery done.  It is somewhat of a "selling job" that is done.  It is not appropriate, it is not correct, and it is not legal, but it is done.  Perhaps something like this happened in your case.  Whatever was the reason that you thought the doctor was going to "put a slit in it and sew it back," it is the fault of the doctor for that notion and possible misunderstanding to remain.

More than likely, and I could be completely wrong since I was not there, the doctor proposed to do a Nesbit procedure for your curved penis.

For the most men the Nesbit procedure is the most common, easiest and most direct way that a surgeon can address the penile curvature of  Peyronie’s disease. However, it causes shortening of the erect penis by 2.5 to 6 cm (one to two and a half inches), and this is the greatest drawback of it.  The operation is performed under a general anesthetic and takes 40 to 60 minutes.  Men usually go home the day after surgery, or even the same day.

Basically, in the Nesbit operation the main idea is to make an elliptical incision to remove some of the shaft tissue and tunica albuginea from the long side of the bent penis (on the side opposite the inner curve of the bend), in an effort to straighten the curvature.  This tissue removal is responsible for the overall effect of penis shortening when the long side is reduced. The rule of thumb is that for every 25-30 degree of curvature that is present, a loss of approximately 1 to 1.5cm penis (about half to one inch) length at erection will occur.

An incision is made all the way around the shaft, a few millimeters behind the edge of the head (glans) of the penis.  The cut skin of the penis is rolled back down (like rolling or peeling your socks down off your leg), exposing the two corpora cavernosae so the one corpora cavernosa that is opposite the bend and the Peyronie's plaque can be shortened.  This is done by either removing tissue of the corpora with removal using an elliptical incision or simply by drawing it tighter with internal stitches.  After this is done the foreskin usually has to be shortened also so that it matches the new shorter length of the penis.  As in any operation, infection of the incision lines can be a problem and the foreskin, if left behind, sometimes becomes swollen after surgery; for this reason many surgeons will also perform a complete circumcision to prevent this complication. Otherwise direct surgical complications are not common, but occasional to infrequent side effects after surgery of erectile dysfunction, permanent numbness and penile pain can occur.

Hopefully, this explanation of the Nesbit procedure is helpful.  Keep in mind that this is the simplest Peyronie's surgery.  You can see Peyronie's surgery is a lot more complex than what you thought.  TRH

Does any Urologist perform a needle aponeurotomy for Peyronies disease?

Needle aponeurotomy for the hand is all I see online. I am a Kaiser Permanente subscriber and even at that, I don't see anywhere online where needle aponeurotomy is performed on a penis…Got any suggestions? Do you know of any Urologist in my medical plan who does needle aponeurotomy for Peyronie?


Martin Carroll, Jr.

Greetings Martin,

Well, you are certainly an adventurous person. Here you are a layperson and you are thinking outside the box about your Peyronie's treatment, but you are in a risky area. The problem is that this idea of using a needle to tear up the fibrous Peyronie's plaque without having to cut the penis shaft open has already been explored.

As you know, needle aponeurotomy is a type of surgery done on the palm of the hand to surgically reduce the cords that develop in Dupuytren's contracture. It is a less invasive hand surgery performed by inserting a needle under the skin of the palm, and then blindly slashing and tearing at the cords and contracted fascial tissue since the skin is never opened by the surgeon so he/she never actually sees the tissue that is being cut and torn. The purpose of this procedure is an attempt to weaken and reduce the cords that develop under the skin in Dupuytren contracture to the point that the surgeon can eventually break or snap the weakened Dupuytren cords. The recurrence rate of the Dupuytren nodules and cords returning after needle aponeurotomy is fairly high, about a year or two faster than conventional hand surgery. Even though they return after this kind of hand surgery, the real caution and reason many people do not get this surgery is that when the Dupuytrens comes back in that year or two it will come back worse than the first time around. This is common for many of these Dupuytren hand surgeries and a good reason to think long and hard about getting started with the first one.

There are many hand surgeons who are proponents of this technique, and others who are not. No surgical technique is perfect, and they all carry risks. You might want to read more about these drawbacks and apply that thinking to what might happen if that same kind of technique was done for Peyronie's disease.

This same technique in which the tip of a large gauge needle is used as a cutting tool to reduce the Peyronie's plaque while the actual slashing and tearing of the tissue is not directly observed by the doctor who is doing the penis surgery is called the Leriche technique for Peyronie's disease. But it is not called an aponeurotomy because there is no aponeurosis in the shaft of the penis; that is why you were not able to find any information using the terms you were searching. If this surgery for the penis was to be named in a way similar to what is being done in the hand, it might a name like Needle Tunicotomy. This term would be applicable because it is the tunica albuginea of the penis that would be surgically cut by the needle tip and left in place, just as it is the aponeurosis of the palm that is cut with the needle in Dupuytren's contracture. You will not find this term anywhere but here because I coined it. to read more about this procedure, click on “Leriche technique for Peyronie's surgery.”

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There are many more conservative ways of trying to correct your Peyronie's disease than having the internal scar blindly being cut to shreds. I suggest you consider avoiding that kind of risk and look at some of the less risky non-invasive Alternative Medicine options that are on the PDI website. TRH


After Nesbit Peyronie's surgery the curved penis came back – now what?

Hi Dr Herazy,

I was diagnosed with Peyronie's disease in Oct 2009. the urologist put me on potaba which did nothing. I then tried neprinol that did nothing. I saw the uro again and he put me oh high doses of oral Vitamin E and said I was to start VED therapy. My penis curve did not improve at all and in fact became worse. I was then also put on pentoxifylline which again did nothing. After no improvement and the curve to my penis being 40 degrees upward he told me the only solution was Nesbit surgery which I underwent out of desperation in May last year 2011. All was fine, my penis was very straight but shorter by about an inch but then in Sept.Oct the same year I began to notice my penis curving up again! Now in August 2012 it is really back to where I was in 2009 with an upward curve of 40 degrees. Very depressing as same curve just shorter penis!

What do you suggest in light of my previous drugs and treatment to try and cure this myself as I am beginning to give up on the uro's and certainly do not want more surgery after the first one failing me! What do you think about this if I order: DMSO, Super CD Serum, Vitamin E unique Oil, stretching video, Scar-X and Acetyl-L- Carnitine? I am in the UK. Hello, please help as I am now desperate and depressed.


Greetings Gary,

I commend you for your tenacity and strength to continue to work to help yourself in view of all that has happened to you.

It appears that you have now spent some time reading a few ideas presented on the PDI website about Alternative Medicine treatment of Peyronie's disease. It sounds like when you earlier used Neprinol by itself you did not receive any good advice and you wasted that opportunity to do something positive and helpful for your curved penis. That is always the problem when buying Neprinol from people who do not know how to use it correctly.

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Please do not evaluate Neprinol based on using it by itself. In my opinion that is not the best way to use Neprinol. It is a great therapy product but it must be combined within a well balanced Peyronies treatment plan that addresses other aspects of this complicated problem. You did the best you knew how to do, but you just did not receive good information. Neprinol cannot do it all by itself, but then again, no other therapy product can either; they all must be combined for greatest effectiveness.

If you read about the Nesbit Peyronie's surgery procedure and outcomes on the PDI website you will learn that it is not uncommon for Peyronie's disease to return within a few years; sometimes sooner and sometime later, but it will always return. The surgeons do not like to discuss this aspect of their work because it does not do a lot for their business prospects. In this regard I strongly suggest that you consider putting yourself on an aggressive support plan to minimize the potential of fibrous tissue return. The outline that you suggest is not a bad one and could be helpful in your situation. If it makes sense to you, as apparently it does, I suggest you put yourself of this plan you designed and try it for a month to see if it makes a difference in the size, shape, density and surface features of your scars – no plan can be evaluated on paper; it is only by applying it and evaluating how it affects your PD scars will you know if it is actually effective for you.

Please let me know if I can be of help to your effort. TRH


Any advice about my Peyronie’s disease?

Dar Dr. Herazy,

I am a 46 year old man and 6 years ago I noticed a curve in my penis when erect and a loss of significant size- width and length.   I do not have pain though and went to a urologist (hard to do, embarrassing) and the guy was not cool.  He grabbed my flaccid penis for a second and told me to take l-lysine or something.   I am really at wit's end and have basically given up a life of intimacy because of this.  I don't want a weird operation, but feel my case is not super severe.  It certainly hasn't worsened over the years.  Any advice?



I am not sure about your reference to l-lysine, an essential amino acid, being prescribed by your doctor as a Peyronies treatment.   I suppose it is possible, but the connection between the two is not direct. Further, although you did not come out directly and say so, I will assume that your urologist gave you a diagnosis of Peyronie's disease.

There are three forms of carnitine: L-carnitine, acetyl-L-carnitine and proprionyl-L-carnitine.  Acetyl-L-carnitine (ALC) is the principal form used in most research and treatment of Peyronie’s disease (PD).   The two primary building blocks of carnitine are the essential amino acids lysine and methionine.   While this might be the basis for the thinking behind prescribing l-lysine to you, it seems more direct to simply prescribe that you take acetyl-L-carnitine.  Perhaps you were overwhelmed, as most men are when they first learn that they have Peyronies disease, and you misunderstood.

Peyronie's surgery is the most common medical option that is presented to a patient, even suggesting surgery before more conservative options are tried.  PDI is not against surgery as a treatment of Peyronie's disease, but it is best considered as a last resort, not as a first measure as some doctors are inclined to do. Please be very careful about considering any Peyronie''s operation since the negative consequences can be devastating. 

