Recognizing and Diagnosing Peyronie’s Disease: What You Need to Know

Peyronie’s disease is a condition that can be both physically painful and emotionally distressing, often marked by a noticeable curvature of the penis and discomfort during erections. Early identification and diagnosis are critical to managing symptoms and maintaining sexual health and quality of life. For many, the journey begins with self-awareness and a willingness to speak with a healthcare provider.

What Is Peyronie’s Disease?

Peyronie’s disease occurs when fibrous scar tissue, or “plaques,” form inside the penis, causing it to bend or become misshapen during an erection. The severity can vary widely—from mild curvature with little impact on sexual function to severe pain and difficulty with penetration. Some men may also notice a decrease in penile length or firmness of erections.

Initial Diagnosis: What to Expect

Self-Report & Questionnaires

In many cases, the first signs are noticed by the patient. Men often report:

Pain with erections
A visible curve or change in shape during erection
A lump or hardened area under the skin
Difficulty having sex due to bending or buckling

Healthcare providers may use a structured set of questions or validated tools like the Peyronie’s Disease Questionnaire (PDQ) to gather information about physical symptoms and how distressing they are. The PDQ evaluates not just physical signs but also the emotional and psychological impact.

Self-Check Questions to Consider:

If you’re concerned about Peyronie’s disease, ask yourself:

Do I feel pain during erections?
Is my erection less firm than before?
Has my penis changed shape or become curved?
Does it feel shorter or appear indented (like an hourglass)?
Do I feel a new bump or nodule?
Is penetrative sex more difficult due to curvature?

Answering “yes” to one or more may signal that it’s time to consult a healthcare provider.

Physical Examination

Diagnosis usually includes a physical exam. This might involve:

Palpation: Feeling the flaccid penis to identify plaques or scar tissue.
Stretched length measurement: Used to assess penile health and track disease progression.

In some cases, the provider may need to examine the penis in an erect state. To facilitate this, a medication may be injected to induce an erection in the office. The curve is then measured, often using a device called a goniometer.

Diagnostic Tests and Imaging

Ultrasound: The gold standard in imaging for Peyronie’s disease. It helps identify scar tissue and assesses blood flow to rule out other causes of erectile dysfunction.
MRI or CT scans: Rarely used but may identify plaques at early stages or before they calcify.
X-rays: Can detect calcified plaques.
Blood Tests: Occasionally used to assess testosterone levels, although the link between low testosterone and Peyronie’s disease is not definitive.

Differential Diagnoses

Several other conditions may mimic Peyronie’s disease, including:

Sclerosing lymphangitis: A temporary, rope-like lesion often from vigorous sexual activity.
Penile trauma: Like a fracture, which can cause similar symptoms.
Erectile dysfunction (ED): Especially in its early stages.
Penile cancer: Very rare, but can present with pain and curvature.

Talking to Your Doctor

Discussing sexual health can feel awkward or intimidating, but it’s an essential step. Here’s how to make it easier:

Write it down: Jot down symptoms, questions, and concerns ahead of time.
Bring a checklist: Use tools like a printable discussion guide to ensure you cover important topics.
Remember: Urologists are highly trained and have likely seen similar (or more severe) cases. Their goal is to help—not judge.

Why Early Diagnosis Matters

While not all cases of Peyronie’s disease require treatment, early intervention can improve outcomes, especially if the condition is still evolving. Left unaddressed, it may worsen or lead to permanent erectile dysfunction or relationship stress.

Takeaway

Peyronie’s disease is more common than most men realize—and it’s treatable. Don’t let embarrassment stop you from seeking help. By staying informed, performing self-checks, and speaking openly with a healthcare provider, you can take control of your sexual health and find a path toward effective treatment or management.

By Cara Jones, BDO Staff Writer | Published May 10, 2025