Non-surgical treatment for Peyronie’s disease
Not every bend needs an operation, and not every treatment sold for Peyronie’s disease works. This guide sets out what non-surgical treatment can realistically achieve, in which phase, and when surgery becomes the better choice.
Peyronie’s disease is scar tissue, called a plaque, in the tough sheath around the erectile tissue of the penis. Because scar does not stretch like normal tissue, the penis bends towards it during an erection. This guide answers the question many men start with: can it be treated without an operation?
Non-surgical treatment has a real place, but a narrower one than is often suggested. What it can achieve depends on three things: the phase of the disease, the degree of curvature and the quality of your erections. And not every man needs treatment at all. If the curve is mild, sex is comfortable and satisfactory, and the disease is stable, observation is entirely reasonable.
| Treatment | When it is used | Realistic role |
|---|---|---|
| Pain control and reassurance | Active phase | Controls pain while it settles, which it almost always does by itself |
| Tablets and creams | Sometimes in the active phase | Of limited proven benefit |
| Traction or vacuum device | Daily, over three to six months | May help maintain length in selected men; can help correct some of the curvature |
| Injection into the plaque | Selected men, as a course of treatments | An option with other agents; collagenase (Xiapex) is no longer available in the UK |
| Low-intensity shockwave | Active phase | May help with pain; the evidence that it corrects curvature is weak |
Can Peyronie’s disease be treated without surgery?
Yes. Non-surgical treatment can be trialled in both the active and the stable phase, and it can reduce the need for surgery or reduce the extent of surgery needed.
The realistic aims are to control pain while the disease is active, to maintain length, to limit the curve and to keep sex possible. Even the better-supported options are described in modest terms: BAUS says traction and vacuum therapy “can help correct some of the curvature”, which is an improvement rather than a reversal.
Reducing the extent of surgery is a worthwhile goal in itself. Plication, the simplest straightening operation, works by shortening the longer side of the penis, and it is best suited to curves under about 60 degrees in men with good erections and adequate length. If non-surgical treatment keeps the curve smaller and preserves length, a simpler operation may be enough later.
Are there any cures for Peyronie’s disease in the UK?
There is no single cure. Pain usually settles by itself and the curve can be treated, but no treatment can be relied on to return the penis exactly to how it was.
The curvature resolves on its own in only a small minority of men; in most it stays the same or worsens during the active phase before stabilising. Collagenase (Xiapex), an injection you may have read about, has been withdrawn from the European market and is no longer available in the UK. Even surgery, as the NHS notes, does not usually straighten the penis to how it was before it curved. The realistic goal is a penis that is comfortable and functionally straight for satisfying sex.
Why does the phase of Peyronie’s disease matter?
Because the goals differ. In the active phase the curve is still changing and pain is common; in the stable phase it has settled, and only then is surgery appropriate.
The active (acute) phase usually lasts six to twelve months. The stable (chronic) phase follows, once the curve has stopped changing and pain has usually resolved. Surgery is reserved for disease that has been stable for at least three to six months, which in practice is usually at least twelve months from when symptoms began, because operating on a curve that is still evolving risks an incomplete result.
Non-surgical treatment is not restricted in the same way and can be trialled in either phase, although pain control and shockwave are mainly relevant while the disease is active. Taking dated photographs of a natural erection every few months is a simple way to show whether your curve is still changing.
How is the pain of Peyronie’s disease managed?
Pain on erection is usually worst early on and almost always settles by itself, so the aim is to control it while it does, with pain relief and reassurance.
Reassurance matters more than it might sound. The lump is scar tissue, not a tumour, and it does not become cancerous; many men delay seeking help because they fear otherwise. Knowing that the pain has a predictable course makes it easier to live with. Low-intensity shockwave therapy may help with pain in the active phase. If pain is affecting your sleep or your sex life, tell me rather than simply putting up with it.
Do tablets or creams work for Peyronie’s disease?
