ED & Sexual Medicine — Southern California
Peyronie's disease, explained
If erections have developed a bend, a dent, or a pain that wasn't there before — it has a name, it's physical, and it's treatable, with more real options than most men know. Here's the plain-language explainer most men never get.
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Individual results vary. Treatment only after evaluation by a licensed clinician.
The results and experiences featured on this site are examples, not promises. Individual results and patient experience vary. A medical consultation and prescription are required before any medication is provided.
The Condition
What Peyronie's disease is
Peyronie's disease is scar tissue — doctors call it plaque — in the tunica albuginea, the elastic sheath around the erectile chambers. Scar doesn't stretch the way the tissue around it does, so when an erection expands everything else, the scarred spot holds — and the result can be a curve, a dent or narrowing, shortening, or pain with erections.
Four things worth hearing plainly. It is a physical, structural condition — not "in your head," and not caused by anything shameful. It is more common than most men think.[1] Most men who have it have never heard its name — which is often the loneliest part, and the easiest one to fix. And it is treatable: men are evaluated and treated for Peyronie's disease successfully every day, with established and investigational options to choose from.[2] Individual results vary. You're a lot closer to an answer than you were a minute ago.
The Timeline
It moves in two phases — and the second one is calmer
The active phase
The good news first: the pain usually eases as this phase settles.[3] Until then the scar is still forming, pain with erections is common, and the curve can still be changing — sometimes week to week.
The stable phase
The scar has settled. Pain usually fades, and the curvature stops changing — by definition, once symptoms have held steady for at least three months, which is commonly 12 to 18 months after onset.[3] This is the phase where the widest range of treatment decisions opens up.
Why the phase matters: it changes which treatments make sense. Some options belong to the active phase, others should wait for stability — surgical correction in particular is a stable-phase decision.[3] One more reason the evaluation comes before the plan, not after the brochure.
When to Come In
Reasons to get it looked at
Come in if erections have become painful. Come in if a curve is new, or getting worse. Come in if intercourse has become difficult. And come in if the change is simply weighing on you — distress is a legitimate reason on its own, full stop.
One more: ED and Peyronie's disease often travel together — scar tissue can interfere with the pressure seal that holds an erection — so the evaluation looks at both, in one private conversation. And earlier tends to be better: the sooner the phase is identified, the more options stay open.[3]
The Options
What can be done — and there's more than most men know
This is a treatable condition with more real options than most men have ever heard of, and men are treated for it successfully every day.[4] Individual results vary. Treatment aims to do three things: reduce pain, reduce or stabilize curvature, and restore function. Established and investigational options both exist, and a good evaluation matches them to your phase and your goals. One sentence to anchor every expectation in this category: no option guarantees a straight result. The honest goals are reduce, soften, stabilize, and restore function — and for many men, those goals are worth a great deal.
Intralesional injection therapy
Medication injected directly into the plaque by a clinician. For appropriate curvature in the stable phase, an FDA-approved collagenase option exists — the one treatment category in this field with that approval status — and studies report meaningful curvature reduction for many appropriately selected men.[5] Individual results vary. Whether it's delivered here or by referral is something we tell you plainly at your evaluation.
Traction and mechanical therapy
Structured stretching devices worn on a schedule, studied for preserving length and improving curvature. The encouraging part is that it's non-invasive and can pair with other options. The evidence is mixed, and adherence does a lot of the work.[6]
The newer options
Two newer options — the Firm Wave® treatment series and the Vigor Shot™ procedure — are also discussed for Peyronie's disease. For acoustic wave therapy, the encouraging part of the research is on the pain side — studies report reduced erection-related pain — while evidence for curvature change is more mixed.[7] Individual results vary. For PRP, the research in Peyronie's disease is early and still maturing.[8] Both are investigational for Peyronie's disease, and the disclosures apply here in full: acoustic wave therapy's use for ED and Peyronie's disease is off-label, considered experimental and investigational, without specific FDA clearance or approval — and autologous PRP preparations are not FDA-approved for sexual-medicine uses. Which options fit your case, and which we deliver in-house, is settled at your evaluation, not on a webpage.
Surgery, by referral
For severe, stable-phase cases — significant curvature, function that conservative options haven't restored — surgical correction is the established path.[9] Individual results vary. It's specialist territory, and it's a referral. What we don't do in-house, we say so — and we help you get to someone who does. That's the deal.
FAQ
Questions, answered
Is it my fault? Did I injure it?
