Peyronie's Disease Phases: Acute vs Stable and When Surgery Is Considered
Updated: 1 day ago
Peyronie's disease has two phases. In the acute phase, which lasts up to about 18 months, the plaque forms, erections often hurt and the curve can change. In the stable phase, pain settles and the curve stops moving, so surgeons consider an operation only then.
Medically reviewed by Assoc. Prof. Dr. Tuncay Taş, urologist. Updated October 2026.
This guide explains how to tell which phase you are in and what helps in each one. It also covers how doctors measure the curve and when an operation makes sense. Finally, it lists the signs that mean you should see a urologist soon.
What happens in Peyronie's disease?
Normally, each erectile chamber of the penis sits inside a tough, elastic sheath. In Peyronie's disease, a patch of scar tissue, called a plaque, forms in that sheath. Because the plaque does not stretch, the penis bends towards it during an erection.
Doctors think small, often unnoticed injuries during sex or sport start the process. Then the healing goes wrong, and scar tissue builds up instead of normal tissue. In addition, age, diabetes, smoking and a family history raise the risk.
For the full picture of treatment options, read our Peyronie's disease and penile curvature page.
About 1 in 100 adult men in the United States have a diagnosis of Peyronie's disease. However, surveys of symptoms suggest many more men have it without a diagnosis. In short, it is far more common than most men assume.
Acute vs stable phase at a glance
The two phases behave very differently. So the right treatment depends on which one you are in. The table sums up the main differences.
Feature | Acute (active) phase | Stable (chronic) phase |
Usual timing | First 6 to 18 months after symptoms start | Usually from 12 to 18 months onwards |
Pain | Common, mainly with erections | Usually gone or mild |
Curve | May appear, grow or change shape | Unchanged for at least 3 to 6 months |
Plaque | Soft or tender, still forming | Firm, sometimes hard with calcium |
Main goal of treatment | Ease pain and limit curve and length loss | Straighten the penis if the curve affects sex |
Is surgery an option? | No, except in rare cases | Yes, if the curve or erections cause problems |
The acute phase
The acute phase is the time when the plaque is active. It usually begins with pain or a lump, and the curve follows. Above all, this is a time to protect the penis and track changes, not to rush into surgery.
Typical signs of the acute phase
Painful erections: pain often sits at the plaque and fades as the phase ends.
A new or growing curve: the bend may increase over weeks or months.
A lump you can feel: the plaque may feel like a firm band or nodule.
Changing shape: a dent, narrowing or hourglass shape can appear.
Shorter erections: many men notice some loss of length.
How long does the acute phase last?
For most men, the acute phase lasts 6 to 18 months. According to NIDDK, the stable phase usually begins 12 to 18 months after symptoms first appear. Still, the exact length varies from man to man.
Usually, pain settles first. In contrast, the curve may keep changing for a few more months. So an end to the pain alone does not mean the disease is stable.
What helps during the acute phase
Treatment in this phase aims to ease pain and limit damage. Assoc. Prof. Taş usually combines several simple steps, chosen for each man.
Pain relief: simple anti-inflammatory painkillers often help with painful erections.
Traction therapy: a device worn daily gently stretches the penis and may reduce curve and length loss. Our guide to penile extenders and traction therapy explains what they can and cannot do.
Collagenase injections: in selected men, injections into the plaque can soften it and reduce the curve. These are the only FDA-approved drug treatment for Peyronie's disease.
Protecting the penis: avoid sexual positions that bend the erect penis sharply, since new injuries may worsen the plaque.
Treating erection problems: erection tablets may help, as good blood flow keeps the tissue healthy.
Sex during the acute phase
Most men can keep having sex during the acute phase. However, a painful or bent erection makes some positions risky. So choose positions where you control the angle, and stop if you feel sharp pain.
In addition, talk openly with your partner about the pain and the curve. Many couples find that this lowers the pressure. As a result, erections often improve too.