The fact that the curvature of your penis has not worsened over the years does not mean it cannot do so at any time.  It is always wise to be cautious and aggressive in treating yourself to eliminate the Peyronie's plaque even if the distortion is slight and stable, because any case of untreated PD can worsen suddenly. 

My advice is to spend some time on the PDI website learning about the Alternative Medicine treatment of Peyronie's disease, and how you can do simple things to increase your body's ability to heal the Peyronie's plaque like the 50% of men whose PD just goes away naturally.  Our approach is not radical; we area only attempting to increase  or support a natural healing process that happens in half of the cases of PD.   It is not like we attempt to get you to grow a 6th finger on your hand or to jump over the moon.  This is all basic stuff about natural repair and attempting to promote normal body function.   A good place to begin looking is "Start Peyronies treatment."    TRH

Peyronie’s disease caused my divorce and makes me ashamed to get intimate; who can I go to for help?

I have had Peyronies for two years now. I live in Charlotte NC and being in the middle of the Bible belt have been ashamed and have not sought treatment for this reason.  It has been a major contributor to my recent divorce.  I am now trying to date but again am ashamed to get intimate could you refer me to doctor in Charlotte NC as I am now ready to address this.




Greetings Marc,

Sorry to hear of your Peyronie's disease and how it affected your marriage.

I do not know of anyone in the  Charlotte area in whom I have confidence.   Sorry.   However, there is another issue that is perhaps even greater than your Peyronie's disease, and that is your attitude about yourself and your Peyronie's disease.

Whatever doctor you eventually decide to consult for your health problem, if he is like 99% of those I hear about he will likely rush into the room, do a very brief history and examination, confirm your suspicion of having PD, tell you there is not much he can do and he will suggest that you come back in six months to see if you have gotten bad enough to do Peyronies surgery on you.  Unless you are the world's luckiest guy, he will not actually talk to you in any meaningful way or discuss your personal situation.  That is just how it is in the real world of medical practice these days.

You should get a diagnosis and make sure you know what your problem is exactly.  After that, you should carefully consider your treatment options.   You can use the standard drugs and surgery, or you can use Alternative Medicine to see if you can avoid the medical approach.   One of the things about the inevitable use of Peyronie's surgery is that there is always at least an inch or two lost of length and the possibility of continued penis curvature, possibility of erectile dysfunction as a result of surgery, to say noting of the external scars that are visible from surgery.  All of these can contribute to the shame and embarrassment you feel now.   Do not think that just because you submit to medical care that your days of reduced penile function and altered penile appearance are over; far from it.   Some men's  PD problems are worse after surgery than before it.   This is why PDI suggests more conservative measures that can reduce your penile curvature without risk of surgery and drugs. 

Regardless of what route you decide to take you must improve your self-opinion and how you view life as someone with Peyronies.  This is a huge subject and something that I cannot undertake in a response to the Q/Q section.   I suggest that you get my book "Peyronie's Disease and Sex" because it will help you in all the ways that I mention and it will offer useful advice about getting back into the dating pool again.   TRH   

Does Peyronie's disease go away like it came or is this for the rest of my life?

Dr. Herazy,

I have been married for 10 years.. 46 years old.. had sex the other night it seemed like my penis had a leather strap around the lower bottom.. and was not stable.. it has a indention all the way around the lower part and it also has a lump or bump in it and with this comes pain.. ALL OF THIS HAPPENED OVER NIGHT! I am shocked and scared.. My wife and I have always had a healthy sexual relationship and this is frightening to think that this has happened out of thin air. It has cut down on the size of my penis and the sensation is not there that was before!

I have had issues with my testicles, especially the left.. swelling at times and after having back surgery in 2009 NO DOCTORS could figure out what was making my left testicle swell. Felt like someone had kicked me down in the groin for 6 weeks and finally went to a pain management Doctor and they did a Caudal Block Injection… right above the crack of my rear end. He said that during the back surgery they may have got into those nerves but all I know is with in 5 minutes of the injection I felt relief after 6 weeks of feeling like someone had kicked me.. the nausea, stomach pain, and testicle pain.. the whole works finally subsided.

Does this go away like it came or is this for the rest of my life?



Greetings Robert,

Your description makes it sound like you have Peyronie's disease, although it is not possible to know for certain without a direct physical examination and more information from you. You should go to an experienced and compassionate urologist in your area for an examination and diagnosis to confirm my suspicion.

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If it turns out that you do have Peyronie's disease you need to know that in about 50% of cases it will resolve itself with no residual problem or side effects afterward. If spontaneous reversal or recovery happens it will typically occur within 12-18 months after onset of the problem.

The medical community says that there is no way to change the damage done by Peyronie's disease for the unlucky 50% whose problem does not go away on its own. I happen to disagree with this statement, since I and many hundreds of men who have used the PDI treatment protocol have been able to increase our ability to either greatly reduce or eliminate the foreign Peyronie's plaque fibrous material. This is good to keep in mind since the only current medical treatment for Peyronies disease is penis surgery. However, Peyronie's surgery can develop some very nasty side effects and bad results. Please do all that you can to avoid Peyronie's surgery.

The PDI concept of Peyronies treatment is that the 50% of cases in which this penis problem goes away on its own represents natural healing, as the body should be able to do for anyone. The natural Peyronie's treatment protocol you see in this website is an attempt to increase or support the innate ability of the body to heal. I maintain that anyone with this problem should first attempt to see if his body is capable of natural recovery (as happens in half of the men who develop PD) before using more extreme and irreversible methods.

To review helpful information, see “Start Peyronie's treatment.” TRH


Dilemma: I can’t find anyone who is skilled and has successfully performed Peyronies surgery

Hi Dr Herazy,

I have Peyronies disease, I have tried all sorts of oral medications to no affect. It has been over 2 years and I know psychologically I buried my head in the sand. It has caused major problems with my wife. The curvature is nearly at right angles making it nearly impossible to have sex. I still have sexual desire but that is about it.

I know the only way forward is surgery. My dilemma is finding someone who is not only skilled but has successfully performed this surgery.

I live in Sydney Australia if you can refer me to someone that I can see I would be greatly appreciated

Warm wishes,



Greetings David,

It appears to me you have not read much information available to you from the Peyronie's Disease Institute.

Why do you assume the  only option available to you for your Peyronie's disease is surgery?    If 50% of men who develop PD experience a spontaneous or natural  healing of their PD ("it goes away on its own"), why do you believe that your body would not be able to heal if you were to give yourself the best opportunity to recover by really concentrating your effort in that direction?   Many men have done just that.  Many men who I work with have had their Peyronies  problem for longer than just two years.  Many have had PD for 5-10 years, or more.  some get great recovery and reversal of their curved penis and reduction of the Peyronie's plaque, and others have only slight improvement.  The results are variable because each man conducts his plan a little differently and some do it better than others.

It should tell you something – it should ring out loud and clear – why are you having trouble finding anyone in your country who is skilled and successful in performing Peyronie's surgery.   When Peyronie's surgery goes bad, it can be a real catastrophe.   Since you have PD you already demonstrate the tendency and ability to create too much scar when you penis is injured.    Surgical work on this very same tissue can result in an even greater amount of scar formation.   This is the reason why I have so many MDs who contact me when they develop PD; they want nothing to do with surgery when it is their penis on the line.  Once you have been operated on, there is no way to truly reverse the effects of the first surgery.   Please be very careful who talk to about this kind of surgery and get a clear understanding of the kind of results they say you should expect. 

This is an article I wrote you might find helpful:  Peyronies surgery:  Finding a surgeon.

I suggest you spend time reading some of the ideas about working with Alternative Medicine to support your natural healing potential.  TRH

How should I wash after Peyronie’s surgery?

after surgery for peyronies desease how often should you wash the penus and the best way of washing after peyronies surgery and what with?



You really should talk to the doctor who will do your Peyronie’s surgery for the specific answers to this questions.  Your surgeon will help you with this information.  

Is there a reason you believe you need to have Peyronie’s surgery?   Have you tried to help yourself so that you might not need to have penis surgery?    TRH


Which PDI treatment plan would be beneficial to my Peyronie’s disease?

I had been having problems with pain upon erection and lumps along the shaft of my penis for several months and then I started having a lot more pain.

I went to a urologist who initially told me he couldn't find anything abnormal but during a subsequent follow-up visit he told me that I have Peyronies Disease and that the lumps were plaque formation and there wasn't much I could do about it. He advised oral Vitamin E (which I take religiously) and waiting to see if it got better without injections or Peyronie's surgery.

I had never heard of this disease so I have been researching it. I do not have any obvious outward sign like scars or any curvature but I can feel the plaque deposits and have very painful erections.  Sometimes there is pain even without erections. I don't remember having any specific injury or trauma to my penis during sex but sex definitely makes the pain worse. I am really worried that although there is no curvature now, there will be if I follow the doctor's "wait and see" plan.

I already feel a "pulling upward" sensation with erections. I would like to know which of your treatment plans would likely be most beneficial to me. The biggest problem is the pain and the lumps that seem to produce this "tugging or pulling" feeling. My first thought is to jump in with both feet into the most aggressive treatment you have but maybe that is not the correct thing to do. I would really appreciate any guidance you can give me.


Thank you for your question.

You must stop doing anything that causes your Peyronie's disease to be more painful.  Pain indicates that you are again stressing the deep plaque or scar tissue of your Peyronies, and this is harmful and will delay your recovery.  This does not specifically mean stopping sexual intercourse; it only implies you must determine what you  are doing during intercourse, or how you engage in intercourse, that causes physical stress upon the penile tissue and change that aspect of your technique.   This is a huge, diverse and important subject, and for this reason I suggest you should consult a book I wrote, "Peyronie's Disease and Sex."    

