Some pictures of Peyronie’s disease show a curving penis that goes to the right or left or almost straight up, while other pictures show a bottleneck shaped penis or another that looks like it is dented in several places? Some men who have Peyronies do not have any kind of bent or curved penis, while other men who have a gently or abruptly curving penis are told they do not have Peyronies. All of this seems confusing and contradictory.

The explanation that clears this confusion starts with understanding that there is more to Peyronie’s disease than the presence or absence of a curving penis. A good deal of the confusion starts with a common incorrect statement that you will find on the Internet that goes something like, “Peyronie’s disease is a bent penis …”

This kind of misinformation originates with the manufacturers of the mechanical penis stretching devices that must be tightly clamped onto the head of the penis for eight hours a day. Their message is that straightening the penile curvature of Peyronie’s disease is as easy and simple as straightening out a bent paperclip. If they can get you to believe that “Peyronie’s disease is a bent penis …” they can make you believe a complex and stubborn tissue pathology can be corrected with a simple solution.

The fact is that the central problem of Peyronie’s disease is the presence of excess fibrous material, or scar, within the delicate tunica albuginea of the penis. This mass of fibrous material, similar in composition to common scar tissue that is found on the surface of the skin, probably occurs in response to trauma or a genetic weakness. All of the other symptoms of Peyronies occur because of the presence of this scar tissue under the surface of the shaft. The pain, the reduced sexual function, and especially the curving penis can all be traced back to starting with the PD scar.

Peyronie’s pain is felt because the scar material in the tunica albuginea presses up against another layer of tissue, Buck’s fascia, found directly above the tunica albuginea.  The tunica albuginea has no nerve supply, and therefore does not send a pain message.  Buck’s fascia has a very good nerve supply, and therefore sends a pain message when pressure is applied to it by the scar found in the tunica albuginea below it.

Sexual function is reduced either of two ways. First, by the presence of a severe distortion that prevents or makes difficult entry of the penis into the vagina. Second, by reduction of the ability of the penis to become erect if the PD scar prevents closure of the deep dorsal vein of the penis, leading to Peyronie’s disease impotence.

Penile curvature results when the fibrous Peyronie’s scar limits full expansion of the corpora cavernosa when it attempts to fill with blood during the erection process. This can cause a weak or limited erection in all or part of the penis, resulting in a wide variety of twists, turns, curves and dents in the penis.

Without the presence of the fibrous scar none of these problems – like a curving penis – would develop. For these reasons it is said that Peyronie’s disease is all about the scar.

If a man has always had a bent or curved penis, chances are that it is not Peyronie’s disease but a normal variation of his body called a congenital curve of the penis. If a previously straight or slightly bent penis suddenly develops a new distortion then it should be evaluated to learn if it is Peyronie’s disease.