What is the cause of penile curvature (Peyronie's disease) only during erection?

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Last updated: February 19, 2025View editorial policy

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From the Guidelines

Peyronie's disease is the most likely cause of penile curvature only during erection, characterized by the formation of scar tissue inside the penis, leading to curved and sometimes painful erections. This condition typically presents in men in their mid-50s, with recent onset of penile curvature accompanied by mild to moderate penile pain, as noted in the 2015 AUA guideline on Peyronie's disease 1. The patient usually doesn't recall a specific sexual or non-sexual event that preceded symptom onset, and the erection is still firm enough for intercourse. Key characteristics of Peyronie's disease include:

  • Penile curvature that may preclude intercourse or make intercourse difficult
  • Varying degrees of penile pain
  • Inability to palpate any abnormalities on the penile shaft in the non-erect state It's essential to consult a urologist for proper diagnosis and treatment, as rare pathologies such as penile tumors must be excluded. Treatment options may vary depending on severity, but the focus should be on addressing the condition to prevent potential complications like erectile dysfunction and emotional distress.

From the Research

Causes of Penile Curvature (Peyronie's Disease)

  • Peyronie's disease is caused by progressive fibrotic scarring of the tunica albuginea, resulting in curvature or other deformities of the erect penis 2
  • The severity of penile curvature or other deformity may contribute to a man's inability to have intercourse (sexual disability), due to difficulty with penetration, partner pain, or emotional stress 2
  • The degree of curvature is a significant predictor of sexual disability, with curvature >60° being a robust independent predictor of the ability to have intercourse 2

Factors Contributing to Penile Curvature

  • Penile curvature can be caused by a variety of factors, including trauma, genetics, and certain medical conditions 3
  • Fracture of the penis, which is a relatively rare condition, can also lead to penile curvature 4
  • Other penile deformities, such as adult-acquired buried penis, can also contribute to penile curvature and sexual disability 5

Treatment Options

  • Treatment options for penile curvature and Peyronie's disease include oral phosphodiesterase type 5 inhibitors, surgery, and other pharmacotherapies 3
  • Surgery, such as skin reduction technique, can be effective in correcting penile curvature and improving sexual function 6
  • Counseling and psychotherapeutic therapies can also be helpful in addressing sexual disability and related issues 3

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Men's Health: Male Sexual Dysfunction.

FP essentials, 2021

Research

Fracture of the penis: nine cases with evaluation of reported cases in Japan.

International journal of urology : official journal of the Japanese Urological Association, 2003

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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