Taking vitamin E by itself, or taking the wrong kind of vitamin E, no matter how religiously you take it will not help your PD.  You must use the right type of vitamin E, take it at the right time and in combination with other important therapies for it to help your problem.  Please refer to the section in the PDI website about vitamin E that covers this important subject. 

Penile distortion can occur immediately in Peyronie's disease, but it can also take months or years to develop.  Further,  I have communicated with many men whose PD distortion suddenly worsened after being static for a few years.  For this reason you must not assume your problem will always look the way it looks at this time; they usually worsen over time.    

No one can tell you ahead of time which PD plan will work best for you.   Please read "Do you simply recommend the same treatment products to all Peyronies cases?"   You will then understand that all treatment must be unique and driven by specific response of your Peyronie's plaque or scar.  Lastly, it would appear that you think that the Peyronie's scar is located on surface of the shaft; it is not.     The Peyronies plaque and scar are terms for the same fibrous material that is found deep within the penis below the skin surface; in the world of PD the scar and plaque mean the same thing.  The scar or plaque are not visible from the exterior since they are internal.

 Let me know if I can help you in any way with eliminating your PD scar with Alternative Medicine.  TRH    

Why didn’t the first skin graft take?

I had peyronie's surgery back on 19 Sept 11.  My urologist removed two large masses which he told me was scar tissue. He also said he repaired the areas with grafts. It has been almost two month now and I have a 1 1/2 x 2" open wound on the shaft of my penis. I continue to keep it clean and bandaged but it does not seem to be healing. I've been told by another urologist that I need another skin graft. 

Unfortuntatetly I'm currently depolyed to Afghanistan and not scheduled to return until June.    Why didn't the first skin graft take?   Is there a risk in waiting until I return back to the states?




Greetings Tony,

Thank your, sir, for standing tall and strong to protect the freedom we all enjoy.   Our thoughts and prayers are with you and your brave comrades.   

There are several possible reasons why your post-surgical wound is not healing, that you should have your doctor explore for you:  diabetes, reduced local circulation, poor wound care, heavy aspirin usage, compromised immune system and poor nutrition.  Any of these can contribute to this situation and perhaps others if someone takes a close look at you. 

The complication rate for Peyronie's disease surgery is higher than for many other types of surgery.   This is why I always strongly encourage men to do whatever they can to avoid this radical option until all conservative options have been explored.   

The sooner you begin your healing and wound closing the better.   If no one seems to be listening to your problem, I  suggest you contact your home town congressman to work to get you some help and attention.     TRH

Do you perform Peyronie’s surgery?

Hello doctor!

I read your book and I am happy that the vitamins worked for you!

My husband has Peyronie's disease the last 2 years. He saw 2 doctors and they just recommended surgery,

Do you perform Peyronie's surgery? If you don't, could you please let me know which one is the best surgeon?

Thanks so much



Yes, the PDI treatment concept worked for me and for many men who followed the concepts you see on this website.  I assume the great majority of men who have been helped to regain their freedom from Peyronie's disease were also told they needed surgery, just like your husband.  They resolved their PD problem by using Alternative Medicine treatment and did not need Peyronie's surgery.

When you go to a surgeon you will usually find that they tend to think of and recommend surgery.  Since I am not a surgeon and I philosophically prefer to first use natural conservative means before resorting to drugs or surgery, I suggest before considering any type of risky surgery that your husband should first attempt a few months using Alternative Medicine to correct his problem.   TRH   

Too late for help after Peyronie's surgery?

Dear Dr. Herazy,

My husband developed Peyronie's disease almost seven years ago after an injury while making love. His urologist first did a series of injections with verapamil. When that did not help he talked us into surgery by saying that it was the only way to straighten his 90 degree curvature. The surgery went very badly and now his curvature is worse and he has no feeling in his penis. He has become withdrawn and is very angry with himself and takes it out on me. i am so glad to have finally found your non-drug website and only wish we had found it sooner before the surgery. Do you think it is too late for my husband to get help from your alternative medicine treatment ideas?

Thank you.

Marge V.

Greetings Marge,

Sorry to hear of your husband's bad reaction to Peyronie's surgery.

There is no way I can answer your question directly, since there are far too many unknowns and variables. However, I can tell you that many men who have had bad Peyron

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ie's surgery results have seen a reduction of scar tissue after following a PDI treatment plan; some of these changes were very small and some were remarkably great. The work is always long and difficult because of the complications of additional scar tissue, but always worthwhile for any reduction of numbness and reduction of other problems such as curvature and pain that can occur. There is no way to tell ahead of time if your husband is capable of any change in his scar tissue, but if some can be made it could result in some degree of improvement of his current sad situation.

I suggest that you get both of my books and that you and your husband read them, especially “Peyronie's Disease & Sex.”

Go slowly with your husband and do not push him too much to follow any of these ideas, He is angry and scared about injuring himself more with any kind of additional treatment, and most of all he is embarrassed. Give him some room to warm up to the ideas of safe Alternative Medicine care. If he has any questions or hesitation please encourage him to email me directly. I will try to help him as much as I can. TRH


Peyronie’s Surgery

Finding a surgeon for your Peyronie’s surgery

There are those times when Peyronie’s disease surgery must be done. If you sincerely feel you have faithfully and honestly used all possible drug and non-drug options to avoid Peyronie’s surgery, and they have all been unsuccessful, and now you cannot continue with the pain and limited sexual ability that started with Peyronie’s disease, then you should carefully consider penis surgery.

From my experience in talking and emailing to many hundreds of men each year since 2002, I have only occasionally found men who are happy with the results of their Peyronie’s surgery. Am I saying that most Peyronie’s operations are failures? Not necessarily. All I can say is that of those men to whom I speak, the great majority are not pleased with their results to restore the penile curvature of Peyronie’s disease.

When I get to speak to someone who has good things to say about his Peyronie’s surgeon and the results of the operation, I always make it a point to ask a lot of questions about the surgeon’s name and location, his credentials, and the interpersonal issues and insights that develop while working with the surgeon.

Here is some advice in helping you select a Peyronie’s surgeon, or any surgeon, because it all comes down to the same traits and characteristics that make someone a good surgeon:

1. Do your research. While many physicians can claim to do surgery, or be someone who specializes in being a Peyronie’s doctor, you should only consider using a doctor who is a board certified surgeon in the area of specialty you need the care. You definitely do not want to have surgery performed by someone who comes to you randomly, without experience in working with Peyronie’s disease. The need to have experience and site-specific and disease-specific training cannot be emphasized too much. After all, it is your penis that is going to be cut on, and you want the best you can find holding the knife above you.

2. There is no need to rush into anything. Plan on spending at least six months doing your research. No need to rush into anything. The more time you spend the fewer mistakes you will likely make when you must decide. If it takes you a full year to collect information, all the better you will feel and all the better your results will occur.

3. Your doctor should be a Board Certified Urologist with a sub-specialty in genitourinary surgery, or a Board Certified Urologist with a sub-specialty in surgery that does exclusively genitourinary surgeries. For example, a surgeon might be a board certified urologist with a subspecialty in genitourinary surgery, but might also further specialize in operating only on male patients. Whether this surgeon might do male urogenital surgery on the elderly (geriatrics) or male children (pediatrics) only makes his experience more valuable.

4. Generally, using a plastic surgeon is not a good idea. While a plastic surgeon might be skillful in facial work, and have a good technique and a good hand for

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doing the fine details around the face, that does not mean these skills will carry over into removal of the PD scar material. If your primary Peyronie’s or genitourinary surgeon wants to use a plastic surgeon for one particular phase of the PD surgery, and that primary surgeon will stay at the operating table the entire time, that is fine. It all comes down to training and experience in the area of the penis, especially removal of the PD scar.

5. Your surgeon should have vast experience with Peyronie’s disease, having performed at least 25 prior surgeries of the specific type you need – usually the Nesbit plication, or others. The larger this number, compared to others, the more likely you should consider this doctor. Someone who has done 10 Nesbit surgeries does not know as much as someone who has done over 100. You want someone who has seen it all, done it all, knows what to do in all circumstances, and will not be surprised while you are under the knife – or later.

6. While this might seem to be a small and superficial consideration, I suggest you employ a surgeon with a meticulous office and very neat appearance, and a clean non-cluttered desk –you want someone who is really meticulous and highly motivated for fine detail work to be doing your Peyronie’s surgery for you. You want a neat-freak, someone who is “anal” doing this kind of work, cutting into your one and only manhood.

7. Good eye contact and warm personality – two reasons: not only will this be what he/she will be like when you are under his/her knife, but how you will be treated in discussions and after surgery care – not ignored or forgotten. You want someone who will be open and friendly and a good communicator before surgery, because these are great doctor skills after the surgery when you need it the most.

8. If you have a friend that is a nurse in area, ask her to ask around for you about the surgeon you are thinking about using. I worked for orthopedic surgeon who was the rave of the hospital and all the nurses who worked in that hospital brought their kids for broken bones and for their husband’s bad backs. Nurses are more likely to know, and talk about, the bad stuff and the good stuff concerning doctors in your area. It is a high recommendation when you know that nurses like work of the doctor you want to use.

9. Go to the internet to Google your surgeon professional work history with your state board of medical review to see if any disciplinary actions have been taken against this doctor. This is important because it will give you a strong indictor about the skill and ability he/she possesses. If your doctor has been sued three times for malpractice, and there are two others who have never been sued, the decision becomes much easier to make.

