What it is
A plaque of scar tissue forms in the tunica albuginea (the tough envelope surrounding the erectile chambers), often after subclinical injury. During the acute phase (roughly 6–18 months) the plaque is inflamed and pain and curvature evolve; a chronic phase follows when the plaque stabilizes.
Symptoms
- Palpable plaque or lump
- Penile curvature (dorsal, lateral, ventral, or complex)
- Pain with erection, particularly early on
- Shortening or narrowing (hourglass deformity)
- Erectile dysfunction in a subset of patients
Evaluation
Diagnosis is largely clinical, with a focused history, exam, and photographs of the erect penis. Duplex ultrasound is used when erectile function or vascular contribution is in question.
Treatment
Non-surgical
Options include intralesional collagenase (Xiaflex), verapamil, or interferon — chosen for eligibility, curvature, and phase. Traction therapy and vacuum devices are adjuncts. Oral therapies alone have limited evidence.
Surgical
Reserved for stable disease with functionally limiting curvature; options include plication, plaque incision/grafting, and — with concurrent ED — penile prosthesis.
Nutrition and lifestyle
General cardiovascular wellness supports erectile physiology and healing: not smoking, blood-pressure control, aerobic fitness, weight optimization, and quality sleep. Antioxidant-focused nutrition is often discussed; evidence for any single oral supplement to reverse plaque is limited, and any regimen should be individualized with your clinician.