Peyronie’s disease can be treated through injections, traction therapy, or surgery, depending on how severe the curvature is and whether the condition is still changing or has stabilized. The first step in choosing the right approach is figuring out which phase you’re in, because treatments that work well in one phase can be premature or ineffective in the other.
Active Phase vs. Stable Phase
Peyronie’s disease progresses through two distinct phases, and your treatment options depend entirely on which one you’re in. During the active phase, the scar tissue (plaque) inside the penis is still forming and changing. Pain during erections is the hallmark symptom of this stage. The curvature, narrowing, or other deformities may still be getting worse. Some men notice an indentation or hourglass shape developing alongside the curve.
The disease is considered stable once symptoms have remained unchanged for at least three months. At that point, the plaque has matured, the curvature has settled into its final shape, and pain is less common. Surgery is only appropriate during the stable phase, since operating on a still-changing plaque can lead to poor results. During the active phase, the focus is on slowing progression and managing pain.
Why Most Oral Treatments Don’t Work
If you’ve searched for Peyronie’s treatments, you’ve probably seen vitamin E, colchicine, and tamoxifen mentioned. The evidence on these is clear, and it’s not encouraging. Controlled trials have consistently found no significant improvement in curvature or plaque size with vitamin E, even in large studies. Colchicine showed no objective improvement in curvature or plaque size in a randomized, double-blind trial. Tamoxifen at 20 mg twice daily produced no significant improvement in pain, curvature, or plaque size compared to placebo. Omega-3 fatty acids and carnitine have also failed to show benefits in controlled studies.
Two oral options have slightly more support. Pentoxifylline showed significant improvement in curvature, plaque volume, and erectile function scores in a double-blind, placebo-controlled study of men with early chronic Peyronie’s. Potassium para-aminobenzoate (sold as POTABA) reduced plaque size compared to placebo in a multicenter trial, though you’d need to take it four times daily for 12 months. Neither of these is a home run, but they have at least some controlled evidence behind them, which puts them ahead of the supplements that dominate online forums.
Injections Into the Plaque
Injecting medication directly into the scar tissue is the most established non-surgical treatment. The best-studied option was collagenase clostridium histolyticum (formerly sold as Xiaflex), which broke down the collagen in the plaque. It was the only FDA-approved injection for Peyronie’s but was withdrawn from the U.S. market in 2020 due to manufacturing issues, not safety concerns. Availability varies by country and may change, so it’s worth asking your urologist about current access.
Verapamil injections remain available and are supported by clinical guidelines. Several clinical trials have shown reductions in plaque size and improvements in curvature and erectile function. However, the evidence is complicated: some studies found that saline injections (the placebo) also reduced plaque size and curvature, raising questions about whether the drug itself is doing the work or whether the mechanical disruption of the plaque from the needle matters. The effect of verapamil remains debated, but it’s generally considered a reasonable option during the active or early stable phase.
Interferon alpha-2b has also been studied in a multicenter, placebo-controlled trial and is another injection option your urologist may offer.
Traction Therapy
Penile traction devices apply a gentle, sustained stretch to the penis over time. Traditional traction devices required 2 to 9 hours of daily wear to produce benefits, which made them impractical for most men. Newer devices have shortened that significantly. One second-generation device (RestoreX) showed improvements in both penile length and curvature with just 30 minutes of daily use. Study protocols tested either 30 minutes per day for five days a week, or 30 minutes twice daily for seven days a week.
Traction therapy is typically used alongside other treatments rather than as a standalone fix. It can be started during the active phase and is also used before or after surgery to preserve or recover length. The commitment is real, but for men looking to avoid or delay surgery, it’s one of the few non-invasive options with measurable results.
Shockwave Therapy: Limited to Pain
Extracorporeal shockwave therapy (ESWT) uses focused sound waves directed at the plaque. It sounds promising, and some clinics market it aggressively for Peyronie’s. The clinical reality is more limited. A prospective study found no significant changes in curvature, plaque size, or sexual function across the full study population. What it did help with was pain: 76% of men with penile pain saw it resolve, and pain seemed to clear up faster than it would have on its own. If pain is your primary symptom, shockwave therapy may help. If you’re trying to correct curvature, the data doesn’t support it.
Surgical Options for Stable Disease
Surgery is the most reliable way to correct significant curvature, but it’s reserved for men whose disease has been stable for at least three months. There are three main approaches, and which one fits depends on the severity of the curve and whether you have erectile dysfunction.
Plication
Plication is the simplest surgical option. The surgeon places stitches on the longer side of the penis (opposite the plaque) to straighten it, essentially shortening the longer side to match the shorter side. This works best for curvatures under about 60 degrees without significant narrowing or hourglass deformity. The trade-off is some degree of shortening, which is the most common complaint regardless of surgical technique.
Plaque Incision and Grafting
For more severe curvatures, the surgeon cuts into or partially removes the plaque and patches the gap with a graft. This can correct larger curves while preserving more length. However, it carries higher risks. Compared to plication, men who underwent grafting were significantly more likely to experience loss of rigidity, reduced sensation, and difficulty with intercourse. Despite these differences, overall satisfaction rates between the two procedures were similar, and both achieved comparable straightening results.
Penile Implant
When Peyronie’s disease coexists with erectile dysfunction that doesn’t respond to medication, an inflatable penile implant addresses both problems at once. The implant itself often straightens the curvature during placement, and if it doesn’t fully correct, the surgeon can perform additional maneuvers during the same operation. This is typically the right choice when the erectile dysfunction is severe enough that straightening alone wouldn’t restore sexual function.
What Recovery From Surgery Looks Like
Recovery after plication (the most common procedure) follows a predictable timeline. You’ll return for a wound check within 24 hours. For the first 48 hours, cold packs help manage swelling. You can’t shower for five days, and baths, pools, and hot tubs are off-limits for two weeks. Cycling and similar activities are restricted for four weeks.
The hardest restriction for most men is the six-week ban on all sexual activity, including masturbation. Surface healing typically takes about six weeks, but complete internal healing can take several months. Patience during this window matters, since stressing the repair site too early can compromise results.
Choosing the Right Approach
The best treatment depends on three factors: whether your disease is still active or has stabilized, how severe the curvature is, and whether you have erectile dysfunction. During the active phase, the focus is on managing pain and potentially slowing progression with traction therapy, pentoxifylline, or injections. Once the disease stabilizes, you can make a clearer decision about whether the curvature is bothersome enough to warrant surgery.
Mild curves (under 30 degrees) that don’t interfere with sex may not need any intervention. Moderate curves often respond well to plication. Severe or complex deformities may require grafting. And when erectile dysfunction is part of the picture, an implant can solve both issues at once. The key is getting an accurate assessment of your curvature angle and erectile function before committing to a treatment path.