However, it is always best to avoid any surgery, especially Peyronie’s surgery, if at all possible. That is what the Peyronie’s Disease Institute is all about. Helping you to naturally treat Peyronie’s disease by helping your body to heal and repair so you can eliminate the scar and avoid getting cut on in the first place. Look at a few of the testimonials about our Alternative Medicine treatment for Peyronies.


Peyronie’s Disease Treatment and Insanity

Einstein and Peyronie's treatment

We have all heard Albert Einstein’s definition of insanity:  “Doing the same thing over and over again and expecting different results.”   Well, I think this sometimes applies to the way some men conduct their Peyronie’s disease treatment plans.

I am reminded of Einstein’s famous quote each time I communicate with someone who wants to know why his Peyronies treatment is not getting results even though he is faithfully following it daily, for weeks and months at a time.

Please review the following email exchange between one of your PD Warrior brothers and me. You will see the writer had no idea about the size, shape, density or surface quality of his scars yet he was trying to treat himself with Alternative Medicine.   Because he had no idea of where he was, where he had been, or where he wanted to go, he was easily discouraged and was not successful with his Peyronies treatment.

I will use the familiar method to keep the email question sent to me in black and my responses to him in red within his email so the information becomes more of a conversation between us.

Hello Dr. Herazy,

It has been a while since we talked on the phone when I asked for help getting started treating my Peyronies correctly.   My name is BXXXXX, maybe you remember me.   I am the student at the University of XXXXXXXXX who was in the bike accident and was hospitalized with a fractured pelvis.  Three months later I was diagnosed with PD.  I asked my doctor if he thought there was a connection between the accident and the PD and he said no.  From my experience Peyronie’s disease is a fairly common outcome if you sustained direct injury to the penis shaft when your pelvis was fractured.  Many men develop Peyronies disease  after injuries that occur during sexual activity that are less serious than what you went through, so I am not sure why he would have said this.  Also, your Peyronies could have started either from the injury to the shaft that took place during the bicycle accident, or from the catheterizations that took place during surgery or afterward.  Because of my limited funds I settled on using a PDI medium plan plus PABA.

I thought because I am young and the injury was recent I would get over the PD fast.  That is usually true for most men, but even some younger men take longer to recover because of overall poor health, stressful lifestyle, poor diet, genetic predisposition, or other reasons like drug abuse. But after two months I got discouraged and quit care for a few months.  I was following the medium plan for two months and my curve stayed the same as far as I could tell, so I stopped doing everything.   You made a few mistakes early in your care:  1. You did not contact me for ideas and advice about your treatment when you ran into a problem.  You were in a totally new area of your life and you were trying to do it all by yourself when you have help available.  Big mistake.  2.  I looked up your records and you did not get “Peyronie’s Disease Handbook” that would tell you how to go about treating your problem.  For this reason you used the phrase “my curve stayed the same as far as I could tell.”  This means that you were not using the condition of your curve to tell you if your treatment was successful or not, and this is a big mistake made by people and MDs who have no idea how to approach PD treatment. The condition of the penile curvature is determined by the internal PD scars that affect the tunica albuginea.  If you want the curve to go away you must get rid of the scars.  All of your evaluation and attention should be directed to understanding and documenting the condition of the size, shape, density and surface qualities of each of your scars.  Once your scars are reduced or eliminated you will change in the distortion pattern or bend that you have.  3.  You were guessing about your care because you were guessing about your condition at the time you were treating yourself.

Before you go on a diet to lose weight you must at least measure your waist and weigh yourself so you know your situation at the start of your diet.  If you do not measure your waist and weigh yourself, how will you know if your diet is working?  If you are guessing about your weight, you will either quit a plan that is working because you do not know that it is working, or you will stay on a diet too long that is not working.   If you know your exact waist measurement and weight you will be able to tell immediately when the diet starts to work – or not.

You will then be able to intelligently either stay on a diet that is helping you or change the diet if it is not helping you – all based on your knowledge of the situation.  You must do the same with your PD treatment. Then I reinjured myself during sex   Always be very careful during sexual activity and maintain control of the situation because it is you who will suffer most.  All woman-on-top positions are dangerous because you do not have good control over her and she can bend the penis if she comes up too far and you slip out.   When she comes back down again you will get your shaft bent. and my curve got even worse.  I thought I had no choice but to start PDI treatment again since the idea of Peyronie’s surgery is out of the question for many reasons.     Good thinking.  Surgery is the last thing you want to do if you have PD.  I have many posts on the PDI blog about Peyronie’s disease surgery that goes bad.

I am sorry to say that after ten weeks of faithfully   No, you did not faithfully follow the PDI concepts of treatment. You think you did, but you did not.  You tried to make up your own rules and they did not work for you.  You cut a few steps out of the process and you wasted time and money guessing about your treatment.   As a necessary step at the beginning you must determine the exact size, shape, density and surface quality of each of the scars you can find. Once you know that, then you can begin care.  By applying or using whatever level of treatment you think would help you, you should frequently monitor your scar to see how they are responding to whatever kind of treatment you have chosen to use.  To learn more about this process, please refer to chapter four of the “Peyronie’s Disease Handbook” and many blog pages that refer to this process. treating my problem I believe I have not made any changes with my bend or the pain I have,  Again, it is not the bend or pain that is important – but it is the condition of the scar that is causing the bend and the pain that is important.  All focus and attention should be on the scar that is causing all of the things you notice. although sometimes it is difficult to say.   That is exactly the point I am making.  It is difficult for you to say because you were guessing for four and a half months and you got confused and frustrated along the way. The two nodules on the top of the shaft are smaller some days, but it is difficult to know for sure.  It is good that you can tell that they are changing, that means that your tissue will respond to your treatment if it is already responding to things that you are doing in your daily life.

For the last ten weeks this is what I take:

Nattokinase – 2/dose between meals
Fibrozym – 2/dose between meals
Vitamin E 400/400 – 3/day
Maxi-Gamma E – 1/day
Vitamin C – 1/day
MSM – 3/day
Scar-X – 2/day
PMD DMSO with Unique-E and Super CP serum – 1/day
PABA – 6/day
Massage and Exercise program – 4 or 5/week

There is nothing wrong with the plan you are following.  The problem is that you are not sure your body is not responding to it because you have no baseline for comparison to judge progress.  So, the job in front of you is to know exactly the size, shape, density and surface qualities of your scars, and to then see what you have to do to your plan to make your scars change from that baseline.  It is that simple – and that difficult.  More about that will be covered below.

If you are looking for my suggestions about what you might want to consider changing with your PD program:

1.    Consider increasing your enzyme dosage; maybe even adding Neprinol into your plan.

2.    You really should reduce the Factor 400/400 vitamin E for now

3.    Consider increasing the vitamin C intake

4.    Adding moist heat applications prior to your PMD DMSO treatment is always a good idea

5.    Consider getting the PDI Manual Stretching video – it is an inexpensive way to add a very different level of treatment to your plan

6.    Consider using the Genesen Acutouch pens – they are effective and often increase treatment results within a short time for many men

You do not want to follow all of these changes or additions at once; doing one at a time while monitoring your PD scar for positive changes is how it is done.

Putting these two different times I followed your system of treatment I worked for a total of about 4½ months and do not have anything to show for it.  How do you know you have nothing to show for it?  You could have a nice reduction of the size, shape, density or surface quality of your scars but you would never know it because you have not taken the time to learn how to document these important measurements.

Your system makes sense and I like the logic of it, but I do not know how to make it work for me.   It is really not that complicated or difficult to make the system work once you get a few things explained to you. What changes should I make to my treatment plan to create more definite changes in my problem?    All you have to do is to make some change – any change – to your PD treatment plan and check back in 7-10 days to see if there is any change in the size, shape, density or surface quality of your scars.  If you see a change, then keep doing what you are doing.  If you see no change, then change something else.  It is as simple – and complicated – as that.

Since neither you nor I am smart enough to know ahead of time what your body needs to recover from PD, it is your job to try different things to learn first-hand how your scar will respond to whatever changes you decide to make.

Following the same ineffective plan for four and a half months is insane.  If you are walking north and you really want to be going south, you must stop what you are doing and turn yourself around.  Successful PD treatment is not a matter of popping a handful of pills into your mouth, hoping that something will happen.  You must learn what it takes to make your PD scar respond favorably and continue to do that.  You must be in control of your plan and understand your Peyronie’s plaque or scar behavior better than your MD – and that should be pretty easy.  I can help you if you let me. TRH

Thanks for your time and help.


I hope reviewing this email exchange was helpful.

It really is not a complicated process to figure these things out.  I believe the problem is that most people are accustomed to going to the doctor and following orders; they are not accustomed to being in charge of their treatment.   After men realize that their MD has no viable PD treatment to offer them, then they finally take on the challenge of taking control of their destiny and they start to see results.

Why is My Penis Curved?

Might not need to straighten your penile curvature

To answer this common question it is first necessary to know if this penile curvature is something you have had all your life, or if it is something that just appeared after being fairly straight all of your life; if it is an old or a new feature of your anatomy.  Usually there is little   reason to straighten your penis if that is the way you were born.  If a small curvature has not caused any problem in the past, it is not likely to be Peyronie’s disease and you should not treat it.

If you have had a curved penis all your life, then it is most likely due to a normal and natural variation of tissue in that part of your body.  The human body is often made with slight imperfections and variations, and this might be one of yours.   Just as someone might be born with one ear that is shaped differently than the other, or one leg slightly longer than the other, you might have a penis that is curved just because it is not made perfectly.

