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What should you do if your penis starts to curve?

This question originally appeared on Quora. Answer by Keck Medicine of USC.

It can be hard to talk about issues below the belt, but if you or your partner experiences this problem; you don’t need to suffer any longer. Has sex been less fun and more painful in the bedroom? Have you noticed that something down below is curving like a banana? Is this affecting your relationship?

Having a slight bend to your erect penis can be normal. However, having a curvature that precludes penetration or causes painful intercourse is not. Learn more about Peyronie’s disease, a progressive, painful and psychologically debilitating disease causing penile curvature. There is now a new, non-surgical treatment option to improve your symptoms.

Dr. Leo R. Doumanian, associate professor of clinical urology at the USC Institute of Urology of Keck Medicine of USC and USC Verdugo Hills Hospital treats several men per month with Peyronie’s disease, or penile curvature. For these men, there is now hope. Learn more about the new injectable therapy.

What is Peyronie’s Disease?

Peyronie's disease manifests as a progressive penile curvature during erection and oftentimes causes pain, both of which can prevent a man from having penetrative sex. The degree and direction of penile curvatures can range. However, the vast majority of curvatures are either directed laterally to the side or bent upwards towards the ceiling.

The curvature is caused by the development of scar tissue, also called a Peyronie’s plaque, surrounding the erectile bodies of the penis. The plaque may spontaneously develop due to genetic factors or sometimes, there's an inciting factor, such as an injury to the penis. However, the exact cause of Peyronie’s disease is unknown. Without treatment, the curvature can worsen and seldom spontaneously resolves.

The disease can be psychologically debilitating and can affect your partner, too. Fortunately, there are effective treatment options available.

Who Gets Peyronie’s Disease?

Peyronie’s disease is most likely to affect men 40 to 60 years of age. Up to half of men with Peyronie’s disease also experienced erectile dysfunction. An estimated 338 in 100,000 or about 65,000 men in the United States are diagnosed with Peyronie’s disease each year. Dr. Doumanian believes this number is greatly underestimated because many men are too embarrassed to seek urological consultation for such an intimate problem.

How is Peyronie’s Disease Treated?

Xiaflex is a new injectable drug that was approved by the U.S. Food and Drug Administration in late 2013. Men with penile curvature have plaques in the fibrous connective tissues surrounding their erectile bodies. By injecting this medication into the plaque, an enzymatic reaction causes the fibrous scar tissue to soften and disintegrate. Envision a hot knife cutting through a stick of butter. Reduction in the size and nodularity of the plaque results in less curvature and a straighter erection.

Most men require up to four treatment cycles of Xiaflex to get the best results. A cycle typically includes an in-office injection, a waiting period of 1 to 3 days followed by a second in-office injection. This is followed by another 3 day waiting period and then an in-office session on penile remodeling to help straighten the penile curvature. You will continue practicing gentle stretching and straightening exercises at home. The waiting period between treatment cycles is six weeks on average.

What If That Doesn’t Work?

If the injections do not help with your penile curvature, surgery may be necessary. Surgical correction can involve excision of the plaque to help straighten the curvature.

If you or your partner suffers from penile curvature, make an appointment with a urologist.

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