How Peyronie's Disease Is Diagnosed

Initial diagnosis of Peyronie's disease may be based on self-report of curvature of the penis and/or pain with erection. The healthcare provider may also ask questions about other symptoms or use a structured questionnaire designed for men who may have Peyronie's disease. However, in order to determine the extent of the disease, a physical examination is often needed. Sometimes this will consist only of the healthcare provider examining the flaccid penis and seeing if plaques or scars can be felt. Other times, this may require an examination of the erect penis and/or diagnostic imaging.

Self-Checks

People who are concerned they might have Peyronie's disease should ask themselves the same questions that a healthcare provider would in an exam. Answering these questions can give an idea about whether a diagnosis of Peyronie's disease is likely, and it can help you prepare to talk to a healthcare provider about your condition. That's important because sexual health and sexual function can be difficult to discuss with anyone, let alone an authority figure like a healthcare provider. Therefore, the more prepared you are, the easier it will be.

Peyronie's Disease Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

Download PDF

Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life.

Sign Up

You're in!

Thank you, {{form.email}}, for signing up.

There was an error. Please try again.

Questions to ask yourself if you suspect you might have Peyronie's disease:

1. Do I have pain in my penis when I get an erection?
2. Do I have trouble getting an erection that is as firm as it used to be?
3. Is my penis curved when I have an erection? Has this curve changed over time?
4. Does my penis seem shorter than it used to when it is erect?
5. Does my penis seem like it has an indentation, or an hourglass shape, when it is erect?
6. Have I noticed a new nodule, or bump, in my penis?
7. Do I have problems having penetrative sex because my penis bends or buckles?

Not all cases of Peyronie's disease need treatment. However, sometimes early treatment of Peyronie's disease can help improve long-term function.

One thing to note: having an erection that isn't as firm as it used to be, or having trouble getting an erection, isn't necessarily suggestive of Peyronie's disease on its own. There are many causes of erectile dysfunction.

Labs and Tests

Initial diagnosis of Peyronie's disease usually occurs after your healthcare provider asks you a number of questions about your sexual history and sexual health. However, there are also several types of tests that may be indicated for diagnosing Peyronie's, determining how severe it is, and figuring out whether treatment is appropriate. Tests can also be helpful in determining which treatment is appropriate, if treatment is indicated.

Palpation

The first test for Peyronie's disease is the healthcare provider palpating the flaccid penis. During this test, the healthcare provider will be feeling the penis for areas that seem indented, hard, or otherwise different from the rest of the penis as a whole.

At this time, the healthcare provider may also measure the length of the stretched, flaccid, penis. The ability to stretch the penis is also a measure of penile health.

Peyronie's Disease Questionnaire (PDQ)

To test the extent of your Peyronie's disease, your healthcare provider may also use the Peyronie's Disease Questionnaire (PDQ). The PDQ is a 15-item test that asks about psychological and physical symptoms that can be caused by Peyronie's disease and about how bothersome those symptoms are. It can be both used as a way to determine the severity of disease and to see how and if treatment is improving your ability to function.

Measurement of Curvature

This test is usually done on the erect penis. To help you have an erection in the healthcare provider's office, the healthcare provider will usually inject your penis with medication that causes it to become erect. At this point, the healthcare provider will measure the curve of your erection. Ideally, this is done with a device known as a goniometer. However, it can also be done manually.

Blood Tests

Some healthcare providers will use blood tests to assess testosterone levels in men who are suspected to have Peyronie's disease, but this is somewhat controversial. There is not a clear, well-established association between testosterone levels and Peyronie's disease.

However, there is some suggestion that an inability to have a firm erection may increase the risk of Peyronie's. This could also be linked to testosterone levels, although low testosterone on its own does not usually cause erectile dysfunction in the absence of other health problems.

Imaging

Ultrasound is the major type of imaging used to diagnose Peyronie's disease. Your healthcare provider uses ultrasound of your erect penis to look for any issues with blood flow that could point to other problems that can affect erectile function. High-resolution ultrasound can also be used to identify the plaques and scarring that are the hallmark of Peyronie's disease.

Other imaging tests can also be used to identify plaques in the penis at various stages of formation.

• X-ray can identify changes in the soft tissue of the penis
• CT scans can identify plaques before they have started to calcify
• MRI can identify early signs of Peyronie's disease, but is usually not used because of cost.

Differential Diagnoses

There are a few other conditions that may be mistaken for Peyronie's disease

• Sclerosing lymhangitis causes a superficial, rope-like lesion on the penis. It is usually the result of extremely vigorous sex. This type of lesion usually resolves on its own after a period of abstinence
• Trauma to the penis, such as a penile fracture, can many of the same features as Peyronie's disease.
• Erectile dysfunction may be mistaken for the early symptoms of Peyronie's disease.
• Cancer in the penis (either primary or metastasis from elsewhere) can present with some of the same symptoms as Peyronie's disease, including pain with erection and penile curvature. This is extremely rare, however.

Talking to a Healthcare Provider

It can be frightening to go to your healthcare provider and talk about your sexual health. People are often taught that sex isn't something you talk about outside the bedroom. However, it can be extremely important to learn to talk about it in the diagnosis room.

If you're concerned about discussing your sexual health symptoms with your healthcare provider, write them down. If you think you might not be comfortable talking about your symptoms, providing a written list can help you get the care you need. You will likely still need to answer some additional questions from your healthcare provider, but writing your symptoms down can make it easier to start the conversation.

And remember, urologists have extraordinary amounts of training in penile health. The likelihood that you're going to show them something they haven't seen before is pretty low. And even if you do, their role isn't to judge you. It's to help you feel better.