Inside the penis are three chambers of special tissue that have the ability to expand and become rigid when filled with blood.  If any of these three chambers is larger or smaller than the other two, or has some anatomical variation that prevents it from completely filling with blood, the penis will be distorted in some manner when erect.

This is rather common among men and is not in any way related to Peyronie’s disease and does not warrant treatment or concern.  So long as sexual function is not limited in any way the curvature is considered a normal variation that makes you a unique person.

On the other hand, if you have had a fairly straight penis all your life, and at some time later you noticed an unusual bend, curve, twist, or dent-like physical deviation during erection that was not there previously, then that recent change in your anatomy suggests the possibility of Peyronie’s disease.  This is especially true if the unusual bend, curve, twist, or dent-like physical deviation is accompanied by Peyronie’s pain and reduced hardness of your erection.  Confirming the problem of Peyronie’s disease even more would be your recollection of a recent accident or injury, or use of a drug that is known to have Peyronies as a side effect.

Straighten your penis sometimes unnecessary

Even though the distortion of your previously perfect penis can be very disturbing to a man, it is not the real problem of Peyronie’s disease.  While the curved penis gets your attention, it is the internal Peyronie’s plaque located in the tunica albuginea layer of the penis that is the real issue.  The way to straighten your penis is by eliminating the internal Peyronie’s plaque that is the cause of the curvature.  Having surgery to straighten your penis carries a high risk of failure and tragedy, and only creates the opportunity for more internal Peyronie’s scar tissue to develop as a result of the penis tissue being cut during surgery.  This is the reason so many men find that after having Peyronie’s surgery their curvature becomes worse; it is because of additional internal scar tissue that results from the surgical incisions.

This is why Peyronie’s Disease Institute advocates that Alternative Medicine first be used to eliminate the internal Peyronies plaque before penis surgery to treat Peyronie’s plaque is attempted.  For additional information about this process, please review safe and effective Peyronie’s treatment options.

My Penis is Curved

How to straighten a penis

What a shock when you realize, “My penis is curved.  How did that happen, and what is going on down there?"  And the most important question to Google, "How to straighten my penis?”

While there are several other causes of a curved penis to suddenly happen, the most common one, and the most difficult one to deal with is Peyronie’s disease.   Peyronie’s disease is a condition that occurs in about 6-10% of men over the age of 40 (although it can affect teenagers and men in their early 20s) in which a dense and thick mass of fibrous tissue, called a Peyronie’s plaque or scar, is found within the tunica albuginea layer on the inside of the penis.  The presence of a nodule or band of fibrous tissue under the skin of the penis will prevent the normal expansion of the chambers of the penis during an erection.  This causes the erection to be distorted resulting in a curve, bend, hinge, hourglass or bottleneck distortion.

To assist you to determine if you have PD, please visit Peyronie’s symptoms and check out some of the Peyronie’s pictures of curved penis.  It is necessary for anyone who thinks he might have Peyronie’s disease to go to his doctor to have a complete examination so an accurate diagnosis can be made. Do not make the mistake to think you can self-diagnose this problem.

It is important to remember that the problem of Peyronie’s disease is not that you have a curved penis.  The problem is actually the Peyronie’s scar that is present within the deep tissue of the tunica albuginea causing incomplete filling of the penile chambers, resulting in the curved penis that got your attention.  For this reason any treatment that is directed solely at trying to make the penis straight without removing or eliminating the PD plaque will not be successful.

While the Peyronie’s Disease Institute does not take a position against Peyronie’s surgery, we feel too many men resort to penis surgery far too soon before trying conservative treatment.   If a man knows he has Peyronie’s disease he should also know the problem is that his body produced excessive scar tissue or plaque in response to a small injury or inflammation of the deep penile tissue layer.  What does he assume will happen to that same tissue when a surgeon cuts that same tissue and also tugs on it, stretches it, and put stitches into it during the course of Peyronie’s surgery?  There is a very good chance that more excessive scar tissue will result.  This is why many urologists and surgeons take a position against all Peyronie’s surgery.

Since 2002 the Peyronie’s Disease Institute has educated men about the use of Alternative Medicine to assist the body to heal the Peyronie’s plaque.  Fifty percent of men naturally recover from Peyronie’s disease without any help or outside intervention; the problem just goes away on its own like any other health problem should.  Our approach is to assist each man to enable his body to heal naturally like those in that lucky 50% group.

So if you are one of us who has said in shock, “My penis is curved,” you now know what to do about it.  Learn more about Peyronie’s disease treatment with Alternative Medicine. Another good source of information is the Peyronie’s Disease Handbook.

Penis Surgery to Treat Peyronie’s Plaque

Peyronie’s surgery from correction to amputation

It is not uncommon for a man to learn that he has Peyronie’s disease and to have his doctor immediately recommend penis surgery to attempt to remove the Peyronie’s plaque or straightened his curved penis.

When faced with even a mild degree of penis curvature someone might think that penile surgery is the only treatment option.   It seems to me from my perspective in talking to a dozen men each week about their history with Peyronie’s disease that many of them are given strong pressure to have surgery far too early in the process.

It seems they are not being told that many who undergo penis surgery end up with numerous side effects like pain, numbness or loss of all sensation of the penis, additional loss of length and girth greater than their PD gave to them, greater curvature than their PD gave to them, and total impotence or inability to develop an erection.   I frequently communicate with men who have more pain, distortion and loss of sexual ability after penile surgery than before it.

In a desperate effort to satisfy their sexual partner, and under false expectation of how easy and safe the surgery will be, men sometimes make matters worse with Peyronie’s disease surgery.  Worse yet, it often happens that a man will have a second Peyronie’s surgery to correct the errors and problems created by the first Peyronie’s surgery – only to have even greater problems after the second surgical attempt.

For information about the Leriche surgery technique for Peyronie’s disease.

Peyronie’s surgery to the extreme

The worse case of failed Peyronie’s disease surgery I ever spoke to occurred sometime in 2006.  I received a phone call from a man who asked if I guaranteed the treatment we present in the PDI website.  I told him that no medical procedure or therapy is ever guaranteed – even aspirin.  I said there is no such thing as a medical guarantee provided anywhere in the world because of the complexity of human physiology.  I asked him why he was interested in a guarantee.  He said he was desperate for something to help his terribly curved penis that had gotten progressively worse after each of three separate penis surgeries.  He said he was scheduled to have his fourth penis surgery in two weeks, but he would cancel that surgery if I could give him a guarantee that the PDI process would correct his problem.  I told him I was sorry that I could not make such a guarantee, and said I doubted his surgeon was going to guarantee the next operation.  He corrected me.  He told me that the next surgery was going to “fix’ his problem because the next operation was for the surgeon to amputate – completely cut off – his penis!

He went on to explain that his penis was now just a tiny two inch mass of twisted scar tissue; he had no feeling in his penis; for the last two years when he urinated he would get his abdomen wet; his wife was long gone and he felt that suicide was his only other option, so having his penis cut off made sense to him.

I was shocked.   Just as I was starting to explain that I could not guarantee his results at this late stage in his problem I heard a click, and the phone was silent.  The entire conversation took less than five minutes, but it was the most powerful discussion I have ever had with any of my Peyronie’s men.  I will never forget the empty and desperate tone of his voice.

Penis surgery for a man who already has Peyronie’s disease presents a greater risk than for someone who does not have a Peyronies problem:

  1. High degree contracture due to fibrous tissue buildup, resulting in greater curvature than prior to surgery.
  2. Greater chance for numbness or total loss of sensation, or Peyronie’s pain,
  3. Greater chance for impotence.

Start with conservative Peyronie’s treatment, then penis surgery if necessary

I am not saying that a bad outcome will happen to all men who have Peyronie’s surgery, but it can and does happen so the possibility should be clearly kept in mind before rushing into surgery.    Every day I hear from men who tell me their doctor on the first visit suggested penis surgery to “correct” their Peyronie’s disease.

It is my opinion that it is safer and wiser to take a more conservative route of care using the Alternative Medicine form of natural Peyronie’s treatment options that have been presented here since 2002, before considering surgery.

Penis Doctors or Peyronie’s Doctors? – Take Your Pick

Doctors who specialize in Peyronie’s disease

When you think about going to a “Peyronie’s specialist,” you should understand a few things that could make all the difference in the world to you.  You should also know that Alternative Medicine is your safest and most logical approach to Peyronie’s treatment – more about that at the end of this article.

Each month I am asked for the name of a few Peyronie’s doctors; someone who specializes in the treatment of Peyronie’s disease, in a particular part of the country or a specific city. My answer that I do not know of any such doctor always seems to be a surprise.   Often a follow up question is posed in which I am then asked for the names of penis doctors, and again I give the same answer.

For anyone interested in finding a Peyronie’s doctor, first consider that Peyronie’s disease is known as “the doctor’s nightmare.”   Notice, the name is not “a man’s nightmare,’ or “a curved penis nightmare,” or “a patient nightmare,” but “doctor’s nightmare.”   This suggests how much doctors in general do not like dealing with Peyronie’s disease.  The average doctor does not like to deal with the diagnosis and treatment of Peyronie’s disease, as well as the many valid complaints and exaggerated demands of both the men and women who must live with this problem.  Frankly, we men with Peyronie’s disease are often a royal pain in the butt for an MD to deal with.