No — and probably not in any way you could have controlled. Peyronie's disease is thought to involve an abnormal healing response, sometimes to minor injury a man never even noticed.[2] It isn't caused by anything shameful, and blame has no place in the workup. What matters now is the phase you're in and the options it opens.
Will it get worse?
It depends on the phase — and the phases have an end. In the active phase the scar is still forming and the curve can still change, in either direction. Once the stable phase arrives, the pain usually fades and the curvature generally stops changing.[3] That's exactly what the evaluation sorts out, and why acting on good information beats waiting on worry.
Does it go away on its own?
The pain often does, as the active phase settles. Meaningful curvature rarely resolves on its own[3] — which is why the options on this page exist. Mild cases can stay mild, and "wait and see" is a reasonable plan for some men — but it should be a decision you make with a clinician, not a default you fall into.
Can it be treated without surgery?
Often, yes — and that's the encouraging part.[4] Injection therapy, traction, and investigational options like the Firm Wave® treatment series and the Vigor Shot™ procedure exist, matched to your phase and severity, each with its own honest evidence picture and disclosures. "Fixed" is the wrong promise, though: no option guarantees a straight result, and severe stable-phase cases may still point to surgical referral, the established path for stable-phase disease.
Does Peyronie's disease explain my ED?
It can contribute. Scar tissue can interfere with the pressure seal an erection depends on, and the distress it causes can pile on from the psychological side. Plenty of men have both going at once — and the evaluation treats them together, looking at the whole picture, not one symptom. See how the ED evaluation works
What does the evaluation involve?
A private conversation with a licensed clinician — your history, your medications, when the change started and how it's behaved since — plus an assessment of the phase. You'll leave knowing what phase you're likely in, what your options honestly are, and what we'd do next if you were family.
What does treatment cost?
It depends on the path — and some paths are referrals, which we'll tell you plainly. You'll know your full cost before you start, reviewed with you before you enroll. Call 949-570-0800 and ask — nobody will make you book to find out. HSA/FSA accepted for eligible services.
Citations & References
The research behind this page
Every clinical statement on this page is footnoted to peer-reviewed research, a professional-society guideline, or an official regulatory source. Each reference was resolved and checked against its published record before it was placed here.
- Stuntz M, Perlaky A, des Vignes F, Kyriakides T, Glass D. The prevalence of Peyronie’s disease in the United States: a population-based study. PLoS One. 2016;11(2):e0150157. PMID 26907743. Nehra A, Alterowitz R, Culkin DJ, et al. Peyronie’s disease: AUA guideline. J Urol. 2015;194(3):745–753. PMID 26066402. U.S. population survey: 0.7% physician-diagnosed, 11.0% probable, 11.8% combined; the AUA guideline cites 13.1% of men with a diagnosis, treatment, or any symptom of Peyronie’s disease.
- Nehra A, Alterowitz R, Culkin DJ, et al. Peyronie’s disease: AUA guideline. J Urol. 2015;194(3):745–753. PMID 26066402.
- Nehra A, Alterowitz R, Culkin DJ, et al. Peyronie’s disease: AUA guideline. J Urol. 2015;194(3):745–753. PMID 26066402. Mulhall JP, Schiff J, Guhring P. An analysis of the natural history of Peyronie’s disease. J Urol. 2006;175(6):2115–2118. PMID 16697815. Stable disease is defined as symptoms unchanged for at least three months, commonly 12 to 18 months after onset; in untreated men, pain resolved in 89% over 12 months while curvature improved in 12%, remained stable in 40%, and worsened in 48%.
- Nehra A, Alterowitz R, Culkin DJ, et al. Peyronie’s disease: AUA guideline. J Urol. 2015;194(3):745–753. PMID 26066402. Salonia A, Bettocchi C, Boeri L, et al. European Association of Urology guidelines on sexual and reproductive health—2021 update: male sexual dysfunction. Eur Urol. 2021;80(3):333–357. doi:10.1016/j.eururo.2021.06.007.
- Gelbard M, Goldstein I, Hellstrom WJ, et al. Clinical efficacy, safety and tolerability of collagenase clostridium histolyticum for the treatment of Peyronie disease in 2 large double-blind, randomized, placebo controlled phase 3 studies. J Urol. 2013;190(1):199–207. PMID 23376148. Nehra A, Alterowitz R, Culkin DJ, et al. Peyronie’s disease: AUA guideline. J Urol. 2015;194(3):745–753. PMID 26066402. Two phase 3 placebo-controlled trials; the AUA guideline supports intralesional collagenase with modeling for stable disease with curvature between 30° and 90° and intact erectile function, with average curvature reduction of about 17°.
