Peyronie's disease is more common than most men realize, and it is rarely something anyone wants to bring up. Fibrous scar tissue — called plaque — forms inside the tunica albuginea, the tough sheath that surrounds the erectile chambers. Because scar tissue does not stretch the way healthy tissue does, the penis bends toward the plaque during an erection. Some men notice a curve. Others notice pain, an hourglass or indentation deformity, loss of length, or erections that no longer feel firm enough for sex.
It is a real medical condition with a real physical cause, not a matter of technique or willpower, and it is treatable. What it is not is a condition with a single simple fix. The honest picture is that some treatments for Peyronie's disease are well supported by clinical evidence, some are supported only for specific symptoms like pain, and some are still considered experimental by the American Urological Association and the European Association of Urology. A page that tells you otherwise is selling you something.
At Atlanta Medical Institute in Buckhead, our approach is to evaluate you properly first — history, examination of the plaque, a frank conversation about erectile function and what is actually bothering you — and then walk through the options in plain language, including the ones we do not perform ourselves. Dr. Leslye Pace, our Chief Medical Officer, brings a regenerative medicine and pain background to this work, and our physicians will tell you directly when a urologist or a surgical consultation is the more appropriate next step.
Eligibility for any treatment, and the specifics of any protocol, are decided by a physician after an in-person evaluation. Nothing on this page is a promise of a particular result, and results in Peyronie's disease vary considerably from one man to the next.
Program Benefits
- Physician evaluation of plaque location, curvature, and erectile function before any treatment is recommended
- A candid explanation of which options are FDA-approved, which are off-label, and which are still investigational
- Acoustic wave therapy for men whose primary complaint is penile pain, with realistic expectations set up front
- Assessment of contributing factors such as low testosterone, diabetes, and vascular disease
- Coordination and referral to a urologist when intralesional drug therapy or surgery is the better path
- Discreet, unhurried appointments at a single Buckhead office
What Causes the Plaque to Form
The prevailing explanation is that repeated microtrauma during intercourse triggers an abnormal wound-healing response in the tunica albuginea. Instead of the tissue remodeling normally, collagen is laid down in a disorganized way and the scar persists. Most men cannot point to a single injury, which is part of what makes the condition so confusing when it appears.
Several factors are associated with a higher likelihood of developing Peyronie's disease or a more severe course, including diabetes, vascular disease, low testosterone, smoking, pelvic or prostate surgery, and Dupuytren's contracture of the hand, which involves a similar fibrotic process. Identifying and addressing those contributors is part of a complete evaluation, not an afterthought.
The Acute Phase and the Stable Phase
Peyronie's disease typically moves through two phases, and which phase you are in changes what treatment makes sense. The acute or active phase generally covers the first six to eighteen months. Pain is most common here, the curvature may still be changing, and the plaque is still forming. The chronic or stable phase follows, usually after roughly twelve to eighteen months, when pain has often settled and the deformity has stopped progressing.
Waiting it out is not a reliable strategy. The published natural-history literature suggests that spontaneous improvement happens in only a minority of men — on the order of one in eight in the frequently cited series — while a substantial share stay the same and a substantial share get worse. That is a good reason to be evaluated early rather than hoping it resolves, even though many treatments are deliberately reserved for the stable phase.
Are You a Candidate for Evaluation?
An evaluation is reasonable for any man who has noticed a new bend, a palpable lump along the shaft, pain with erections, an indentation or narrowing, loss of length or girth, or erections that have become unreliable. You do not need a dramatic curve to be worth seeing — pain and erectile difficulty are legitimate reasons on their own.
A few situations warrant prompt attention rather than watchful waiting.