Peyronie’s specialists

Most often it is the urologists who come closest to the idea of being penis doctors or Peyronie’s doctors.  But even they often want to avoid the many frustrations and long explanations that are a part of working with men who have Peyronie’s disease.  I guess that 99.4% of men who are given a diagnosis of Peyronie’s disease have not once ever heard of it before it is dumped on them.  That this condition exists is a total shock to the man who first learns he has the problem. And just like the denial phase of someone who learns of the death of someone, there is a denial phase when first being told that the reason for the penile curvature, pain, or strange lump is an interesting thing called Peyronie’s disease that has no known cause and no known medical cure – other than Peyronie’s surgery.   This news creates a lot of denial issues in the patient that the doctor must take the time to explain away.

It is said that no one is happy while dealing with Peyronie’s disease.  Another reason the doctor is not happy is because he or she has no standardized or accepted form of medical treatment to rely upon.  Generally, there are four three basic approaches for managing this problem medically:

  1. Offer no treatment, but simply monitor the progression of the problem. Suggest the patient come back in six months to determine if the problem has deteriorated enough to warrant the risks of surgery.
  2. Offer the patient to either “try verapamil or cholchicine or POTABA for a while, although I have not had much luck with any of them, or you can always use some vitamin E if you would like.”   This kind of low key and unenthusiastic recommendation is based on the fact that none of these approaches work, and the doctor knows it.  The MD is put in a tough position because he or she cannot help PD, and this is a known fact from the start.  Talk about a negative situation that only gets worse as the penis shrinks or sex becomes difficult as a curved penis develops.
  3. Suggest surgery right away.
  4. Go home, ignore it, and try to learn to live with it.

These four options all seem wrong to the thinking patient. Yet, the doctor feels obligated to offer some kind of treatment when none actually exists, and he knows ahead of time that the patient will be upset when nothing helps.  Long explanations, distrust, and complaints will follow over a few office visits until the patient figures out the doctor really has no Peyronie’s disease treatment. The doctor knows ahead of time he will look incompetent and non-caring no matter what he does.  Hence the term, “doctor’s nightmare.’

For all these reasons only a few medical doctors have focused on Peyronie’s disease treatment.  Some of those who work in this area of urology are:

Thomas Lue, MD – Los Angeles, CA
Culley Carson, MD – Chapel Hill, NC
Lawrence Levine, MD – Chicago, IL
Martin K. Gelbard, MD, Los Angeles, CA
Sudhakar Krishnamurti, MD – Hyderabad, India

These doctors are essentially using the same drugs as any general practitioner or urologist, with perhaps maybe the surgery they perform being different in some cases.   You need to understand that while these doctors can be called Peyronie’s specialists because they hold themselves out to being more interested in or spending more time in the area of Peyronie’s disease treatment and diagnosis, there is not that much different they can offer than the doctor down the street in your town.  The great difference with these doctors is the number of people they see who have PD, so they will have more experience in this area.

For this reason when some calls to ask about a Peyronie’s doctor, I suggest they just contact a local urologist they have confidence in and stick with him.

Since there is no accepted standard medical treatment for Peyronie’s disease, and so many doctors suggest not doing anything for the first 6-18 months, I strongly suggest that a person consider building up his own ability to heal and repair the Peyronie’s plaque or scar.  Information can be found at natural Peyronie’s disease treatment.

Peyronie’s Disease Treatment and Russian Roulette

Peyronie's Disease Treatment is Not a Time to Gamble

Standard medical care of Peyronie's disease often is to do nothing for the first year or so. The medical thinking is this: “In half of cases the curved penis  goes away on its own. If it doesn’t go away, we can always do Peyronie's disease surgery.” For the half of the Peyronie's disease cases that do not go away, the scar and problem either stay the same or get a lot worse. If the PD results in an "acceptable" level of pain, an "acceptable" degree of penile curvature, or an "acceptable" level of sexual impairment, the outcome of the Peyronie's disease is said to be "satisfactory" and the wait-and-see strategy is said to have been successful for that individual.

Do you know who judges what is an "acceptable" outcome for YOUR penis? Well, it is not you. That determination is made for you, ahead of time, by someone else. Your doctor is only hoping that you will eventually develop a certain "acceptable" level of a penile problem. If you get only as bad as he or she hoped, then your doctor's opinion will be that everything worked out pretty well for you − even if you don't think so. Can you believe that? Did you know this is how the wait-and-see strategy is justified?

Peyronie's disease treatment can be a gamble if you do nothing for a year or two while your curved penis can worsen.  Peyronie's surgery is also a gamble.

You should find out early in your care if it is your doctor's opinion that a 5-10-20° bend in your penis is a "satisfactory" outcome, and is not worth the trouble of perhaps taking some enzymes and other supplements. You should find out if it is your doctor's opinion that not being able to have intercourse normally − as you have done previously − for the rest of your life is a "satisfactory" outcome, and is not worth the trouble of perhaps doing some exercises and using DMSO with copper and vitamin E. You should find out early if it is your doctor's opinion that a dull ache and throb (maybe even a sharp pain) in your private parts every time you happen to get an erection is a "satisfactory" outcome, and is not worth the effort of perhaps following a nutritional program of MSM, vitamins E and C, Japanese herbs and maybe some carnitine. Carefully read those medical websites that discuss Peyronie's disease treatment options. You will find how common is the opinion that so long as the penis is not terribly distorted and extremely painful, then everything is "acceptable".

If you have PD you should know that the medical profession has a very low standard by which to judge what is an "acceptable" level of pain and distortion for YOUR penis, and what is an "acceptable" level of sexual impairment in YOUR bedroom. Using these standards by which to judge the health and well-being of YOUR penis, the medical profession has determined that this wait-and-see treatment approach makes sense to them. But, does it make sense to YOU? A man with PD should know his doctor is willing to take a chance like this with YOUR penis, when there are many reasonable conservative treatment options — even if they are currently unproven. Peyronie's Disease Institute thinks this wait-and-see approach is a poor gamble and a bad strategy.

Peyronie's disease treatment with bad odds

The watch-wait-and-do-nothing strategy for Peyronie's disease treatment must sound good only to the surgeon. To PDI it sounds like playing Russian Roulette with very bad odds. In Russian Roulette there is one bullet in a six-cylinder gun; that’s a one out of six chance of losing. In the wait-and-see approach, half of the cases clear up spontaneously; that’s a one out of two chance of losing. Or to put it another way, that’s like playing Russian Roulette with three bullets in a six-cylinder gun. No thanks.

Of course, if the PD worsens so that pain and/or distortion are intolerable, or intercourse is impossible, or impotency results, then surgery can always to taken as a possible solution.

Most would agree that it is better to do all that you can for your Peyronie's disease, as soon as you can, using as many of the safe and scientifically grounded options that are known to have some limited success in helping the PD scar heal. If after following an aggressive alternative medical program, such as is presented on this website, there is less than complete repair and healing — as can happen — then surgery can still be used. Yes, you are taking a chance that the currently unproven alternative therapies PDI advocates might not work for you, but the down-side is minimal for the most part. We leave it to the reader to decide which is the greater risk: ignoring the problem, or exploring an uncharted treatment area. For further discussion, click on Heads You Win, Tails You Don’t Lose.

Standard medical care of PD often is to do nothing for the first year or so. The medical thinking is this: “In half of cases the PD goes away on its own. If it doesn’t go away, we can always do surgery.” For the half of the PD cases that do not go away, the scar and problem either stay the same or get a lot worse. If the PD results in an "acceptable" level of pain, an "acceptable" degree of penile distortion, or an "acceptable" level of sexual impairment, the outcome of PD is said to be "satisfactory" and the wait-and-see strategy is said to have been successful for that individual.

Do you know who judges what is an "acceptable" outcome for YOUR penis? Well, it is not you. That determination is made for you, ahead of time, by someone else. Your doctor is only hoping that you will eventually develop a certain "acceptable" level of a penile problem. If you get only as bad as he or she hoped, then your doctor's opinion will be that everything worked out pretty well for you − even if you don't think so. Can you believe that? Did you know this is how the wait-and-see strategy is justified?

You should find out early in your care if it is your doctor's opinion that a 5-10-20° bend in your penis is a "satisfactory" outcome, and is not worth the trouble of perhaps taking some enzymes and other supplements. You should find out if it is your doctor's opinion that not being able to have intercourse normally − as you have done previously − for the rest of your life is a "satisfactory" outcome, and is not worth the trouble of perhaps doing some exercises and using DMSO with copper and vitamin E. You should find out early if it is your doctor's opinion that a dull ache and throb (maybe even a sharp pain) in your private parts every time you happen to get an erection is a "satisfactory" outcome, and is not worth the effort of perhaps following a nutritional program of MSM, vitamins E and C, Japanese herbs and maybe some carnitine. Carefully read those medical websites that discuss PD treatment options. You will find how common is the opinion that so long as the penis is not terribly distorted and extremely painful, then everything is "acceptable".

If you have PD you should know that the medical profession has a very low standard by which to judge what is an "acceptable" level of pain and distortion for YOUR penis, and what is an "acceptable" level of sexual impairment in YOUR bedroom. Using these standards by which to judge the health and well-being of YOUR penis, the medical profession has determined that this wait-and-see treatment approach makes sense to them. But, does it make sense to YOU? A man with PD should know his doctor is willing to take a chance like this with YOUR penis, when there are many reasonable conservative treatment options — even if they are currently unproven. PDI thinks this wait-and-see approach is a poor gamble and a bad strategy.

Peyronie's disease treatment with bad odds

The watch-wait-and-do-nothing strategy for Peyronie's disease treatment must sound good only to the surgeon. To PDI it sounds like playing Russian Roulette with very bad odds. In Russian Roulette there is one bullet in a six-cylinder gun; that’s a one out of six chance of losing. In the wait-and-see approach, half of the cases clear up spontaneously; that’s a one out of two chance of losing. Or to put it another way, that’s like playing Russian Roulette with three bullets in a six-cylinder gun. No thanks.

