Peyronie’s Disease in Bangladesh: Symptoms, Stages, Causes & Risk Factors

What Is Peyronie’s Disease?

Peyronie’s disease happens when firm scar tissue — called plaque — forms inside the penis and gradually changes the shape of an erection. Many men first notice a bend they never had before, while others see uneven narrowing, indentations, or a visible loss of length. These changes can make erections painful or difficult, and naturally affect confidence and intimacy.

This condition is different from the harmless natural curves many men are born with. Peyronie’s develops suddenly, tends to progress, and is usually linked to new scar tissue. Studies suggest that as many as 1 in 10 men may have signs of Peyronie’s disease, though only a small number seek treatment — especially in countries like Bangladesh where sexual-health topics are often kept private.

Stages of Peyronie’s Disease

Doctors generally describe two distinct phases:

Acute Phase

This early stage may last up to 18 months. The scar tissue begins forming, the shape of the penis changes noticeably over time, and erections can become quite painful. Some men feel discomfort even when the penis is flaccid.

Chronic Phase

After the plaque stabilizes, the curvature usually stops getting worse. Pain often decreases, but the deformity becomes permanent, and many men experience some degree of erectile dysfunction. Loss of length or narrowing may also be more obvious during this stage.

Symptoms of Peyronie’s Disease

Symptoms vary depending on the location and size of the scar tissue, but common signs include:

Penile Curvature

Hourglass or Bottleneck Narrowing

About two-thirds of men notice a narrowing at one point along the shaft, giving the penis an hourglass-like appearance during erection.

Hard Lumps Under the Skin

The scar tissue can feel like firm, flat, bone-like patches beneath the skin.

Pain or Painful Erections

Pain is especially common in the acute phase and can range from mild discomfort to sharp pain.

Shortening or Narrowing of the Penis

Some men lose a small amount of length, typically 0.5–1.5 cm, depending on how the plaque forms.

Difficulty With Sexual Function

Up to 54% of men with Peyronie’s also experience erectile dysfunction, often due to restricted blood flow or psychological stress.

Erectile Dysfunction and Peyronie’s Disease

Peyronie’s can make erections physically challenging. Scar tissue limits how much the erectile chambers can expand and how well they can maintain pressure. For many men, this leads to:

Medications like sildenafil (Viagra), tadalafil (Cialis), or vardenafil can help in some cases, but not all. When the plaque restricts expansion, pills may not work as effectively. Without proper care, many men face emotional strain, frustration, and relationship stress — all of which can worsen the problem.

What Causes Peyronie’s Disease?

There is no single explanation, but several factors are strongly linked to the condition.

1. Penile Trauma (Most Common Cause)

Minor injuries during sexual activity — often unnoticed — can damage the tunica albuginea, the thick layer of tissue surrounding the erectile chambers. For some men, especially those genetically predisposed, this leads to inflammation and abnormal scar formation.

Severe injuries such as a penile fracture are also strongly associated with Peyronie’s and can increase the risk of later erectile dysfunction.

2. Connective Tissue Disorders

Some people naturally form scar tissue more easily. Conditions like:

are more commonly seen in men with Peyronie’s, suggesting a shared pattern of abnormal collagen behavior.

3. Autoimmune Diseases

Autoimmune disorders — where the immune system mistakenly attacks the body — also appear more frequently among men with Peyronie’s. Examples include psoriasis, psoriatic arthritis, rheumatoid arthritis, lupus, and Sjögren’s syndrome.

Risk Factors for Peyronie’s Disease

Several health and lifestyle factors increase the likelihood of developing the condition:

Peyronie’s Disease in the Bangladesh Context

In Bangladesh, Peyronie’s disease often remains undiagnosed for years. Many men hope it will “go away on its own,” or hesitate to speak to a doctor due to social stigma. Conditions like diabetes, obesity, heavy smoking, and high stress — all common in Bangladeshi men — further increase the risk. As a result, many only seek help when pain, curvature, or sexual difficulties begin affecting their emotional well-being or relationship.

Complications of Peyronie’s Disease

Peyronie’s disease often affects men on more than just a physical level. While the curvature or deformity is the most visible part of the condition, the emotional and psychological impact can be just as significant — sometimes even more so.

A 2023 study showed that more than one-third of patients develop calcification within the plaque. When this happens, calcium settles into the scar tissue and turns it into a hard, almost bone-like structure. Many men find this stage particularly alarming. The sudden change in texture, the firmness, and the fear of progression can trigger a great deal of anxiety.

