When non-surgical treatment makes sense
Peyronie's disease usually has two phases. In the acute phase the plaque is still forming, erections may be painful and the curve can change. In the stable phase the curve has stopped changing, usually for at least three months. Surgery is normally reserved for the stable phase, so the acute phase is when non-surgical treatment is most often considered.
Non-surgical treatment may also suit men in the stable phase who have a mild curve, who do not want an operation, or who are not fit for surgery.
An honest summary. The evidence for most non-surgical treatments is limited or mixed. The options with the most support can reduce the curve modestly in some men, but results vary widely and many men see little change. If the curve is severe or intercourse is impossible, surgery is usually more effective.
Penile traction therapy
A traction device is a small frame worn on the penis that applies a gentle, steady stretch. Over time, the stretch is thought to encourage the scar tissue to remodel.
- What it may do: modestly reduce the curve and help prevent, or partly recover, loss of length.
- What it asks of you: consistent daily wear, often for several hours a day over a period of months. Many men find this hard to keep up.
- Evidence: among the better-studied non-surgical options, though studies are small and results vary.
Traction is also sometimes used after surgery, for example after grafting, to help the tissues heal at full length.
Vacuum erection devices
A vacuum device is a cylinder placed over the penis; a pump draws blood in and produces an erection-like stretch. Some doctors suggest it as a form of stretching therapy in Peyronie's disease, and it can also help with erectile dysfunction.
The evidence for vacuum devices in Peyronie's disease is limited. They should be used gently and only as advised, because too much pressure on a painful, active plaque can cause bruising.
Injections into the plaque
Several medicines can be injected directly into the plaque (intralesional injection), usually as a course of treatments over weeks or months, often combined with gentle stretching or traction.
Collagenase
Collagenase clostridium histolyticum is an enzyme that breaks down collagen in the plaque. It is the injection with the strongest trial evidence for reducing curvature in suitable men, typically those with a stable curve of moderate severity. However, its availability varies by country: it is licensed and marketed in some countries but not currently available in others, including many European countries. If you are interested in collagenase, we can advise on whether it is a realistic option for you.
Collagenase can cause bruising, swelling and pain, and rarely a rupture of the erection chamber (penile fracture), so activity must be limited during treatment.
Verapamil and interferon
Verapamil (a blood-pressure medicine) and interferon alpha-2b are sometimes injected into the plaque. Both are used off-label for Peyronie's disease, meaning they are not licensed for this purpose. Some studies suggest a modest benefit in some men; others show little effect. Interferon can cause flu-like symptoms after injection.
Platelet-rich plasma (PRP)
PRP is prepared from your own blood and injected into the plaque. It is being studied, but the evidence is still early and it is not a standard, guideline-recommended treatment for Peyronie's disease.
Shockwave therapy
Low-intensity shockwave therapy applies acoustic waves to the penis through the skin. In Peyronie's disease its main role is to ease pain during the acute phase. Studies have not shown that it reliably reduces the curve or the size of the plaque, so it is not a treatment for the deformity itself.
Tablets and supplements
Many oral treatments have been tried over the years, including vitamin E, potassium aminobenzoate, tamoxifen, colchicine and various supplements. The evidence that they straighten the penis is weak or absent, and current guidelines generally do not recommend them for this purpose. Some men with Peyronie's disease benefit from erection tablets (PDE5 inhibitors) if erections are also weaker.
Simple pain relief can help while erections are painful in the early phase.
Comparing the options
| Treatment | Main aim | Strength of evidence |
|---|---|---|
| Traction therapy | Reduce curve modestly, limit shortening | Moderate, but needs long daily use |
| Vacuum device | Stretching; helps erections | Limited |
| Collagenase injections | Reduce curve | Strongest for injections; availability varies by country |
| Verapamil / interferon injections | Reduce curve | Mixed; off-label use |
| PRP injections | Reduce curve | Early, not standard |
| Shockwave therapy | Ease pain | Helps pain; not the curve |
| Tablets and supplements | Various | Weak; not generally recommended |
Risks and limits
Risks you should know about. Non-surgical treatments are less invasive than surgery but are not free of side effects. Injections can cause bruising, swelling, pain and, with collagenase, rarely penile fracture. Traction and vacuum devices can cause discomfort, skin irritation or bruising if used incorrectly. Most importantly, these treatments often give only partial improvement, and some men see none. Results vary, so decisions should be made with a specialist.
When to consider surgery instead
Surgery is usually more effective once the disease is stable and one or more of the following applies:
- The curve makes intercourse difficult or impossible
- There is an hourglass narrowing or hinge effect
- Non-surgical treatment has not helped enough
- You also have erectile dysfunction that tablets do not help
The main surgical options are plication (the Nesbit procedure), plaque incision and grafting, and a penile implant with straightening. You can read how they compare on our Peyronie's disease page.
Getting advice
The right approach depends on how long you have had symptoms, whether the curve is still changing, how severe it is and how your erections are. The team of Prof. Dr. Ateş Kadıoğlu can review your history and photographs remotely and advise on your options, surgical or not.
Last updated: 28 September 2026. This page is for general information and does not replace a medical consultation. Medical disclaimer.