- A curve that is visibly progressing month to month
- Pain with erections that is not improving
- Curvature severe enough that intercourse is difficult or impossible
- New erectile dysfunction alongside the deformity
- A sudden bend with bruising or a popping sensation, which can indicate penile fracture and is an emergency
What to Expect at Your Visit
Your first appointment at our Roswell Road office is a conversation and an examination. We take a history of when you first noticed the change, whether it has progressed, whether erections are painful, and how erectile function has held up. The physician examines the shaft to locate and characterize the plaque. Photographs of an erection taken at home, or an in-office assessment, are often used to document the actual degree of curvature, because self-estimates tend to be imprecise and the degree matters for treatment decisions.
Because Peyronie's disease so often travels with other issues, we also look at the broader picture: testosterone and other hormone levels where indicated, cardiovascular and metabolic risk factors, and medications. Low testosterone and untreated vascular disease can both worsen erectile function and complicate treatment, and they are worth addressing on their own merits.
From there we lay out the options — including the ones delivered by a urologist — and you decide what to pursue. Nothing is dispensed or performed on the strength of a web page or a phone call.
Treatment Options and What the Evidence Actually Shows
It is worth being precise about the evidence, because this is an area where marketing frequently outruns the data.
Collagenase clostridium histolyticum, sold as Xiaflex, is the only drug FDA-approved for Peyronie's disease. Per the FDA label it is indicated for adult men with a palpable plaque and a curvature deformity of at least 30 degrees at the start of therapy, and it was studied in the IMPRESS I and II randomized trials. It is an intralesional injection given by a trained clinician in cycles, and the label carries a boxed warning about corporal rupture — penile fracture — and other serious penile injury, with distribution restricted to certified prescribers. It is a serious medical therapy and belongs in the hands of a clinician who performs it regularly.
Penile traction therapy is a mechanical, non-drug approach with a reasonable and growing evidence base for modest improvements in curvature and length when used consistently over months. Devices in this category are registered with the FDA as low-risk Class I devices rather than approved after efficacy trials, which is a meaningfully different standard. Intralesional verapamil and interferon alpha-2b are additional injectable options that AUA guidance says may be offered, though the effect sizes are more modest than with collagenase.
Acoustic wave therapy, including branded protocols such as GAINSWave, deserves a clear statement rather than a sales pitch. Low-intensity shockwave therapy is not FDA-approved for erectile dysfunction or for Peyronie's disease. The devices used are cleared for other indications and applied off-label here. AUA guidance is specific on this point: shockwave therapy should not be used to reduce penile curvature or plaque size, but it may be offered to improve penile pain, which is where the evidence is most consistent. Systematic reviews report reliable pain benefit and inconsistent, sometimes no better than sham, results for curvature. If you are considering it, consider it for pain.
Platelet-rich plasma, stem cell, and exosome injections for Peyronie's disease remain investigational. Early human studies have been encouraging enough to justify continued research, but both AUA and EAU guidance still classify these as experimental, and we will say so plainly rather than present them as established care. Oral agents such as vitamin E have generally not held up in controlled trials.
Surgery — plication, plaque incision or excision with grafting, or a penile implant when significant erectile dysfunction coexists — remains the most definitive option for stable, severe deformity, and is performed by a urologist. We will refer you when that is the right answer.
Safety, Monitoring, and Follow-Up
Any treatment we offer is preceded by a physician evaluation and followed by structured reassessment. We document baseline curvature and erectile function so that change can be measured rather than guessed at, and we reassess on a defined schedule instead of continuing a protocol indefinitely because it has been paid for.
We will also tell you when to stop. If a therapy is not producing meaningful change for you, continuing it is not in your interest, and a referral for intralesional drug therapy or surgical consultation is the appropriate step. Report any new pain, bruising, swelling, or sudden change in shape promptly — sudden severe pain with bruising and loss of erection can indicate penile fracture and needs emergency care.
How This Fits with Our Other Men's Health Services
Peyronie's disease rarely shows up alone. Erectile dysfunction, low testosterone, and metabolic conditions frequently sit alongside it, and treating the curve without looking at the rest of the picture tends to leave men only partly better. Because our Buckhead office handles men's health, hormone therapy, and weight management under one roof, those threads can be pulled together in one evaluation.