But even in cases without calcification, Peyronie’s disease can deeply affect well-being. Research indicates that nearly 80% of men experience some form of emotional distress. Between 48% and 62% face depression — often increasing with time — and more than half report difficulties in their intimate relationships. The combination of physical change, pain, and feelings of inadequacy can create a cycle of stress that puts pressure on both partners.

Although Peyronie’s disease does not directly cause infertility, it can make conception more challenging. For some men, intercourse becomes painful; for others, erectile dysfunction or incomplete ejaculation interferes with penetration or reduces the chances of pregnancy. A few studies even suggest that Peyronie’s may affect the completeness of ejaculation, which can contribute to male-factor infertility.

Some research also links Peyronie’s disease to a higher likelihood of other health conditions, including prostate enlargement, prostatitis, lower urinary tract symptoms, and, in rare observations, certain cancers such as stomach cancer, testicular cancer, and melanoma. The connections are not yet fully understood, but they highlight the importance of proper medical evaluation.

How Peyronie’s Disease Is Diagnosed

Because many men naturally have some degree of curve, it can be difficult to distinguish what is normal from what is concerning. Peyronie’s disease, however, has distinct characteristics, and an experienced urologist is the best person to identify them.

During an evaluation, the doctor will want to know:

The physical exam is usually straightforward. The doctor will feel for plaques — firm, flat, or raised areas under the skin. The key features of Peyronie’s are:

In some cases, a more detailed assessment is needed. The doctor may need to examine the erect penis directly to measure curvature and understand how the plaque affects function. This is especially important when considering treatment options like collagenase injections or surgery.

To create an erection safely in a clinical setting, a urologist may use an intracavernosal injection, which produces a temporary erection for evaluation. An ultrasound may also be used to check blood flow, examine the plaque, and determine whether calcification is present. This helps the doctor decide which treatments are likely to be effective.

Treatment Options for Peyronie’s Disease

Not all men require active treatment. For many, the pain associated with Peyronie’s gradually fades, even without intervention. However, the curvature rarely resolves on its own. Younger men, or those in the early months of the condition, may see mild improvements, but most benefit from some form of treatment when symptoms affect sexual function or emotional well-being.

Treatment decisions depend on how the disease affects a man’s daily and sexual life. If the curvature makes intercourse difficult, if erectile dysfunction develops, or if the psychological impact becomes overwhelming, it’s time to consider treatment.

Doctors typically begin with gentler, non-surgical options before moving toward invasive procedures.

Common treatment categories include:

Penile Traction Therapy

Traction devices apply gentle, consistent stretching forces to the penis, aiming to counteract the pull of the plaque. A 2023 review found that traction therapy can help reduce curvature. While it doesn’t consistently improve erectile function, other studies — especially one using a specific, well-designed device — reported gains in length, straighter erections, and improved erectile quality when men used the device regularly for six months.

Penile Injections

Injections are designed to weaken or break down the plaque directly.

Collagenase (Xiaflex®)

This is the only FDA-approved medication for Peyronie’s disease. It works by dissolving collagen — the main component of plaque — and can significantly reduce curvature when used properly.

Interferon

A protein-based treatment that may reduce plaque size, curvature, and pain. Some patients also report improved erectile function.

Verapamil

Commonly used for heart conditions, verapamil has shown some benefits in earlier, less-controlled studies. However, rigorous clinical trials have not consistently supported its effectiveness, so it is used selectively.

Oral Medications and Supplements

Most oral treatments have not shown strong results in high-quality research. However, some may have limited benefits for specific patients.

Surgery for Peyronie’s Disease

Surgery is reserved for more severe or function-limiting cases. It is typically considered when curvature prevents intercourse, when other treatments fail, or when a patient has both Peyronie’s disease and significant erectile dysfunction.

Plaque Incision/Excision With Grafting

The plaque is cut or removed, and a graft is placed to restore shape. Often recommended for curves over 60°, though the risk of postoperative erectile dysfunction is higher.

Plication

The side opposite the curve is shortened slightly with sutures to straighten the penis. It has a high success rate and low complication risk, but may result in mild shortening. Best for curvatures under 60°.

Penile Implant

Ideal for men with Peyronie’s and severe erectile dysfunction. Implants restore rigidity and often help straighten the penis at the same time.

Shockwave Therapy

Low-intensity shockwaves are used to reduce pain and soften the plaque. Research is still limited, and results vary, but some men experience meaningful relief.

Can Peyronie’s Disease Be Prevented?

There is no proven way to prevent Peyronie’s disease entirely, but reducing trauma to the penis can lower risk.

Practical tips:

Above all, early evaluation matters. If you notice unusual pain, a new curve, or any injury during sex, seeking medical advice promptly may prevent the condition from progressing.