What to avoid in the acute phase
First, avoid surgery while the plaque is still active, because the curve can return or change afterwards. Second, be wary of costly supplements. Guidelines do not support oral vitamin E or similar pills, as studies have not shown a real benefit.
Similarly, shockwave therapy may ease pain, according to NIDDK. However, it does not reliably straighten the penis. So it should not replace proper assessment and tracking.
The stable phase
Once the plaque matures, the disease settles. Pain usually fades, and the curve stops changing. At this point, the shape you see is likely the shape you will keep, so planning becomes possible.
Signs that the disease has stabilised
Doctors look for three signs together. Each one alone can mislead, so the combination matters.
No pain: erections have been pain-free, or nearly so, for some months.
A steady curve: the angle has not changed for at least three to six months.
Enough time: about nine to 12 months have passed since the first symptom, as the European Association of Urology advises.
Can Peyronie's disease go away on its own?
Pain usually goes away on its own. The curve, however, rarely disappears. Long-term studies suggest that roughly 1 in 10 men improve without treatment, about 4 in 10 stay the same and around half get worse before the disease settles.
Because of that, waiting is reasonable in the acute phase but not forever. If the curve stops you from having sex once it is stable, a decision about treatment makes sense. Meanwhile, keep tracking the curve, because a monthly record shows when it has truly settled.
How doctors tell which phase you are in
No single test labels the phase. Instead, a urologist builds the picture from your story, an examination and measurements over time. Here is what to expect at the first visit.
History and examination
First, the urologist asks when symptoms began, whether erections hurt and how the curve has changed. Then he feels the penis for the plaque and measures its stretched length. In addition, he checks for erection problems, since they change the treatment plan.
Measuring the curve
In practice, the most accurate measurement uses an erection produced in the clinic with a small injection. The doctor then records the angle, the direction and any narrowing. Photos taken at home help too, but they often underestimate the curve.
Ultrasound and blood flow
A penile Doppler ultrasound shows the plaque, any calcium in it and the blood flow. This matters before surgery, because weak blood flow points towards a different operation. Our post on what a penile Doppler ultrasound shows explains the test in detail.
Tracking your curve at home
Good records shorten the path to a clear decision. So, during the acute phase, keep a simple diary and bring it to each appointment.
Photograph monthly: take a photo of the erect penis from the side and from above, in the same light and position.
Note the pain: score pain with erections from 0 to 10 each month.
Record changes: write down any new dent, narrowing or loss of length.
Note erection quality: record whether erections stay firm enough for sex.
Keep these photos private and show them only in person during your consultation. They help the urologist judge whether the curve has really stopped changing.
When is surgery considered?
Surgery is for the stable phase. Generally, it makes sense when the curve makes sex difficult or impossible, or when a narrowing makes the penis unstable. The type of operation depends on the angle, the shape and the quality of your erections.
Operation | Best suited to | Effect on length | Erections needed |
Plication | Moderate curves without a deep dent or hourglass shape | Commonly 1 to 1.5 cm shorter | Good erections, with or without tablets |
Plaque incision or partial removal with a graft | Severe curves, dents or hourglass shapes | Keeps more length | Strong erections, because weaker erections are a known risk |
Penile implant, sometimes with straightening | A curve together with erection problems that tablets do not fix | Keeps the current length | Not needed, as the implant creates the erection |
How the options compare
Plication is the simpler operation: the surgeon shortens the longer side of the penis, opposite the plaque. According to the guideline tables, it straightens the penis in about 88 to 97 per cent of men. However, the penis commonly loses 1 to 1.5 cm of length.
Grafting cuts or partly removes the plaque and covers the gap with a patch. As a result, it keeps more length, with reported straightening rates of about 86 to 88 per cent. However, erections can become weaker afterwards, so surgeons reserve it for men with strong erections.
A penile implant suits men whose erections no longer respond to tablets. In that case, it treats both problems at once. For more on implants and erection problems, see our erectile dysfunction treatment page.
Peyronie's disease or a curve from birth?
