Peyronie’s Disease Treatment in London: Non-Surgical Options
- Fabio Castiglione
- Mar 14, 2023
- 5 min read
Updated: 10 hours ago
Non-surgical treatment for Peyronie’s disease depends on whether the condition is still changing, the degree and type of deformity, pain, penile length, erection quality and the effect on intercourse. No single medicine, injection or device is right for every patient.
The first priority is an accurate assessment. Shockwave therapy may help pain but does not reliably straighten curvature; PRP remains investigational; and surgery may still be the most predictable option when deformity is stable and prevents intercourse.
What is Peyronie’s disease?
Peyronie’s disease is an acquired disorder in which fibrous plaque forms within the tunica albuginea of the penis. During erection, the affected area stretches differently from surrounding tissue, which can cause curvature, indentation, an hourglass shape, hinge instability or loss of length.
The condition may also cause pain, erectile dysfunction, difficulty with penetration and significant anxiety. A natural slight curve is not the same as Peyronie’s disease, and sudden penile pain or deformity should be assessed rather than self-diagnosed.
Active phase and stable phase
Active or changing phase
During the active phase, pain may be present and the curvature or deformity can continue to change. The duration varies. Conservative management often focuses on documenting progression, supporting erections, reducing distress and considering traction in selected patients.
Stable phase
The disease is considered stable when pain has settled and deformity has stopped changing for a sustained period. If intercourse remains difficult, treatment decisions are based on curvature, narrowing, hinge effect, length, erection quality and patient priorities.
How is Peyronie’s disease assessed?
History of onset, pain, progression, possible injury and effect on intercourse.
Erection quality, response to ED tablets and any loss of length or rigidity.
Physical examination to identify plaque and other penile findings.
Photographs of a full erection taken safely at home, when clinically requested, to document direction and degree of deformity.
Penile ultrasound or Doppler testing in selected cases, particularly when erection quality or surgery planning needs clarification.
Discussion of distress, relationship impact and treatment goals.
Non-surgical treatment options
Observation and education
Observation can be reasonable when deformity is mild, intercourse is possible and the condition is not causing significant distress. Patients should know which changes warrant reassessment and should avoid forceful manipulation or unproven home remedies.
Penile traction therapy
Traction devices apply controlled stretching over time. Studies suggest they may reduce curvature or preserve length in selected patients, but protocols, adherence and outcomes vary. Correct fitting and gradual use matter because excessive force can cause pain or injury.
Vacuum erection devices
A vacuum erection device can support erections and may be used within some rehabilitation plans. Evidence for correcting Peyronie’s curvature is limited. Pressure, timing and ring use should be taught properly to reduce bruising, pain or injury.
Intralesional treatment
Medicines injected into plaque may be considered for selected deformities, depending on local availability, disease features and guideline criteria. Expected improvement is usually partial rather than complete. Risks can include bruising, swelling, pain and, rarely, significant penile injury.
Treatment of associated erectile dysfunction
ED should be assessed and treated alongside the deformity. Options may include lifestyle and cardiovascular risk management, PDE5 inhibitor tablets, a vacuum device, injection therapy or, in severe cases, penile prosthesis surgery.
Read the guide to erectile dysfunction assessment and treatment in London.
What shockwave therapy can and cannot do
Extracorporeal shockwave therapy may reduce penile pain during the active phase in selected patients. European guidance advises against using it to improve curvature or reduce plaque because reliable straightening has not been demonstrated.
See the evidence guide to shockwave therapy for erectile dysfunction.
What about PRP and regenerative treatments?
PRP is prepared from the patient’s own blood and injected into penile tissue or plaque by some clinics. The biological rationale has generated research interest, but clinical evidence for Peyronie’s disease is preliminary. It does not establish dependable improvement in curvature, plaque or length, and routine use is not supported by current guidance.
Read the focused review: PRP for Peyronie’s disease—current evidence and risks.
Stem-cell products, exosomes, microneedling and combinations marketed as regenerative protocols should be treated cautiously. Patients should ask whether the intervention is part of an approved research study and what independent evidence supports it.
Oral medicines and supplements
No oral medicine or supplement has been shown reliably to straighten established Peyronie’s curvature. Tablets may have a role for associated erectile dysfunction or other health conditions, but marketing claims about dissolving plaque should be viewed critically.
When is surgery considered?
Surgery is generally considered when deformity is stable, intercourse is difficult and the patient understands the trade-offs. The operation may involve plication, plaque incision or grafting, or a penile prosthesis when significant ED is present. Choice depends on deformity, length, erectile function and risk tolerance.
Non-surgical care is not always better simply because it avoids an operation. For a severe stable deformity, surgery can be more predictable than repeated unproven procedures.
Questions to ask before treatment
Is my condition active or stable, and how was that determined?
What type of deformity do I have: curvature, indentation, hourglass or hinge effect?
What is the realistic chance and degree of improvement with this option?
Is the goal pain relief, curvature reduction, length preservation or better erections?
What are the risks, alternatives, total cost and follow-up plan?
What happens if the deformity progresses or intercourse remains impossible?
Frequently asked questions
Can Peyronie’s disease resolve without treatment?
Pain often improves with time, but established curvature is less likely to disappear completely. Some men remain stable with mild symptoms, while others develop deformity that affects intercourse.
Can massage break down the plaque?
Forceful massage is not recommended and may cause injury. Any device-based stretching should use a medically appropriate protocol with gradual tension.
Can shockwave therapy straighten the penis?
It may help pain in selected patients but has not shown reliable improvement in curvature or plaque.
Does PRP dissolve Peyronie’s plaque?
This has not been established. Research is preliminary and does not support a promise of plaque removal or dependable straightening.
When should I seek help urgently?
Urgent assessment is needed after an acute penile injury with a crack, immediate loss of erection, severe swelling or bruising. A new deformity without acute injury should still be assessed promptly, but it is not usually an emergency.
Peyronie’s disease assessment in London
Dr Fabio Castiglione provides confidential assessment for Peyronie’s disease and associated erectile dysfunction at Holistic Andrology, 9 Harley Street, London W1G 9QY. Treatment planning is based on disease phase, deformity, erection quality and patient goals.
For clinic information or to request an assessment, visit P-Shocks London.
Medical review and evidence
Medically reviewed by Dr Fabio Castiglione, Consultant Urologist and Andrologist. Last reviewed: 19 August 2026.
Peyronie’s treatment should be selected according to disease phase, pain, deformity, erectile function and patient goals. Shockwave therapy may help pain but is not recommended to improve curvature or plaque; PRP remains investigational.
This article is for general education and is not a diagnosis or individual medical recommendation. A consultation should review medical and sexual history, current medicines, examination findings and tests when clinically indicated.
Clinical sources
European Association of Urology: Penile Curvature and Peyronie’s Disease
European Association of Urology: Management of Erectile Dysfunction
About the author
Dr Fabio Castiglione
Consultant Urologist and Andrologist in London. Holistic Andrology, 9 Harley Street, London W1G 9QY.
GMC reference number: 7541824
Comments