- Ziegelmann M, Savage J, Toussi A, et al. Outcomes of a novel penile traction device in men with Peyronie’s disease: a randomized, single-blind, controlled trial. J Urol. 2019;202(3):599–610. PMID 30916626. Salonia A, Bettocchi C, Boeri L, et al. European Association of Urology guidelines on sexual and reproductive health—2021 update: male sexual dysfunction. Eur Urol. 2021;80(3):333–357. doi:10.1016/j.eururo.2021.06.007. Randomized controlled trial of a traction device reported curvature and length improvement versus no treatment; adherence to the wearing schedule drives outcomes.
- Palmieri A, Imbimbo C, Longo N, et al. A first prospective, randomized, double-blind, placebo-controlled clinical trial evaluating extracorporeal shock wave therapy for the treatment of Peyronie’s disease. Eur Urol. 2009;56(2):363–369. PMID 19473751. Nehra A, Alterowitz R, Culkin DJ, et al. Peyronie’s disease: AUA guideline. J Urol. 2015;194(3):745–753. PMID 26066402. Pain improved versus placebo; the AUA guideline advises clinicians may offer shock wave therapy for pain and should not use it for curvature or plaque.
- Alkandari MH, Touma N, Carrier S. Platelet-rich plasma injections for erectile dysfunction and Peyronie’s disease: a systematic review of evidence. Sex Med Rev. 2022;10(2):341–352. PMID 34219010. Systematic review: human studies of PRP in Peyronie’s disease are few and small, and no recommendation can be made from current evidence.
- Nehra A, Alterowitz R, Culkin DJ, et al. Peyronie’s disease: AUA guideline. J Urol. 2015;194(3):745–753. PMID 26066402. Surgical candidacy is assessed on the presence of stable disease, typically 12 months of symptoms and 3 to 6 months of stable curvature.
Getting Started
Start with a name for it. FINISH STRONG®.
Getting started is simple — and private.
Step 01
Talk
A focused consult — by phone or in person, virtual if you like.
Step 02
Test
An in-person visit: vitals and bloodwork before any products or services.
Step 03
Tune
Proven protocols do the groundwork. Your clinician makes the call — your plan, adjusted over time to your labs and how you actually feel.
Individual results vary. Treatment only when clinically appropriate.
Dr. Vigor® clinics in California are 100% physician-owned. Content on this page is educational and is not a diagnosis; Peyronie's disease care is provided only after evaluation by a licensed clinician, and only when clinically appropriate. A medical consultation and prescription are required before any medication is provided. Treatment plans are set by the patient's own licensed clinician, who alone determines diagnosis, prescribing, and course of treatment — protocols inform that judgment and never replace it. No treatment is guaranteed to correct curvature, and individual results vary. Acoustic wave therapy for erectile dysfunction, including the Firm Wave® treatment series, is considered experimental and investigational; its use for ED and Peyronie's disease is off-label and has not received specific FDA clearance or approval. Autologous platelet-rich plasma (PRP) preparations, including the Vigor Shot™ procedure, are not FDA-approved for sexual-medicine uses. Some Peyronie's disease treatments are provided by referral rather than in-house, and we say which is which. Not all men are candidates for every treatment. Dr. Vigor is a concierge clinic group and does not bill insurance. HSA/FSA accepted for eligible services. Services available at Dr. Vigor clinic locations in California.
Dr. Vigor® clinics in California are 100% physician-owned. Content on this page is educational and is not a diagnosis; Peyronie's disease care is provided only after evaluation by a licensed clinician, and only when clinically appropriate. A medical consultation and prescription are required before any medication is provided. Treatment plans are set by the patient's own licensed clinician, who alone determines diagnosis, prescribing, and course of treatment — protocols inform that judgment and never replace it. No treatment is guaranteed to correct curvature, and individual results vary. Acoustic wave therapy for erectile dysfunction, including the Firm Wave® treatment series, is considered experimental and investigational; its use for ED and Peyronie's disease is off-label and has not received specific FDA clearance or approval. Autologous platelet-rich plasma (PRP) preparations, including the Vigor Shot™ procedure, are not FDA-approved for sexual-medicine uses. Some Peyronie's disease treatments are provided by referral rather than in-house, and we say which is which. Not all men are candidates for every treatment. Dr. Vigor is a concierge clinic group and does not bill insurance. HSA/FSA accepted for eligible services. Services available at Dr. Vigor clinic locations in California.