December 01, 2019

Pain during sex and penis curvature — is this common or treatable?

Q: My husband has been having some pain during sex and his penis has developed a pronounced curve in recent years. He's embarrassed to bring it up with his doctor, so we are wondering if this is common with age or treatable?

A: It's possible that your husband has Peyronie's (pay-roe-NEEZ) disease. This is when a hard, fibrous layer of non-cancerous scar tissue develops under the skin on one or more sides of the penis. When the penis is erect, the scar tissue prevents the elastic tissue of the penis from stretching, causing the shaft to angle. In some cases, it can also prevent the penis from stretching to its full length during erection. This may cause pain, embarrassment and, in some cases, erectile dysfunction.

Treatment of Peyronie's can include oral medications, injection therapy and penile traction — with surgery also being a good option for many men. Oral medications — if used — are best combined with other treatments. The only Food and Drug Administration (FDA)-approved medication for Peyronie's is collagenase clostridium histolyticum (Xiaflex). It's delivered by a series of eight injections into the scar tissue and has been shown to reduce curvature by breaking down the scar tissue buildup.

Penile traction has been shown to reduce curvature and relieve pain in some men with Peyronie's, especially when combined with medications or injection therapy. It involves a device that stretches the penis straight out or against the direction it curves for a period of time. There are several devices available but some may be difficult to use consistently as they need to be worn for three to eight hours a day.

Recently, doctors at Mayo Clinic helped develop a penile traction device — called RestoreX — that's worn for about 30 to 90 minutes a...