Peyronie’s disease plaque

Let’s clear up the confusion about the Peyronie’s plaque, the fibrous scar-like tissue that is the most common characteristic of Peyronie’s disease.  Many people when reading “scar” automatically think they should see it on the skin surface; for this reason I prefer the term Peyronie’s plaque.

Peyronie’s plaque is usually a flat or slightly elevated mass of fibrous tissue just under the skin, in a thin but tough membrane of the penis known as the tunica albuginea.  Sometimes it is cord-like or nodular, but usually it lies flat making it difficult to locate.

Peyronie’s plaque is not in any way related to plaque material that line artery walls. It is benign, meaning it is not cancerous and it is not a tumor.  Peyronie’s disease and this fibrous material is not in any way contagious, and is not in any way the result of any transmittable disease or microorganism – thus there is no way for a sexual partner to “catch’ the Peyronie’s plaque.

The mystery of Peyronie’s disease

For a male health problem that affects up to nine percent of the adult population, it is amazing that practically no man ever hears about PD until the day he is given the diagnosis.  It is this shock – a “mystery” condition that comes out of the blue, for which there is no known cause and no known cure that can wreck a man’s life.  While caught off guard, totally confused and shocked upon first learning about Peyronie’s disease, a man is often does not ask all the standard questions and does not remember the information as he receives his diagnosis.

With so many details pouring into his ears, and so many questions rolling around in this brain, it is easy to understand why a man can leave his doctors office and not remember much about the mystery condition.  Even the doctor’s explanation about a Peyronie’s plaque can become confused, making it sound like it is related to the blood vessels.

Location of Peyronie’s plaque suggested by penile curvature

You can usually count on finding your internal plaque on the concave part of a curved penis.  If a plaque is located on the topside of the penile shaft (the most common location), the penis will bend upward.  A plaque on the underside causes a downward penile curvature.  A plaque on the left lateral side of the penis causes a curvature to the left, and a Peyronie’s plaque on the right lateral side of the penis causes a curvature to the right.

Many times a distortion develops on both top and side, or top and bottom, resulting in twists, hourglass deformities or indentation, even shortening of the penis.

Peyronies plaque is elusive

Each week I receive emails asking, “Since my doctor examined me and could not find any Peyronie’s plaque material, and I cannot see a scar, do you think I really have Peyronie’s disease?”

There is never an EXTERNAL scar or plaque in Peyronie’s disease that can be seen.  The Peyronie’s plaque is always an internal mass of fibrous tissue that is sometimes called a scar, but is not a scar in the usual sense.  Peyronie’s plaques or ‘scars” are only sometimes obvious, while at other times they cannot be found if a person’s life depended on it.  Ultimately, if you have Peyronie’s disease you must assume it is there and you should try as many different tactics as you can to find your scar(s) because having a clear and accurate information will help your Peyronie’s disease treatment effort.

To find the internal Peyronie’s plaque, sometimes it is helpful to think about it being much larger than you have previously imagined; mentally expand the size of the scar you are looking for.  If you were looking for a “pea” before and couldn’t find it, start looking for a “postage stamp” or a “thumb nail” size structure.  This change of the mental image increases your odds to detect it.

When the plaque cannot be located, but there is still pain and distortion of any kind, a diagnosis of PD can still be made.  This is so because the fibrous plaque can be so:

1. Small – it cannot be found

2. Soft – it blends into the other tissue and cannot be detected

3. Deep – it cannot be reached easily

4. Large and flat – that the edges are not determined, almost like something that is so close to you that you do not see it because you are looking far away

When plaque is never found it is because of a combination of two or more of these factors – deep and small, or soft, large and flat, or deep, soft and doctor error, and so on.

It is common to have difficulty locating the plaque for the first time.  Sometimes it is best to forget about finding a “scar.” Instead just try to find something – anything – within the mass of erectile tissue that feels unlike the other tissue.  Finding something unlike the rest of the penis tissue will help define the problem tissue that can be difficult to locate. It might be you have an unreasonable expectation of what a “scar” or Peyronie’s plaque should feel like, making it easy to miss what is rather obvious to someone else with experience in this regard.

After an unusual tissue is found, mark its location on the penis with a marker pen or something that will stay on the skin for a few days.  Return to that location each day to re-evaluate it.  You want to determine if it becomes easier to make sense of it, so you can monitor it during your Peyronie’s treatment.