Oral and topical treatments are of limited proven benefit. They are sometimes used in the active phase, but I would not rely on them to straighten a curve.
If you are considering products sold online, ask what evidence supports them before spending money and, more importantly, time. Peyronie’s disease can cause loss of length, and months spent on a treatment that does not work are months in which other options are not being used. If your erections have also weakened, that deserves treatment in its own right — see erectile dysfunction — and it matters for planning, because the quality of your erections shapes which treatments are appropriate.
Does traction or a vacuum device help Peyronie’s disease?
In selected men, yes. Traction therapy and vacuum devices may help maintain length, and BAUS guidance says that consistent use can help correct some of the curvature.
The commitment is the deciding factor. BAUS describes using a vacuum erection device twice a day for 10 minutes, or a penile traction (extender) device for six hours each day, over a period of three to six months. The NHS likewise notes that these devices need to be used every day for several months, and that they are not usually available on the NHS. Before you buy one, be honest with yourself about whether that routine is realistic alongside work and family life.
Length is the main reason these devices are worth considering. Peyronie’s disease itself can cause shortening, plication shortens the penis by design, and BAUS is explicit that a penile implant will not restore length lost through Peyronie’s disease. Preserving the length you have keeps more options open later. Where a graft has been used at surgery, I may also advise a vacuum device or traction during recovery to maintain length and prevent contraction.
Are injections for Peyronie’s disease available in the UK?
Collagenase (Xiapex) is no longer available in the UK, having been withdrawn from the European market. Injection of other agents into the plaque remains an option in selected men.
Intralesional treatment means injecting an agent directly into the plaque over a course of treatments. It is something I offer, and whether it suits you depends on the plaque, the phase of the disease and what you are hoping to achieve. I will explain what is involved and what a realistic result looks like for you before you decide. If you have read about collagenase elsewhere, bear in mind that information written before its withdrawal may still be online.
Is shockwave therapy worth it for Peyronie’s disease?
Low-intensity shockwave therapy may help with pain in the active phase, but the evidence that it corrects curvature is weak. It is not a substitute for surgery in significant deformity.
That puts the decision in proportion. Active-phase pain almost always settles by itself, so the question is whether easing it sooner justifies a course of treatment. If the main problem is the bend itself, shockwave is not the answer, and you should be cautious of any clinic that presents it as a way to straighten the penis.
What is the most successful treatment for Peyronie’s disease?
It depends on the phase, the curve and your erections. For a significant curve that has stabilised and stops intercourse, surgery is the most reliable way to straighten the penis.
In practice the options line up roughly like this:
- Mild, stable curve and comfortable sex — observation.
- Active disease with pain — pain control and reassurance, with shockwave as an option for the pain.
- Concern about length — traction or a vacuum device, if you can commit to daily use.
- Stable, significant curve with good erections — plication for less severe curves, or plaque incision and grafting for severe curves and hourglass deformity.
- Significant curve with erectile dysfunction that has not responded to medication — a penile implant with straightening at the same operation.
When should I consider surgery instead?
When the disease has been stable for at least three to six months and the curve still prevents or seriously interferes with intercourse, or is causing you significant distress.
The straightening operations involve genuine trade-offs. Plication carries a lower risk of erectile dysfunction and loss of sensation, but it shortens the penis. Plaque incision and grafting suits more severe bends and generally causes less shortening, but carries a higher risk of erectile dysfunction and altered sensation. Where erectile dysfunction is significant, an implant treats both problems in one operation. The choice depends on what matters most to you — length, straightness or reliability of erection.
Which Peyronie’s treatments should I be wary of?
Be wary of anything that promises a cure without surgery, and of any decision made before the disease has been properly assessed. The common pitfalls are:
- Waiting indefinitely. Waiting during the active phase is reasonable; waiting for years in the hope that the curve will straighten by itself is not.
- Operating too early. Surgery on active disease is the commonest reason for a disappointing result, because the curve can keep changing afterwards.
- Relying on shockwave or tablets to straighten the penis. The evidence that either corrects curvature is weak or limited.
