Peyronie's disease (PD) is a benign inflammatory disease of the penis characterised by the formation of fibrous plaques in the tunica albuginea of the corpora cavernosa, causing penile curvature, shortening or thinning.

The cause of PD remains unclear, although several hypotheses suggest that an alteration in the healing process is the most likely cause.

The average age of onset is around 50 years, and its prevalence increases with age, from 1.5% at age 30 to 6.5% in those over 70.

ELP typically occurs in two phases:

1. Inflammatory phase (6–12 months): characterised by pain during erections, progressive deformity, and the appearance of plaques on the penis.

2. Stabilisation phase (from 12 months onwards): disappearance of pain, stabilisation of deformity and hardening of the plates..

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Treatment

Without treatment, progression occurs in 48% of cases, stabilisation in 40% and spontaneous improvement in 12%.

Treatment of ELP is carried out in the stable phase, when the deformity can no longer progress. Treatment in the inflammatory phase is aimed at controlling pain with analgesic medication.

In the stable phase, no oral treatment has been shown to reduce the degree of curvature.

The most widely accepted treatments are as follows:

Intraplaque treatment

Clostridium collagenase injection: indicated for mild curvatures. Reduces the collagen content of the plaque, decreasing the degree of curvature by up to 38%.

Surgical treatment

1. Plication techniques: indicated for mild/moderate curvatures (<60º). Scleral grafts are performed to correct the deformity. The most commonly used techniques are the Nesbit, Yachia, and 16-point techniques..

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2. Patch techniques: Indicated for severe curvatures (> 60º). An incision or excision of the plaque is made and a replacement graft is placed..

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Penile prostheses

In severe deformities with associated severe erectile dysfunction.