Is it possible to have a penile curvature without having a Peyronie’s scar?

Dr. Herazy,

Is it possible to have an extreme curvature in one or both of the blood-filled columns in the inside of the penis without having a scar? I can't find a scar at all. Also, I only have pain (a slight twinge) in the base of the penis and in the curvature?



The only way you could have an extreme penile curvature without having a scar would be to have a congenital curvature (born with a normal curvature) or to develop some other health problem that would cause additional penile symptoms. 

If you have been diagnosed with Peyronie's disease and you have a bent penis you must realize the penile curvature is being caused by something that was not present before you developed PD.  There must be a reason for the distortion, correct?  In your case, the distortion is being caused by extra fibrous buildup that is very difficult to locate.  This is common in Peyronie's disease; I guess that at least half of men with PD have difficulty finding their scar(s).   In fact, it is so common that I wrote a blog post titled, "Can't find Peyronie's plaque or scar."   You could also read another question and answer, "How do I find my Peyronie's scar?" 

It is typical for someone who has been medically diagnosed with PD to still feel uncertain if this diagnosis is accurate and correct.   It is part of a denial response.  If this is true, you must either make up your mind you will either accept the diagnosis or go to another urologist for another opinion to either confirm or deny your Peyronie's disease diagnosis.  I sense that you are beating yourself up with doubts and endless questions.  At some point you must stop fighting the idea you have PD. You need to eventually take that energy you are wasting on endless worry and use it to do something about your problem.  Some men have a difficult time dealing emotionally with severe penile curvature.  If that is true for you, please contact me for a few EFT sessions and I think I can do something to help you in this way, as I have done for so many other men.   

The pain of Peyronie's disease is quite variable in terms of degree and location. Having a slight twinge at the base of the penis, and within the curvature, is consistent with this problem.  But then, having a great amount of pain at the base or toward the top of the penis would also be consistent since the pain of PD is wildly variable. TRH  

Are there muscles in the shaft of the penis?

Dr. Herazy,

Are there actual muscles in the shaft of the penis, or is it all just tissue?

If it's tissue that I'm trying to heal, then which of your products have you seen to be more successful in taking care of a pivot?

More specifically, my pivot starts small and then makes my penis grow top-heavy as it becomes more erect? Is this common?



We need to review some penis anatomy.  There are no muscles in the penile shaft.   The bulk of the penis is made of three cylinders of erectile tissue; two are called the corpora cavernosa and the last is the corpora spongiosum. These long masses of erectile tissue are referred to as spongy tissue, since like a sponge they have large open spaces that can fill with blood and expand during an erection.  Any movement of the penis that occurs when you intentionally contract your lower pelvic muscles comes from the attachment of base or root of the penis to what is called the pelvic sling that contains the pubococcygeus (PC) muscle.  The PC muscle is a what is called a voluntary muscle that works when you want it to work, just like the biceps or gluteal muscles.  It is not part of the penis, but is is closely connected to the base of penis and the PC muscle lifts the penis because of the way it is connected to it.

Your body needs a wide and diverse number of nutrients to heal the damage of Peyronie's disease.  There is no one nutrient that is more important than another in the healing process.  If you think this is not true, let us use the basic example of baking a cake.  A cake is made of just a few ingredients, like flour, milk, eggs, shortening,  baking powder, salt, etc.  And if I would ask you what is the very most important ingredient in a cake, you might answer that you simply must have flour in a cake and therefore that is the most important ingredient.  If that is true, then what would happen if you did not include the half teaspoon of salt or the tablespoon of baking powder in the recipe?  you would soon learn that not only do you have to use all ingredients to bake a cake, they had better be included in the exact amount required.  Baking a simple little cake demands that all ingredients be included at the right time and in the right proportion.  Can you image the process that is going on to correct Peyronie's disease?

Because of the complexity and great number of chemical processes involved in the healing process of Peyronies disease, we do not pretend to know exactly what your body might need that could be different than someone else.  To solve this problem we simply recommend that you include them all so that your body has the opportunity to use what it needs when it needs it.  Do not make the mistake to try to figure this process out so you can isolate one nutrient or chemical in particular.  

There is no special therapy or method of treatment that is used for a pivot (dent, ding, hinge or notch) deformity.  You are not treating the pivot with the PDI concept; you are treating your body so that it can heal the pivot, and your body needs a lot of help.  

The pivot or hinge deformity is very common.  TRH

Cost to continue the large or best Peyronie’s treatment plan?

Dear Dr.Herazy I have a question. 

I purchased the video of the stretching of the PD from you and would like to purchase the large plan but this has also comes with the video. Can you sell it to me without the video and give me some credit?

