Peyronie’s disease can cause erection pain, penile curvature or other deformity, and erectile dysfunction (ED)—and each may need a different treatment. A urologist can assess the disease phase, shape of the penis, pain, and sexual function to help choose care aimed at the problem that is affecting you.
How does the disease phase affect treatment?
A urologic assessment should consider how long symptoms have been present, pain during erection, penile deformity, whether the deformity makes penetration difficult, and erectile function. The European Association of Urology (EAU) uses these factors to guide care; curvature alone does not determine the right treatment. Conservative care is aimed mainly at symptoms and progression in earlier disease, while surgery is generally considered once the disease is stable and deformity compromises intercourse. EAU guidance on penile curvature
Tell the urologist what has changed and how it affects erections and sex. Treatment choices depend on the phase and on the specific goal: easing pain, addressing ED, reducing deformity, or restoring the ability to have intercourse. Some options target one of these problems without treating the others.
Which treatments address which problem?
| Treatment | Main goal | When it may be considered | Important qualification |
|---|---|---|---|
| Oral NSAIDs | Pain | Active or acute disease when pain needs treatment | Safety depends on personal health and other medicines; seek clinician or pharmacist advice. EAU; AUA |
| PDE5 inhibitors | ED | Concomitant ED | Guideline-recommended ED treatment; correct use and instructions matter. EAU ED guidance |
| Vacuum erection device | ED; potentially deformity as part of care | For informed patients seeking non-invasive, drug-free ED management; may also be considered for deformity or multimodal care | Deformity outcome evidence is limited; it is not a reliable straightening treatment. EAU; EAU ED guidance |
| Penile traction device | Deformity | May be considered alone or as part of multimodal care | EAU recommendation is weak and outcome data are limited; discuss use with a urologist. EAU |
| Extracorporeal shockwave treatment (ESWT) | Pain | May be offered for acute-phase penile pain | Guidelines advise against using it to reduce curvature or plaque size. EAU; AUA guideline full text |
| Clinician-administered injections | Curvature in selected cases | Eligibility depends on the drug, disease stability, curvature, and erectile function | These are medical treatments, not at-home products. AUA guideline full text |
| Surgery | Deformity that interferes with intercourse | Generally considered for stable disease after assessment of erectile function and other factors | A specialist weighs the procedure against rigidity, deformity, expectations, and tradeoffs. EAU; AUA guideline full text |
What can help with pain?
NSAIDs for active or acute-phase pain
The EAU recommends non-steroidal anti-inflammatory drugs (NSAIDs) for pain in the acute phase; the American Urological Association (AUA) says clinicians may offer oral NSAIDs to people with active disease who need pain management. These recommendations do not mean NSAIDs are safe for everyone. Health conditions, other medicines, and individual risks can affect whether they are appropriate, so ask a clinician or pharmacist rather than choosing a dose from general advice. EAU guidance; AUA guideline
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Shockwave treatment is a pain option, not a straightening treatment
EAU guidance allows ESWT for acute-phase penile pain. It specifically advises against using it to improve curvature, and the AUA also advises against ESWT to reduce curvature or plaque size. Keep the intended outcome clear when discussing this treatment: a pain intervention should not be presented as a way to correct the deformity. EAU; AUA guideline full text
How is erectile dysfunction managed?
For ED that occurs alongside Peyronie’s disease, the EAU recommends phosphodiesterase type 5 (PDE5) inhibitors and identifies them as first-line ED therapy. They address erectile function, not the penile curvature itself. Ask the prescriber to explain how to use the medicine: incorrect use or inadequate instructions can make a treatment appear ineffective. EAU guidance on ED management
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A vacuum erection device is another option for an informed patient who prefers non-invasive, drug-free ED management. Discuss it with a urologist as a way to address erections, not as a substitute for evaluating the cause of ED or the deformity. Evidence for vacuum devices to reduce Peyronie’s deformity is limited, so dependable straightening should not be assumed. EAU ED guidance; EAU guidance on penile curvature
Can traction or other conservative care change the deformity?
The EAU recommends offering penile traction devices and vacuum devices to reduce deformity or as part of multimodal therapy, but labels this a weak recommendation because outcome data are limited. That means these approaches can be discussed as options, not promised as a cure or reliable way to straighten every penis. A urologist can help decide whether a device fits your condition and what role it would play alongside other care. EAU guidance on penile curvature
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Evidence also varies for other conservative interventions. The EAU describes contradictory evidence for intralesional calcium-channel antagonists and limited data for some approaches; it advises patients that data on platelet-rich plasma remain limited. Ask what outcome is expected and how strong the evidence is before pursuing an intervention.
When might injections be considered?
For collagenase clostridium histolyticum, the AUA says clinicians may offer treatment with clinician and patient modeling for stable disease when curvature is greater than 30° and less than 90°, and erectile function is intact, with or without medication. This is an injection delivered as medical care, not an at-home treatment. The guideline advises counseling about bruising, swelling, pain, and corporal rupture. AUA guideline full text
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The AUA also lists intralesional interferon and verapamil as options, but they have different evidence levels and adverse-effect considerations. They are not interchangeable treatments; a urologist should explain the rationale and risks for any injection being considered. AUA guideline full text
Independent reader supportYour contribution helps us test, update, and keep practical guides available for everyone.When is surgery considered?
EAU guidance recommends surgery only when Peyronie’s disease is stable and deformity compromises intercourse. Before choosing a procedure, a specialist should assess penile length, curvature severity, erectile function—including response to ED medication—complex deformity, and the patient’s expectations. Surgery is a specialist decision rather than an early default. EAU guidance on penile curvature
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The AUA describes different surgical paths according to rigidity and function. Plication or plaque incision/excision with grafting may be considered when rigidity is adequate for intercourse, with or without ED medication or a vacuum device. If ED and/or deformity still prevents intercourse despite medication and/or a vacuum device, penile prosthesis surgery may be considered; the AUA recommends an inflatable prosthesis for prosthetic surgery in Peyronie’s disease. AUA guideline full text
Are supplements or self-directed treatments proven?
The AUA advises clinicians not to offer oral vitamin E, tamoxifen, procarbazine, omega-3 fatty acids, or vitamin E with L-carnitine for Peyronie’s disease because convincing evidence of efficacy is lacking. Do not treat supplements as established ways to resolve curvature, pain, or ED. AUA guideline
Before spending money on a device or pursuing an injection or procedure, ask the urologist which symptom it is intended to address, what benefit is reasonably expected, and what risks or uncertainties apply in your case.
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