Early-Stage Peyronie’s Disease: What Should You Do in the First 6 Months?

A new penile bend, painful erection, indentation or loss of length can be concerning. The first six months are often part of the active phase of Peyronie’s disease, when penile shape or symptoms may still be changing.[1–3]

At this stage, the aim is usually not to rush into surgery. It is to confirm the diagnosis, document change, manage symptoms, protect sexual function and consider whether conservative treatment is appropriate.

What is early-stage Peyronie’s disease?

Peyronie’s disease occurs when scar tissue forms within the strong covering of the erectile tissue. This can cause curvature, shortening, narrowing, an hourglass shape, pain or difficulty with penetration.

Active disease is suggested by a recent change in curvature or penile shape, penile pain, or a short symptom history.[1] Pain often settles with time, but curvature does not always disappear. Natural-history studies show that some men remain stable, some improve and others develop greater deformity.[4,5]

What should you do in the first six months?

1. Arrange an assessment if the change is new or progressing

A urological assessment can help confirm the diagnosis and establish a baseline. It commonly considers when symptoms began, pain, curvature, shortening, indentation, erection quality and whether sexual activity has become difficult. Ultrasound is not required for every patient but may be useful in selected situations.[1]

Learn more about Peyronie’s disease assessment and treatment.

2. Document the deformity

Standardised photographs of a full erection can help track change. Views from above and from the side, taken under similar conditions, are useful for comparison.[1]

Repeating photographs about every 4–6 weeks is usually more useful than checking every day.

3. Manage pain and avoid further injury

Pain is most common during the active phase. Appropriate pain relief can be discussed according to your medical history.[1,2]

Sex does not automatically need to stop, but avoid situations where the erect penis repeatedly buckles or bends sharply. Adequate erection firmness, lubrication and control of penetration angle may reduce injury risk.

A sudden “pop”, immediate loss of erection, marked bruising or swelling requires urgent medical assessment.

4. Discuss traction therapy if appropriate

Penile traction therapy applies controlled stretching forces over time. Studies suggest it can reduce curvature and help preserve or recover some penile length in selected men, although results vary and evidence differs between devices and treatment schedules.[1,6–8]

Traction has also been studied during active Peyronie’s disease.[6] It should not cause significant pain, numbness, skin injury or marked discolouration.

Read more about penile traction therapy for Peyronie’s disease, or use the Peyronie’s Treatment Explorer.

5. Avoid unproven or forceful treatments

There is no high-quality evidence that supplements, massage, “jelqing” or trying to manually break down a plaque reliably straighten Peyronie’s disease.[1–3] Forceful bending may cause additional injury.

Is surgery needed in the first six months?

Usually not. Guidelines generally recommend surgery only after the disease is stable and the deformity causes meaningful functional difficulty. Stability commonly means no change in curvature for at least 3–6 months, often after the condition has been present for around 9–12 months or longer.[1,2]

When should you seek specialist review?

Consider review if you have a new or worsening curve, shortening, hourglass deformity, painful erections, reduced erection quality or difficulty with sexual activity.

Early assessment does not mean you need a procedure. It can provide a baseline, clarify whether the disease is active and help create a structured plan.

Patients in Brisbane, elsewhere in Australia or overseas can request an appointment. Interstate and international patients can also review the international patient pathway.

Take home message

The first six months are best viewed as a period of assessment, monitoring and selective conservative management. Document the deformity, protect erection quality, avoid forceful manipulation and seek review if the condition is progressing or affecting sexual function.

Medical disclaimer: This article provides general educational information only and does not replace individual medical advice, diagnosis or treatment. Management depends on disease stage, penile anatomy, erection quality, symptoms and individual preferences. Seek urgent medical care after a sudden penile injury with a popping sensation, rapid swelling, bruising or immediate loss of erection.

References

1. European Association of Urology. EAU Guidelines on Sexual and Reproductive Health: Penile Curvature. Arnhem: EAU Guidelines Office; 2026.

2. Chung E, Ziegelmann M, Lin HC, Jenkins L, Broderick G, Moon DG, et al. Management of Peyronie's disease: recommendations from the Fifth International Consultation on Sexual Medicine (ICSM 2024). Sex Med Rev. 2026;14(1):qeaf068. doi:10.1093/sxmrev/qeaf068.

3. Bella AJ, Lee JC, Grober ED, Carrier S, Bénard F, Brock GB. 2018 Canadian Urological Association guideline for Peyronie’s disease and congenital penile curvature. Can Urol Assoc J. 2018;12(5):E197-E209. doi:10.5489/cuaj.5255.

4. Mulhall JP, Schiff J, Guhring P. An analysis of the natural history of Peyronie's disease. J Urol. 2006;175(6):2115-8. doi:10.1016/S0022-5347(06)00270-9.

5. Di Maida F, Cito G, Lambertini L, et al. The natural history of Peyronie's disease. World J Mens Health. 2021;39(3):399-405. doi:10.5534/wjmh.200065.

6. Martínez-Salamanca JI, Egui A, Moncada I, et al. Acute phase Peyronie's disease management with traction device: a nonrandomized prospective controlled trial with ultrasound correlation. J Sex Med. 2014;11(2):506-15. doi:10.1111/jsm.12400.

7. Ziegelmann MJ, Savage J, Toussi A, et al. Outcomes of a novel penile traction device in men with Peyronie's disease: a randomized, single-blind, controlled trial. J Urol. 2019;202(3):599-610. doi:10.1097/JU.0000000000000245.

8. Joseph J, Ziegelmann MJ, Alom M, et al. Outcomes of RestoreX penile traction therapy in men with Peyronie's disease: results from open label and follow-up phases. J Sex Med. 2020;17(12):2462-2471. doi:10.1016/j.jsxm.2020.10.003.