Also for how long last the products for the treatment? How much is the additional monthly cost to continue the treatment for one year?? My Urologist put me on pentoxifylline and I taking it already for 2 month but I have seen no improvement. I would like to try your treatment. Thank you.  Please let me know.  Mr. Jetter


Greetings Mr. Jetter,

The gentle PDI Manual Penis Stretching CD is not the same video that is included in the large or medium plan; they are two different videos.  The large and medium Peyronie's treatment plans have the Massage & Exercise video that is different than the stretching video.   To follow the medium or large Peyronie's disease treatment plan you would still need the Massage & Exercise video. 

When you order the large Peyronie's treatment plan you will never have to purchase the Genesen pointers or the Massage & Exercise video again,so they are a one-time expense.  Also, because you will use such as mall amount of PMD DMSO, Super CP Serum and Unique-E oil for each application, most men only order these three therapy items once every three months or so.  The other items (Vitamin E 400/400, Maxi-Gamma, MSM, Nattokinase, Fibrozym, etc.) are usually reordered every 4-6 weeks, or so.  I estimate that the average man spends about $95-$115 each month resupplying his large plan.  This is just a little more than the estimated $90-110 monthly cost to resupply the medium or better PD plan.  

Please let me know if I can help you during the course of your treatment.  TRH  


Questions about the Large (Best) Peyronie’s treatment plan

Dr. Herazy,

I just ordered the BEST plan from your website. I know there's no way for you to know my exact condition, but do you recommend how many BEST plan I should purchase to stay aggressive. I'm concerned about the cost. I might only be able to purchase this one once.  Thank you for your help.


I think you misunderstand about the best or large Peyronie's disease treatment plan, and probably all the other plans. 

You only need to purchase the large or best plan once. After that first purchase you will only have to repurchase what you have used – not everything. 

You will never again have to purchase the Genesen pointers or the Massage & Exercise video.   You will likely only use the PMD DMSO, Super CP Serum and Unique-E oil once every three months or so.  The other items (Maxi-Gamma, MSM, Fibrozym, etc.) you will restock as you use them, about every 4-6 weeks.  I estimate that the average man spends about $95-$115 each month resupplying his large plan.  This is just a little more than the estimated $90-110 monthly cost to resupply the medium or better PD plan.  

Please let me know if I can help you during the course of your treatment.  TRH  

How about using ultrasound as Peyronie’s treatment?

What are your thoughts on using ultrasound technology to treat minor Peyronies scaring?  Thanks


First of all, there is no such thing as minor Peyronie’s scarring.  All Peyronie’s scar tissue has the ability to rapidly progress in a very short time and become a major problem.  For this reason all cases of PD should be taken very seriously and treated aggressively before being given an opportunity to worsen and ruin your life. If your current problem with PD is small, be grateful.  But do not ever assume the problem will stay that way.

After reading a little of the standard medical information about using ultrasound physiotherapy as a Peyronie’s disease treatment I was not sure I was getting a full or accurate explanation about treatment results and effectiveness. What I did notice is that only one of the older research articles from Germany mentioned that the ultrasound machine they used to treat the Peyronie’s scar was a 1 MHz unit (1 million megahertz or 1 million sound waves a second).  At the frequency of 1 million sounds waves per second I know that sound passes too deeply (several inches) into tissue to be of value in treating Peyronie’s disease because the scar tissue is located about 1/4 inch below the surface.  This means that the German research was using the wrong kind of ultrasound machine; it would not get good treatment results because the heat generated by the ultrasound machine would not heat the superficial layer where the PD problem is located.

For this reason I contacted two of the largest manufacturers of ultrasound equipment for their opinions about using a 3 MHz unit (3 million megahertz or 3 million sound waves a second), which is commonly used by the cosmetics industry because units of this size heat only the very superficial layers of tissue, meaning a small fraction of an inch below the surface down to about 1/2  inch of depth.  In my opinion this would be a perfect frequency to use for Peyronie’s disease.   Neither of these two companies could say that ultrasound has been adequately tested or proven to work, and suggested that if I wanted to ultrasound for Peyronie’s disease I should be the one to do the research for them.

In view of this lack of interest and lack of current clinical background using ultrasound for Peyronies, I developed contacts within cosmetics industry and makers of 3 MHz ultrasound machines to see if any would be adequate to be used as a serious therapy for PD. I finally found that Bellaire Industry makes a great portable unit that is competitively priced.

PDI is currently working with a group of men who have Peyronie’s disease to test treatment protocols that might serve for a future research project.  Click here additional information about the 3 MHz ultrasound unit we are testing for Peyronie’s disease.   TRH

Would you like me to send you pictures of Peyronie’s disease?

Dr. Herazy,

I am not concerned with sex right now and I have no pain, except I have depression from my Peyronie's disease.

