The circumference of the shaft may also be reduced, resulting in an erect penis that is flail at the site of the constriction, firm proximal to the constriction and soft distally. The first symptom of Peyronie's disease may be focal pain with erection, new curvature with erection or inability to penetrate as a result of curvature or distal flaccidity. 3,4 Some patients who do not have pain with erection have tenderness on palpation of the indurated plaque. Penile curvature associated with Peyronie's disease. Penile cross-section showing plaque between the corpora.
Fibrous plaque prevents uniform lengthening as erection occurs.
As the rest of the corpus cavernosum and corpus spongiosum lengthen, the penis bends toward the involved area. A number of authors believe that Peyronie's disease results, in part, from trauma. 5-7 More than 75 percent of patients with Peyronie's disease are between 45 and 65 years of age, when elasticity of the collagen of the penis has diminished. 5 Many patients recall an episode of penile trauma, such as an invasive procedure, blunt trauma or injury during intercourse, at the site of subsequent plaque formation. Some authors 5,12 suggest that either a single episode or recurrent episodes of flexion of the tunica albuginea may result in tears that bleed and form a clot, with subsequent fibrin deposition.