Stages of Peyronie's disease

The Peyronie's disease is a condition of the penis that develops progressively and can cause pain, abnormal curvature, shortening, deformity, and, in some cases, erectile dysfunction. At Andrología Barcelona, we are experts in the diagnosis and treatment of Peyronie’s disease, and we know that understanding which stage the disease is in is key to applying the appropriate treatment at each moment.

What is Peyronie's disease and how does it evolve?

The main cause of Peyronie’s disease is the formation of scar tissue or fibrous plaques in the tunica albuginea, a membrane that surrounds the corpora cavernosa of the penis. These plaques harden areas of the penis, which impairs its elasticity and causes deformity during erection.

Although its exact origin is not always clear, in many cases, it is related to microtrauma, connective tissue disorders, genetic factors, or unresolved inflammation.

The Peyronie’s disease progresses through two main stages, each with distinct clinical characteristics and treatments.

Phase 1: acute inflammatory phase

This is the initial phase of Peyronie’s disease, when the condition is still developing. In this phase, the active inflammation of the tissue causes progressive symptoms and, in many cases, pain. The fibrous plaques begin to form, leading to penile curvature.

Main symptoms of the acute phase:

Pain in the penis, especially during erection.
Appearance of one or more palpable plaques.
Progressive curvature of the penis.
Shortening or narrowing of the penis.
Deformities such as hinge effect or hourglass shape.
Erectile dysfunction in some patients (20-54%).

Recommended treatments for the inflammatory phase

In this stage, the goal is to stop the progression of the disease and relieve symptoms. Treatment options include:

Oral anti-inflammatory or analgesic medication to control pain.
Penile traction treatments, aimed at correcting or slowing curvature using daily devices.
Intraplaque treatment with hyaluronic acid to prevent disease progression.
Ultrasound monitoring to assess the progression of the plaques.
Low-intensity shock waves for pain treatment.

Phase 2: chronic fibrotic phase

The chronic phase appears when the disease stops progressing: the pain disappears, but the curvature, plaques, and deformities remain stable. At this point, the fibrosis is consolidated, and the condition is considered chronic.

What happens in this phase?

The pain usually disappears completely.
The curvature of the penis remains stable.
No new plaques form.
Deformities and erectile dysfunction may persist.

Recommended treatments for the chronic phase

Since this is a stable phase, oral treatments are no longer effective. Instead, more advanced procedures are considered depending on the degree of the condition:

Intraplacental injections (collagenase): effective for moderate curvatures (>30º) with stabilized disease.
Penile plication surgery: recommended for mild to moderate curvatures (<50º), allows for straightening the penis with minimal aftereffects.
Surgical techniques with grafting: indicated for severe curvatures or complex deformities.
Penile prosthesis implantation: an option for cases with severe erectile dysfunction or highly limiting curvatures.

The Importance of an Early Diagnosis

Detecting Peyronie’s disease in its early stages allows for less invasive treatments and prevents curvature and dysfunction from progressing. Each stage requires a different approach, and only a specialized team can accurately define the most suitable treatment for your case.

Experts in Peyronie in Barcelona

At Andrología Barcelona, we are leaders in the diagnosis and treatment of Peyronie’s disease. We have advanced technology and extensive clinical experience to help you regain your sexual well-being and quality of life.