Not every curve is Peyronie's disease. Some men have a curve from puberty without a plaque, pain or a dent. That condition has its own approach, described on our congenital penile curvature page.
Surgery in Istanbul with Assoc. Prof. Taş
Assoc. Prof. Taş performs plication, grafting and implant surgery for Peyronie's disease in Istanbul. The operation takes about one to two hours, usually with one night in hospital. Most men return to desk work within a week and resume sex after four to six weeks.
Our post on Peyronie's disease treatment in Istanbul describes the process, and the Peyronie's surgery gallery page explains what straightening aims to achieve.
Peyronie's disease and erections
Peyronie's disease and erection problems often go together. In some men, the plaque damages the seal that keeps blood inside the penis. In others, worry about the curve affects arousal, and that worry deserves attention too.
Therefore, a good assessment always checks erection quality. That check decides between a straightening operation and an implant. It also shows whether tablets could help before or after surgery.
Questions to ask at your consultation
A clear plan starts with clear answers. So bring your diary and ask these questions before you decide on any treatment.
Which phase am I in? Ask what signs the urologist used to decide.
What is my curve in degrees? Ask whether the measurement used a full erection.
How are my erections? Ask whether blood flow supports a straightening operation.
Which operation fits my shape? Ask why plication, a graft or an implant suits you.
What will I lose or gain? Ask about length, sensation and the chance of a remaining curve.
Assoc. Prof. Taş answers these questions in person after the examination. Afterwards, you receive a written plan in English, which your doctor at home can read as well.
When to see a urologist
Many men wait too long because they feel embarrassed. Yet an early visit helps, since some treatments work best in the acute phase. See a urologist soon if any of the following apply.
You notice a new curve, lump or dent in the penis.
Erections have become painful.
The curve is getting worse from month to month.
The curve or a narrowing makes sex difficult.
Erections are weaker since the curve appeared.
To plan an assessment in person, book a consultation with Assoc. Prof. Taş or message the team on WhatsApp. Patients from the US, Canada and the UK receive a personal plan and quote after the consultation. Then the coordinator arranges the days in Istanbul.
Frequently asked questions
How long does the acute phase of Peyronie's disease last?
The acute phase usually lasts 6 to 18 months from the first symptom. During this time the plaque forms, pain is common and the curve can change. The stable phase normally begins 12 to 18 months after symptoms start.
How do I know my Peyronie's disease is stable?
Three signs point to a stable phase. Pain with erections has gone, the curve has not changed for at least three to six months, and about nine to 12 months have passed since the first symptom. A urologist confirms this with an examination and measurements.
Can Peyronie's disease go away on its own?
Pain usually settles on its own, but the curve rarely disappears. About 1 in 10 men see some improvement without treatment. In the rest, the curve either stays the same or gets worse before it stabilises.
Why do surgeons wait before operating on Peyronie's disease?
Surgery during the acute phase aims at a moving target. If the plaque is still active, the curve can return or change after the operation. Waiting until the disease is stable gives a straighter and longer-lasting result.
Is there treatment during the acute phase?
Yes. Pain relief, a daily traction device and, in selected men, collagenase injections can help. These steps aim to ease pain and limit the curve and length loss while the plaque matures.
Does Peyronie's disease cause erectile dysfunction?
It can. The plaque may weaken the seal that keeps blood in the penis, and stress about the curve adds to the problem. When tablets no longer help, a penile implant can treat both the curve and the erection problem.
Does Peyronie's surgery shorten the penis?
Plication shortens the longer side, so a loss of 1 to 1.5 cm is common. A graft procedure keeps more length but carries a higher risk of weaker erections. Your surgeon measures you first and explains the trade-off.
Sources
About the reviewer
Assoc. Prof. Dr. Tuncay Taş is a urologist in Istanbul with more than 20 years of experience and patients from over 60 countries. He graduated from Istanbul University in 2004, trained at Taksim Training and Research Hospital, completed a uro-oncology and laparoscopy fellowship at Heidelberg University and belongs to the EAU and the Endourological Society. Read his full profile.
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