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?
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.
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:
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:
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:
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.
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.
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
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.
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.
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.”
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
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.
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.
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
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
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.
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
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?
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.
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
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
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