- Skipping assessment. A lump in the penis should be examined to confirm the diagnosis, and a baseline measurement of the curve is what lets you judge later whether any treatment is working.
Can you live a normal life with Peyronie’s disease?
Yes, many men do. If the curve is mild and sex is comfortable, no treatment is needed; if it is not, Peyronie’s disease is treatable.
It is common, affecting an estimated 3–9% of men, and far more men have it than seek help for it. Many live with it for years before mentioning it, often assuming that nothing can be done or that it is somehow their fault. Neither is true. Distress, low mood and relationship strain are extremely common, and they are a legitimate reason to seek treatment in their own right, not a side issue. If you have a partner, it can help to talk the options through together, since many of the trade-offs affect you both.
What happens when you see me about Peyronie’s disease?
I establish the direction and degree of the curve, whether the disease is active or stable, the quality of your erections, and how much the problem affects you.
That involves your history, examination of the plaque, and objective measurement of the curve — usually from photographs of a natural erection taken at home, or by inducing an erection in clinic with an injection. Penile duplex ultrasound is used where erectile function needs assessing at the same time, because that changes which treatment is appropriate. You leave with a plan, which may be observation, a defined period of non-surgical treatment with a review date, or a discussion of surgery if the disease is stable. More detail is on my Peyronie’s disease page, and you can contact my team to book.
Sources and further reading
Frequently asked
How much does a private consultation for Peyronie's disease cost?
An initial consultation is £350 in person or £300 by video or telephone, and a follow-up is £250. Investigations such as ultrasound are charged separately by the hospital, and you are told the cost before they are arranged. Traction and vacuum devices are not usually available on the NHS, so they are generally bought privately. If surgery is recommended, you receive a written quotation first. See fees and insurance.
Can I have a video consultation about Peyronie's disease?
Yes, and it is a sensible first step for taking a history, reviewing photographs of your curve and discussing the options. Examining the plaque, and measuring the curve in clinic where photographs are not enough, needs an in-person visit, and a physical examination is normally needed before surgery is planned. A video or telephone initial consultation is £300.
What should I bring to a Peyronie’s disease appointment?
Photographs of a natural erection taken at home are the most useful thing you can bring, ideally from above and from the side so that the direction and degree of the bend are clear. If you have older photographs, bring those too, because comparing them shows whether the curve is still changing. A list of your medicines and anything you have already tried for the condition also helps.
Is Peyronie's disease linked to erectile dysfunction?
Yes, in both directions. Erectile dysfunction is a recognised risk factor, because a less rigid penis buckles more easily during sex, and Peyronie’s disease can itself cause difficulty getting or keeping an erection, or instability during intercourse. The quality of your erections matters a great deal to the treatment plan, so it is assessed at the same time. See erectile dysfunction.
Can I buy a traction or vacuum device without seeing a specialist?
You can, since they are not usually available on the NHS and are generally bought privately, but I recommend assessment first. Knowing whether the disease is active or stable, and measuring the curve at the start, tells you whether a device is the right tool and lets you judge later whether it is working. Any lump in the penis should also be examined to confirm the diagnosis.
Does Peyronie's disease only affect older men?
No. It mainly affects men over 40, but younger men can also get it. Whatever your age, the treatment options are guided by the same three things: whether the disease is active or stable, the degree of curvature, and the quality of your erections. A younger man with a mild, stable curve may need no treatment at all, just as an older man might.
Is a lump in my penis always Peyronie's disease?
Not necessarily, which is why any lump should be examined. In Peyronie’s disease the lump is a plaque of scar tissue in the sheath around the erectile tissue. It is not a tumour and it does not become cancerous. Many men delay seeking help because they fear cancer; having the lump examined confirms the diagnosis and means treatment can be planned properly.
Speak to my team
Appointments at The Shard and Canary Wharf are arranged by my PA, Jeanette Bush. Tell us briefly what the problem is and we will find the right clinic slot for you.