Related services at Atlanta Medical Institute:
- Erectile dysfunction evaluation and treatment — /services/erectile-enhancement-ed
- Acoustic sound wave therapy — /services/acoustic-sound-wave-therapy
- GAINSWave protocol information — /services/gainswave
- Low testosterone evaluation and treatment — /services/low-testosterone-treatments
- Premature ejaculation — /services/premature-ejaculation
- Regenerative approaches, including stem cell and exosome therapy — /services/stem-cells-exosomes-therapy
- Medical weight loss, which can improve vascular and erectile health — /services/weight-loss-atlanta-ga
- Meet Dr. Leslye Pace — /about/dr-leslye-pace
Frequently Asked Questions
Will Peyronie's disease go away on its own?+
Usually not. The natural-history literature suggests only a minority of men — roughly one in eight in commonly cited series — see spontaneous improvement, while many remain unchanged and a meaningful share worsen. Pain often fades on its own as the condition stabilizes, but the curvature typically does not. That is why an early evaluation is worthwhile even if nothing is done immediately.
Is GAINSWave or acoustic wave therapy FDA-approved for Peyronie's disease?+
No. Low-intensity shockwave therapy is not FDA-approved for Peyronie's disease or for erectile dysfunction. The devices are FDA-cleared for other indications and used off-label here. American Urological Association guidance says shockwave therapy should not be used to reduce curvature or plaque size, but may be offered to improve penile pain — which is where the published evidence is most consistent. Anyone telling you otherwise is overstating the case.
What is the only FDA-approved medication for Peyronie's disease?+
Collagenase clostridium histolyticum, marketed as Xiaflex. Per the FDA label it is indicated for adult men with a palpable plaque and a curvature deformity of at least 30 degrees at the start of therapy. It is injected into the plaque by a trained clinician, its label carries a boxed warning regarding corporal rupture and other serious penile injury, and it is distributed only through certified prescribers. Whether it is appropriate for you is a decision for a physician after evaluation.
Do I have to wait until the condition is stable before being treated?+
Not for evaluation. Several treatments, including collagenase injection and surgery, are generally reserved for the stable phase once the curve has stopped changing — typically after about twelve months. But the acute phase is when pain is most common and when contributing factors such as low testosterone or poorly controlled diabetes are most useful to address. Come in when you notice the problem; we will tell you what makes sense now and what should wait.
Can Peyronie's disease be cured?+
We would avoid that word. Treatment aims to reduce curvature, relieve pain, and restore function well enough for comfortable intercourse, and many men achieve a meaningful improvement. Some scar tissue usually remains, results vary considerably between individuals, and no treatment guarantees a particular degree of correction. A physician can give you a realistic sense of range after examining you.
Are PRP or stem cell injections a good option for my curvature?+
They are still investigational for Peyronie's disease. Early human studies have shown some reduction in curvature and plaque size, which is why research continues, but both AUA and EAU guidance classify platelet-rich plasma and stem cell therapy as experimental. We will discuss them honestly as research-stage options rather than present them as established treatment.
Do I need surgery?+
Many men do not. Surgery — plication, plaque incision or excision with grafting, or a penile implant when significant erectile dysfunction is also present — is generally reserved for stable, severe deformity that prevents intercourse or that has not responded to non-surgical treatment. It is performed by a urologist, not at our office, and we will refer you if that is the appropriate step for you.
How do I make an appointment?+
Call Atlanta Medical Institute at (404) 264-9553 or use the contact form at /contact. We are at 5009 Roswell Road NE, Suite 201, Atlanta, GA 30342, in Buckhead — our only location — and we see patients Monday through Thursday 9 to 6 and Friday 9 to 4. Appointments for this condition are handled discreetly.
Costs and appointment planning
Review pricing questions, insurance and coverage information, and telehealth visit planning before booking. Confirm the costs and services that apply to your individual care.
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Call us at (404) 264-9553 or book a telehealth consultation. New patients qualify for our 1st month Semaglutide special — $399 (regularly $450).