Of course, if the PD worsens so that pain and/or distortion are intolerable, or intercourse is impossible, or impotency results, then surgery can always to taken as a possible solution, although not a good one as you can read in Peyronie's surgery.

Most would agree that it is better to do all that you can for your Peyronie's disease, as soon as you can, using as many of the safe and scientifically grounded options that are known to have some limited success in helping the PD scar heal. If after following an aggressive alternative medical program, such as is presented on this website, there is less than complete repair and healing — as can happen — then surgery can still be used. Yes, you are taking a chance that the currently unproven alternative therapies PDI advocates might not work for you, but the down-side is minimal for the most part. We leave it to the reader to decide which is the greater risk: ignoring the problem, or exploring an uncharted treatment area.    

Peyronie’s Disease Surgery

Surgical Peyronie’s treatment has many limitations

The Peyronie’s Disease Institute is not against Peyronie’s disease surgery.

The Peyronie’s Disease Institute is against the abuse of surgical treatment of Peyronie’s disease. Considerable surgical risk exists for any man with PD who has an operation to attempt correction of penile distortion.  Adverse outcomes and worsening of the original problem are associated with even a small incision (or injection) made to a penis that already has demonstrated the tendency to create excess Peyronie’s scar formation.

The overuse and abuse of Peyronie’s surgery should be suspected when the treating doctor does not follow reasonable and conservative guidelines to consider a patient a surgical candidate.   A good surgeon will know that a man with Peyronie’s disease should fulfill these basic points before suggesting surgery:

  1. Severity, the most important indicator. The deformity must be severe enough to seriously interfere or stop sexual intercourse.
  2. Adequate time for healing and spontaneous recovery must be given. Usually thought to be from 12-18 months from the time of onset of PD.
  3. Non-responsive to a fair trial of medical therapy. In practice, many doctors attempt only one form of medical treatment.  When that fails the patient is told surgery is the only other option.  It appears that doctors know the poor results achieved by medication to make a difference with Peyronie’s disease that they are quick to want to skip this step and proceed to the operating room.   When vitamin E is offered as a therapy option, it is done so reluctantly and with little hope for success.  Further, no instruction is offered for the correct use of vitamin E, or information about the eight different members of the vitamin E family.  Since no real help is offered to assure that the patient will use vitamin E correctly, it is no wonder that so many men fail.   There is a large body of information available that can assure a man is more successful with vitamin E therapy for his Peyronie’s disease.  Using the correct type of vitamin E, and using it correctly in conjunction with other forms of therapy that work synergistically with it, would only increase the chance of success.
  4. Stable and unchanging scar.   This can mean changing for the better or worse. Since so few doctors, and the men with PD, even locate the PD scar, it is doubtful that this criteria is seriously considered.

For information about the Leriche surgery technique for Peyronie's disease.

Risks of Peyronie’s surgery

Surgery is not a Peyronie’s cure. Because of the unique anatomy and physiology of the penis, the risks of surgery to this area are a little different than other tissues.

  1. Additional scar formation and possible worsening of PD.  Because any man attempting a surgical correction of PD who already has massive scarring, must expect more scarring to develop as a result of that surgery. It is a known fact – seldom discussed with a PD patient before surgery – that surgery for PD will result in more PD, sooner or later.
  2. Loss of penis size. Extensive scar tissue that is severe and persistent enough to cause a deformity serious enough to justify Peyronies surgery, represents a large mass of internal scar tissue. Surgery will remove a large and irreplaceable loss of connective tissue and loss of elasticity of the tissue that is not removed. If it is not bad enough that surgical correction and return of sexual function cannot be guaranteed because of the possibility of complications, every surgical candidate must understand that there will always be a loss of length and diameter of the penis.   Many men tell me that this secondary consequential loss of penis size is hardly discussed before surgery. Most men learn about the loss of penis size after it is too late.
  3. Incomplete straightening, no change, or worsening of the original PD deformity.  Loss of elasticity, additional scarring, and damage to the veins of the penis that can occur as a result of surgery, can also reduce or prevent correction of the original PD problem.
  4. Loss of sensation.  Due to anatomical location of important sensory nerves of the penis, PD surgery can slightly, or greatly, or totally, reduce skin sensation and  pleasure associated with sexual activity.  Temporary reduction of sensation is very common, and permanent sensory loss is less common.
  5. Loss of erection strength.  Surgery cannot help but alter both the inflow and/or outflow of blood to the penis.   By disturbing the pneumatic mechanism that creates an erection it is not uncommon for men to report either loss of erectile rigidity (hardness) or inability to maintain an erection (impotence) – and sometimes both.

If a surgeon has been attempting to get you to undergo PD correction surgery, and you were told the surgical outcomes are “good,” I strongly suggest you get a very clear and detailed explanation for what the surgeon means by “good.”  You might think “good” means that you will be perfect again, that your PD will be gone, that you will feel like a teenager.  The surgeon might be thinking that “good” means only a one or two inch loss of length, only a 50% chance of loss of penile rigidity, only a 50% loss of skin sensation, and restoring your curve from 90 degrees to only 30 or 40 degrees.   It is not an easy thing to determine how to straighten a curved penis.

If your surgeon tells you these things are not true, and that surgical results are “excellent” you might want to ask him what he means by excellent.  If he says you are worrying too much about such a safe and simple operation, ask the surgeon to put that in writing.  Ask the surgeon to guarantee that the surgery will not result in impotence, loss of skin sensation, that you will have a completely straight penis, and that your Peyronie's penis will never return.  You will not get that guarantee because no one can say what will happen to you as a result of PD surgery.

This blog post is not anti-surgery.  This blog post is all about getting a clear and honest idea about reasonable expectations after Peyronie's surgery.  It is my experience that most men are led to believe that their surgery results will be far better than the surgeon and reality can deliver.

Keep in mind that what is good for the surgeon might not be good for the man with Peyronie’s disease.

Treatment for Peyronie’s Disease with Alternative Medicine

Peyronie's Disease Treatment is simple with Alternative Medicine

All Peyronie's disease treatment is surrounded by controversy.  Every drug used for treatment for Peyronie's disease is unproven, to say nothing of the Alternative Medicine treatments proposed by PDI.

No one can say which is the best treatment for Peyronie's disease at this time, because only prescription medication is researched by the drug industry.  Peyronie’s surgery and medication are the only forms of treatment for Peyronie’s disease that the pharmaceutical companies seriously investigate; no other Peyronie’s treatments are even considered.  With no economic motivation Alternative Medicine ideas are ignored.

The Peyronie's Disease Institute offers a way for the average man to apply concepts and have personal control over a form of new treatment for Peyronie’s disease, using Alternative Medicine.  Peyronie’s natural treatment will never be considered by the pharmaceutical and hospital industries, and these business interests will never endorse home treatment for Peyronie’s disease for obvious economic reasons.

The PDI website recommends aggressive use of multiple Peyronie's natural treatment in the acute and chronic stages.  The purpose of this intense treatment for Peyronie’s disease is to increase and support the maximum healing potential of the body.  In this way each man is given the best possible opportunity to repair and regenerate the damaged penile tissue to the best of his ability.

"Proof" of Peyronie's Disease Treatment

In modern society drugs and medical technology with the greatest profit potential are researched most and are pushed hardest into the marketplace. Even though a particular treatment for Peyronie's disease might help people, unless there is strong economic motivation to find “proof” that it works.  Low profit therapies (vitamins, enzymes, homeopathy) are generally ignored by the medical establishment for reason of simple economics.   Simple remedies are labeled “unproven” not necessarily because they do not work, but simply because no one wants to spend the time, effort and money to scientifically prove their effectiveness. A good home treatment for Peyronie’s disease can stay untested (ignored actually), and therefore remain “unproven”.

New Treatment for Peyronie's Disease

Our theories for using aggressive and multiple Peyronie’s treatments are not yet proven.  That proof is probably a long way off, since PDI cannot underwrite Peyronie's disease research the way a large university or billion dollar company can.   PDI is not against surgery or drugs in cases that have been non-responsive to prolonged aggressive use of its new treatment for Peyronie’s disease.  Too many men rush into Peyronie’s surgery believing that is an easy and sure solution to a big problem.

Natural Peyronie's disease treatment theory is that the potential benefits of these subtle natural therapies are enhanced and multiplied by simply using several alternative therapies at the same time.  We strongly suggest that abundant benefits are available to any man who needs treatment for Peyronie’s disease by using what is known and what is available – even if it is not perfect – rather than passively behave like a Peyronie’s victim.

Peyronie’s Disease and Baby Boomers

Peyronie’s disease: male health problem no one knows about

If you are a member of the baby boomer generation and have never heard of Peyronie’s (pay-row-neez) disease, you are not alone. However, if you are a male baby boomer or married to one, you are in the prime age group to experience a problem you know nothing about. This is so because Peyronies disease primarily affects men between 50 to 65 years of age, although an age range of 18 to 80 years has been reported, with an average age at onset of 53. Few people know about the problem until they need Peyronie’s disease treatment. This is why it is important for all baby boomers to know about, and how to avoid, it because this health problem can easily ruin your life. Peyronie’s disease remains one of the most perplexing and difficult urological diseases to treat; it has been called “the doctor’s nightmare”. Most everything about this condition (cause, progression, symptoms, age distribution, response to treatment) is variable and unique to the man who has it. The great variability of Peyronie’s disease that makes it difficult to study and to understand, also makes it almost impossible to treat like other medical conditions. It is a complex problem that is much more common than most people realize. Estimates suggest that up to eight out of 100 men over the age of 40 have Peyronie’s disease – that is a lot of people worldwide – and still only a small percent of people have ever heard of it. People are reluctant to discuss this problem because it involves the male organ. For this reason it is difficult to develop accurate information and statistics, especially since men are so shy on one hand, yet also inclined to exaggerate.