It seems I have only two problems. 1) a failure in the integrity of the wall of my penis on the left side. This is at a specific point rather than so much at a curve, even though that is there also when it is more erect. My penis doubles over to the left because of the failure in the shaft wall when not erect. 2) When erect my penis wants to hug the trunk of my body towards the left side.

Would you like me to send you pictures?



There is no need to send me our Peyronie's pictures at this time.  It might be useful later, but now.

 It is very common for men with Peyronie's disease to feel depressed for a variety of reasons.   For many men this depression arises from the (false) idea there is little you can do to help yourself with your Peyronie's disease and that your life will never be the same.  I suggest you begin spending more time reading and studying the PDI website to overcome this feeling of helplessness that seems to come from the idea that no drug has been found to help PD.  You need to know that the body reverses and corrects PD in a fair number of cases, and for this reason your energy should be focused on increasing and supporting your natural ability to overcome your PD.   Once you understand there is a lot you can do to increase your odds for self-repair and learn more about Peyronie's disease you will feel less scared and depressed.   Once you begin to actually do something to improve your physical condition you will feel empowered and in control of you situation.

There is a great technique I use to help men with their depression, called EFT.   Please go to the PDI website to the page about using EFT for distressing emotional states.  I have worked with many PD men using this technique and the results are often rapid and gratifying. Contact me directly for an EFT session when you are ready to feel better. 

What you describe as a failure of the integrity of the wall of the wall of the penis on your left side is not at all uncommon for men with PD.  This is commonly called a ding, dent,, hinge or pivot.  It can be caused in one of two ways, or a combination of both.  The first is by the abnormal internal tissue tension or pulling from within the shaft by the fibrous PD scar located in the tunica albuginea.  The second is by leaky veins within the shaft that do not close completely because the presence of the PD scar.  You can think of the PD scar acting almost like someone putting his foot in the doorway and preventing door from closing.  In PD the scar prevents the veins from closing, thus no pressure is built up within the shaft.  Without trapping of blood in the shaft the needed hydraulic pressure never develops to create a completely strong erection.  This can happen in just one small area of the shaft that creates the small dent in the side of the penis.   

Your left leaning erection is probably related to both the scar and weak erection on the left side of the shaft. 

There is not any need to send pictures at this time, since PD treatment is not based on the distortion or curve of the shaft.  Treatment is guided by the size, shape, density and surface features of the PD scars that create the distortion.   You must develop an exact knowledge of these characteristics in order to help your PD.   Once you reduce your scars, you will improve the distortion pattern that  bothers you so much.  This physical improvement will greatly help your sense of depression. 

So, I suggest you get busy.  Please get started with a reasonable Peyronies treatment plan that you can find on the PDI website.   If you need help with this, please let me know.  TRH 

Can masturbation cause Peyronie’s disease?

Dr. Herazy, I know you are a busy man, but if you can recommend something specifically for me, then I would greatly appreciate it to boost my confidence. I struggle with a very black depression from my Peyronie's. Here is my status: when not erect my penis is just fine/when about 30% erect I have the beginning of an hour glass shape/when about 70% erect the curve is on the left side/when fully erect it hangs to the left and has a curve on the left side. Also, question: can masturbation cause this to have happened? Thank You


If you are like most men, I believe the primary reason you are so depressed is that you do not realize how much you can actually do to help yourself recover from PD.  A large part of your emotional state is due to feeling helpless and depressed, and these start with not understanding Peyronie's disease.  Therefore, once you begin to learn more about the problem you will feel less scared and alone, as many men do with PD.  Once you begin to actually do something to improve your physical condition you will feel empowered and in control of you situation.

There are three things you can do right now to help yourself:
1.  Go to the PDI website to the page about using EFT for distressing emotional states.  I have worked with many PD men using this technique and the results are often rapid and gratifying. Contact me directly for an EFT session when you are ready to feel better. 
2.  Get my book, "Peyronie's Disease and Sex" to develop a better understanding of yourself and how women relate to your condition.  Men usually make their situation worse by assuming that women will automatically reject a man who has PD; this is often not the case when the man knows how to effectively manage his sexual problems.  This book can help you in this area.   
3.  Get started on the most aggressive Peyronies treatment plan you can sustain for a few months to hopefully begin to make positive changes in your physical condition.   As part of your PD education you should read, "Peyronie's Disease Handbook."  

Masturbation, by itself, will not cause injury that can lead to Peyronie's disease.  However, very rough or physically abusive masturbation practices can cause injury to the tunica albuginea that leads to PD.   All masturbation to be safe should be as gentle and well lubricated as sexual intercourse.   TRH 

Does this Peyronie’s treatment really work?

