In urology, PD almost always refers to Peyronie’s disease, a condition where scar tissue forms inside the penis and causes it to curve during erections. It affects somewhere between 0.5% and 9% of men depending on how the condition is measured, and many cases likely go unreported. While “PD” can also stand for peritoneal dialysis in nephrology or kidney care settings, in a urology clinic the abbreviation points to Peyronie’s disease.
What Peyronie’s Disease Actually Is
The penis contains two cylinder-shaped chambers called the corpora cavernosa that fill with blood during an erection. These chambers are wrapped in a tough, flexible outer layer called the tunica albuginea. In Peyronie’s disease, scar tissue (called plaque) builds up within that outer layer. This plaque is made mostly of collagen and can harden to the thickness of bone in severe cases.
Because the scar tissue doesn’t stretch the way healthy tissue does, the penis bends at the site of the plaque when it becomes erect. The curve can go upward, downward, or to either side. Some men also notice the penis becoming shorter during erections, or developing an hourglass-shaped indentation where the plaque sits.
What Causes It
The leading theory is that Peyronie’s disease starts with trauma to the penis. Sometimes this is a single obvious injury, like bending during intercourse. More often, it results from repeated low-grade stress, such as ongoing attempts at sex with incomplete erections. The body’s healing response overshoots, laying down dense scar tissue instead of normal flexible tissue.
Not every man who experiences penile trauma develops Peyronie’s disease, which suggests genetic factors and differences in wound healing play a role. The condition is most commonly seen in men over 40, though it can occur at younger ages.
Symptoms and How It Progresses
The most common signs include a noticeable bend in the erect penis, a firm lump or band of hard tissue felt under the skin, pain during erections, and difficulty getting or maintaining an erection. The area over the plaque often feels tender to the touch.
Peyronie’s disease moves through two distinct phases:
- Acute (active) phase: This is when the plaque is still forming. The curvature may worsen over time, and erections are often painful. This phase typically lasts up to 12 months but can continue for as long as 18 months.
- Chronic (stable) phase: The plaque stops growing, pain usually fades, and the curvature stabilizes. For most men, this begins 12 to 18 months after symptoms first appear. The curve doesn’t go away on its own, but it stops getting worse.
The distinction between phases matters because it determines which treatments are appropriate.
How It’s Diagnosed
A urologist can usually identify Peyronie’s disease through a physical exam, feeling for the hardened plaque beneath the skin. You may be asked to photograph the curvature at home during an erection so the doctor can measure the angle. In some cases, an ultrasound is used to map the plaque’s location and size and to evaluate blood flow within the penis.
The Psychological Toll
Peyronie’s disease affects more than just physical function. In a large cohort study published in The Journal of Sexual Medicine, about 13% of men with PD also had depression and roughly 17% had anxiety. The visible change in the body, pain during sex, and worry about a partner’s reaction all contribute. Many men avoid intimacy entirely, which can strain relationships further. These emotional effects are a real part of the condition, not a side issue, and treating them alongside the physical symptoms leads to better outcomes.
Non-Surgical Treatments
During the acute phase, when the plaque is still changing, urologists generally prefer non-surgical approaches. Men with mild curvature, little pain, and no trouble with sex may not need any treatment at all. For those with bothersome symptoms, several options exist.
Pain is typically managed with over-the-counter anti-inflammatory drugs. Injections directly into the plaque are an option for men in the active phase or those who aren’t ready for surgery. The only FDA-approved injection is a collagen-dissolving enzyme (sold as Xiaflex). A full treatment course involves up to four cycles spaced about six weeks apart, with two injections per cycle plus a manual straightening procedure performed in the office. In clinical trials, men receiving the injections saw their curvature improve by about 34% over a year, compared to roughly 20% improvement with placebo injections.
Penile traction devices are another option. Older protocols required wearing a device for three to eight hours daily for up to six months, which most men found impractical. A 2019 study from Mayo Clinic researchers tested a newer traction system used for just 30 to 90 minutes per day over three months. More than 75% of men using the device saw measurable improvement, with an average reduction of 17 degrees of curvature. Over a quarter of participants gained 20 degrees or more of correction.
When Surgery Becomes an Option
Surgery is reserved for men whose curvature has stabilized (the chronic phase), whose bending is severe enough to prevent intercourse, and who have waited at least a year from the onset of symptoms. The two main surgical approaches offer different trade-offs.
Plication is the simpler procedure. The surgeon places stitches on the longer side of the penis to match the shorter, scarred side, straightening the shaft. It’s faster, carries lower risk of erectile problems, and preserves sensation well. The main downside is that some men can feel small nodules at the stitch sites, and the penis may become slightly shorter because the longer side is being pulled in.
Plaque incision with grafting is used for more severe curvature or when shortening is a concern. The surgeon cuts into or removes the plaque and patches the area with graft tissue. This approach better preserves length but carries higher rates of reduced rigidity, loss of sensation, and, in some cases, new erectile dysfunction. A study comparing the two found that grafting patients were significantly more likely to experience these complications.
For men who have both significant curvature and erectile dysfunction that doesn’t respond to medication, a penile implant can address both problems at once, straightening the penis while providing the rigidity needed for intercourse.
Other Meanings of PD in Medical Settings
If you encountered “PD” outside a urology-specific context, it could refer to peritoneal dialysis, a treatment for kidney failure where waste products are filtered through the lining of the abdomen rather than through a machine. It can also abbreviate Parkinson’s disease, which sometimes overlaps with urology because Parkinson’s frequently causes bladder control problems. In a urology office or urology-focused medical record, though, PD nearly always means Peyronie’s disease.