Definition of Peyronie’s disease

Peyronie’s disease can best be understood as an exaggerated wound healing in response to an injury in which an excessive amount of Peyronie’s scar tissue develops within the man’s shaft. Peyronie’s disease (also known by over 12 different names, among which is “iduratio penis plastica”) is very special disorder of the connective tissue in which fibrous “scars” or “plaques” develop usually after direct injury. This Peyronie’s plaque occurs in a special tissue of the shaft known as the tunica albuginea, a fibrous chamber or envelope that surrounds the two penile cylindrical shaped masses of spongy tissue known as the corpora cavernosa. The corpora cavernosa enlarge during sexual excitement, and the tunica albuginea covering, are designed to expand and elongate. If there is fibrous scar or plaque material in the tunica albuginea, the expansion and elongation cannot develop properly resulting in bending, weakness, shortening and incomplete filling of the organ. Sometimes this distortion is mild (just a few degrees) and does not affect the ability to perform, while at other times the distortion can be extreme (more than 90 degrees) resulting in greatly adverse consequences. A certain degree of normal penile curvature can and does occur in some men. This is a benign and natural condition many men are born with, commonly referred to as congenital curvature; this is not Peyronie’s disease.

Peyronie’s disease signs and symptoms

Four common findings of Peyronie’s disease:

  1. Pain – caused by inflammation and stretching of internal tissues in response to injury and distortion; can be present constantly or only during erection
  2. Nodule or mass formation – variable size lumps or elongated cords can develop in one or multiple areas; sometimes these are difficult or impossible to locate depending on the density, depth and size of the scar formation
  3. Curvature or distortion – caused by presence of one or more nodules or masses of scar tissue in the tunica albuginea, preventing normal expansion during erection; can be minor to gross in appearance
  4. Reduced sexual ability – due to physical distortion that prevents penetration or due to reduced firmness that also prevents penetration (erectile dysfunction).

The onset of Peyronie's disease symptoms can be sudden or slow, but often appears within a month or two after direct injury. The pain of Peyronie’s disease is extremely variable; from hardly noticeable to the kind of pain that prevents sleep. Peyronie’s pain is worse in the beginning, usually gradually improving over time – improvement in a few weeks while others continue for years. For these reasons Peyronie’s pain is not a reliable way to judge the severity or calculate the time for eventual recovery. Even though Peyronie’s disease is a male health problem, women are also affected by it. They are indirectly and adversely affected by the erectile dysfunction, organ curvature and distortion that make intercourse often impossible, as well as loss of organ size that often occurs over time. Additionally, and perhaps even to a greater degree than men, woman bear the brunt of the mood swings, anger, brooding and ill-temper that accompany their partner’s Peyronies problem.

Treatment of Peyronie’s disease

There is no standard or accepted medical Peyronie’s cure since no drug is proven to eliminate the scar within the shaft. The only accepted and available medical treatment is Peyronie's disease surgery. However, given enough time after Peyronie’s surgery the condition will only re-appear in a worsened presentation. This surgical outcome is made bleaker by knowing that even the first Peyronie’s surgery can result in total loss of sensation (anesthesia), increased pain and increased curvature and greater scar formation than before surgery, and in some cases amputation. The Peyronie’s Disease Institute has specialized for the last eight years in the use of Alternative Medicine therapies and techniques that are found to be successful in perhaps 60-80% of cases. None of the therapies are known to result in adverse reactions or side effects. For more information about the Alternative Medicine approach, visit Peyronie’s disease treatment.

Prevention of Peyronie’s disease

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With so many variable aspects of this problem to consider, it is important to know that in addition to everything else, there is no universal agreement about the cause of Peyronies. Some say that injury alone cannot start the problem as we have described above, but that other genetic and metabolic factors must also be present. The Peyronie’s Disease Institute takes the position that this is true. However, if a man never sustains direct injury to the area he is far less likely to develop Peyronies. With age not working in the favor of any baby boomer couple, it is important to evaluate all situations in which direct injury can affect this area – especially sexual activity. This requires that special caution is exercised if a baby boomer gentleman finds he no longer has the usual firmness he previously possessed (erectile dysfunction). Attempting intercourse with a partially flaccid organ can result in sudden buckling or abrupt bending during insertion or the sex act itself. Another way to prevent injury is to modify the techniques used during sexual relations. The single most common injury that starts Peyronie’s disease occurs when the female partner is on top, and she loses hold of him while she thrusts down, jamming and painfully bending him against her upper thigh. To avoid this kind of injury it is important to not use any female-superior position, but to use other techniques in which physical contact is controlled, firm and not likely to disengage during activity. Even if baby boomers have never heard of this terrible condition that robs a couple of one of the greatest pleasures of life, it happens every day. Now that you know about Peyronie’s disease you can do a lot to protect the best years of your life. Dr. Theodore Herazy has practiced Alternative Medicine for over 40 years, and has directed the Peyronie’s Disease Institute for the last eight years. He has written two books about this problem, “Peyronie’s Disease Handbook” and “Peyronie’s Disease and Sex.”


Leriche Technique for Peyronie’s Surgery

Peyronie’s disease surgery with Leriche method carries risk

The Leriche technique is a new surgical treatment of the stable phase of Peyronie’s disease.  At this time 10 cases are reported in the literature, and they were followed for only three months post-surgically.  While many more Leriche surgeries have taken place, primarily in France, they have not been reported in the literature for review. For this reason any man considering this technique must realize not much historical data has been collected to prove the effectiveness of this new procedure to reduce the curved penis of Peyronie’s disease, or evaluate for complications.  If a man wishes to volunteer to be one of the first for a new surgical approach, this would be that opportunity.

It is important to remember the Leriche technique is a different kind of penis surgery, but it is surgery nonetheless.  In all other Peyronie’s disease surgery techniques – like Nesbitt – there is ALWAYS more scarring that occurs as a result of surgical intervention.  In this new technique patients are operated on an outpatient basis under local anesthesia, after identification of the Peyronie’s plaque is made by ultrasound examination.  In the Leriche technique multiple tears (plication) of the PD plaque are made with an 18 gauge needle almost as though the surgeon was trying to shred the plaque, with the idea that it will be enlarged, spread out and flattened.

Leriche surgery by comparison to the Nesbit technique is minimally invasive, and solely for this reason might have a better range of outcomes. It is suggested following the Leriche surgery that the patient must engage in early and daily sexual activity for at least one month to obtain a good outcome.  Early reports suggest 30 percent of men who undergo the Leriche procedure are cured; however this opinion is based on limited post-surgical follow up of three months.  Another 50 percent gain sexual function after two or more additional Leriche surgeries.  For the 20 percent of men who do not respond well to the Leriche approach, the technique will not interfere with additional surgery or penile implant.

Time will tell how truly effective the Leriche technique is for correction of the Peyronie’s problem.

Penis surgery always carries risk

Most other types of Peyronie’s surgery are performed on an outpatient basis under general anesthesia, and can last up to two and a half hours. A second doctor, a plastic surgeon, may be needed when specialized grafting techniques are used. Surgery for Peyronie’s disease is a major event to a very sensitive part of the body with a large nerve supply, so there is never an easy walk in the park no matter what kind of surgery is performed.

Martin K. Gelbard, MD, world-renown Peyronie's disease expert, states, “Unfortunately, surgery does not offer a cure for Peyronie’s disease. The scarring in men with deformity severe and persistent enough to warrant an operation represents an irreversible loss of connective tissue elasticity. Though surgical restoration of sexual function can be both effective and reliable, potential candidates need to understand the compromise inherent in this approach.” Compromise means that after surgery some degree of the old problem and limitation usually remains, and new problems (more scarring, reduced sensation or numbness, new bends, more pain) will occur in spite of the best effort of the Peyronie’s disease surgeon.

Every surgical procedure has risk; none are totally safe or foolproof.   No Peyronie’s disease surgery can restore the penis to its former condition. Some surgery shortens the penis more than others. Some are more effective in straightening curvature. Every surgery carries the risk of less than perfect straightening, and sometimes the curvature is worse after corrective penile surgery because excess scar formation can occur from the trauma of surgery. Lastly, surgical side-effects are possible resulting in loss of rigidity (hardness) or inability to maintain an erection (impotence), due to permanent surgical alteration of blood flow in the penis, pain greater than before surgery, as well as permanent loss of sensation (numbness) that makes sexual pleasure a thing of the past.

Please keep this in mind:  You have PD because your body made a foreign scar in your penis as an over-reaction process – usually to some type of trauma.  Any surgery – like the Leriche technique – involves cutting holes into and tearing the internal tissue of the penis.  This kind of trauma often results in more scars in a man who has already shown he is capable of creating excess scar formation after any level of injury to the penis.

What will probably happen is that the researches will find 6-12-24 months after the Leriche surgery that men will develop more scars, like they do after other penis surgeries when done to men who already make too much scar material after injury, and the technique will fall out of favor.

Please ask a lot of questions and be very slow to submit to penile surgery if you already know you make more scar than the average man.  For this reason it might be worthwhile considering using a more conservative Peyronie’s disease natural treatment with Alternative medicine.