Dr. Herazy, I am 43 years old with this condition. It sucks my erections are not as good as they used to be. I have also lost some of my length and width. The curve is upward,it has been 3 years now and I need some aggressive treatment that WORKS…REALLY WORKS….BOTTOM LINE DOES YOUR TREATMENT THERAPY WORK… AND CAN IT REALLY HELP ME. I am taking Peyreton at the moment and really questioning the herb. I do not feel its doing anything. If you can help please respond.


If you think about your basic Peyronies treatment question and what you are asking of me, I cannot respond either way.  No one can know ahead of time if any valid treatment will help any health condition.   You are asking for a guarantee, and I cannot do that for you; no one can do that for anything in life.

No doctor can say that any blood pressure medicine will work, no surgeon can guarantee results, and you will note that not even the makers of aspirin can guarantee results.  Your request shows me you do not understand the Peyronie’s treatment concept that is taught on this website. 

What I can tell you is that I receive anywhere from 10-12 emails and phone calls telling me of positive results and good success reducing the size, shape, density or surface features of the PD scar and subsequent improvement of penile curvature for every one email or phone call saying there is no progress under the PDI treatment. 

I can also tell you that the way you ask your question, “…can it really help me” is asked as though you want me to take the responsibility for your recovery and you are somehow not involved.  That is not the way this treatment works.  With the Peyronie’s treatment concept you find on this website I offer ideas and suggestions to increase your ability to heal and repair the Peyronie scar, and you do the work.  You must take responsibility to learn, to understand and to apply these concepts to increase your ability to heal the PD scar; it works well for a high percent who work aggressively and diligently.  I have no way of knowing how you will apply what I teach, so I cannot guarantee any results for you.  

You bought your Peyreton because of the wild promises you read in their ad.  Not only did they guarantee you results from one or two bottles of their product, they made it sound as though the treatment is as easy as popping a few magical herbs and if it did not work they said you would get your money refunded to you.  Good luck with that one.  Over the years I have tried to communicate with the makers of Peyreton and I have yet to receive a single response from them.  I have offered to sell their product on my website if it is as good as they say, and they ignore my requests for information about their product and their company.  Many dozens of men have communicated with me over the years who say they got no help from Peyreton and were cheated on the promise of a refund from this company.  You should have known better.  I cannot make any promise to you because recovery from Peyronie’s disease is never easy, it is never as rapid as anyone wants, and not everyone does it the right way.  You seem to want things easy and fast and guaranteed, and I cannot do that for you.  Your request for a guarantee suggests you do not understand the treatment concept that is taught on this website. 

if you want help getting over your PD I suggest that you spend some time reading about how this works for a lot of men.   If you really want to recover you will do this and you will contact me if you have questions.  Here is a good page to get started.  Just read the entire first page to get a better idea of how this Peyronie’s treatment really works; you might even click on a few links that interest you. You will find that I will do all that I can to help you do the work of recovering from PD to the best of your ability.   TRH

How often and for how long do you recommend moist heat for the Peyronie’s scars?

How often and for how long do you recommend moist heat for the Peyronies scars?   Thanks, Roger

Greetings Roger, 

Use moist heat prior to the topical or external therapy (DMSO application or especially manual stretching technique) to bring blood to the area of your Peyronies scars.   For this reason it will be more efficient to perform these together as a group so you do not have to do it several times a day.
However, it is probably not advisable to use moist heart immediately prior to Genesen therapy since it would easily throw off any level of tissue sensitivity and make it falsely look like EVERY place you touch with the pens are active – when this is not actually true.  You would wind up wasting your time by treating points that did not need it although they appeared to need it.
5-10 minutes is a good time range to apply the heat.  You are only attempting to draw blood to the area of the shaft, and it does not take that long to dilate the blood vessels for that purpose; you are not poaching meat.   TRH

What is the correct way to apply penis traction for Peyronie’s disease?

I really enjoyed viewing the CD video for the light manual penis stretching technique.   Good information that I can see will be helpful to correct my Peyronies 80 degree bend.  One question. Is the stretching technique a slow fluid motion that continues to increase or a static consistent stretch that is held for minutes at a time? Thanks. Darryl

Greetings Darryl,

Glad you like the gentle manual penis stretching method video.  It is a great technique that I think everyone should add to their plan.  Just do not make the mistake of thinking this is all you have to do to get rid of your PD. 

The way to safely and correctly stretch the penis is to keep the traction light and consistent.  Do not vary the light penile traction force once you develop the deep dull ache that is mentioned on the CD.   

Once the light traction force causes the familiar deep dull ache, it is held at the same static “force” until the dull ache disappears or boredom causes you to decide to stop.  There seems to be a natural tendency for a lot of men to slowly increase the traction force after a few minutes have passed.  Avoid this tendency and strive to consistently maintain the same contact vectors and level of touch.   You will know you have increased your force when you notice the dull ache stop; simply lightening the contact touch should cause the dull ache to return as the fascia again begins to yield.   TRH