I’m Dr. Sébastien Beley, a Paris-based urological surgeon and andrologist, and today I’d like to talk to you about a subject that affects many men but is often misunderstood: Lapeyronie’s disease. Although this pathology is frequently associated with a simple deformation of the penis, its consequences are far more far-reaching, both physically and psychologically. In this article, I’m going to give you a comprehensive review of the effects of this disease, based on my clinical experience and the observations I’ve been able to share with my patients.

Introduction to Lapeyronie’s disease

Lapeyronie’s disease is a condition characterized by the formation of a fibrous plaque within the erectile tissue of the penis, often resulting in visible deformity during erection. This deformity is the result of abnormal scarring that limits the penis’ suppleness and elasticity. Traditionally, when we think of Lapeyronie’s, we immediately think of a curved penis, often upwards. However, this simplistic view does not reflect the diversity of clinical manifestations encountered by patients.

Most of the images and diagrams available on the Internet, which illustrate the disease, show a strongly upward-curving penis. These representations often come from the same old diagram, reused without much adaptation. This can create a misconception in patients who, when diagnosed with Lapeyronie, don’t recognize themselves in these images. That’s why it’s essential to understand that the disease can manifest itself in many ways, and that curvature is just one aspect among many.

Physical manifestations of the disease

1. Penis curvature: a classic but variable symptom

The best-known feature of Lapeyronie’s disease is the curvature of the penis during erection. This curvature may be :

• Upwards (most frequent in representations).
• Downwards.
• Lateral (left or right).

It is important to note that this curvature is not systematic. Some patients show no visible deviation, which can complicate diagnosis, especially if the doctor is not accustomed to taking into account the diversity of the disease’s forms.

2. Loss of elasticity and the sensation of a “stretched penis”.

What is almost always found in patients with Lapeyronie’s disease is a loss of penile flexibility, particularly during erection. The fibrous plaque prevents the tissue from distending normally, giving the sensation of a “tight” or “stretched” penis.

Some men describe this sensation as real discomfort, even pain, because the penis doesn’t expand sufficiently during erection. This restriction can manifest itself as:

• Visible narrowing of the diameter of the erect penis.
• An “hourglass” or “wasp-waist” appearance with gradual constriction.

Unlike curvature, this phenomenon of shrinkage is often more difficult to perceive in the flaccid state, but becomes obvious as soon as the penis becomes erect.

3. Erectile instability

Another frequent consequence is loss of erectile stability. The penis may exhibit what is known as a “hinge effect”, or painful articulation at the plate. This means that the penis may flex or bend in this area, making intercourse difficult or impossible.

This instability is also a source of psychological discomfort, as it compromises self-confidence and the ability to maintain a satisfying sexual relationship.

4. Loss of height: an often underestimated symptom

Lapeyronie’s disease can also lead to a moderate but significant reduction in penile length or diameter. This phenomenon is less visible than curvature, but is often reported by patients as a source of significant suffering.

This loss of volume can be difficult to relate to the disease, particularly for doctors who do not specialize in urology or andrology. However, it is an essential part of the work-up needed to understand the overall impact of the disease.

5. Erectile dysfunction and sensitivity disorders

In addition to physical deformities, Lapeyronie’s disease can affect the quality of the erection itself:

• Decreased quality of erection, sometimes associated with erectile dysfunction.
• Loss of swelling of the glans penis during erection.
• Alteration of sensations, in particular reduced pleasure and perception of orgasm.

These symptoms contribute to a deterioration in sex life, with an emotional impact that is often underestimated.

The psychological consequences of Lapeyronie’s disease

1. Anxiety about the onset of symptoms

The first shock for many men is the discovery of an abnormality in their penis. The appearance of a curvature, shrinkage or pain can generate a great deal of anxiety, especially as the information available on the Internet is often incomplete or erroneous.

This anxiety is amplified by the initial lack of understanding of the disease, which can lead to feelings of isolation and fear.

2. Deteriorating self-esteem and sexual confidence

Lapeyronie’s disease directly affects body image and perception of masculinity. Penile deformity and difficulty in maintaining a satisfactory erection can lead to a drop in self-esteem.

This phenomenon can result in :

• Decreased frequency of sexual intercourse.
• Loss of sexual desire.
• Fear of sexual relations for fear of pain or partner judgment.

3. Depression and its impact on daily life

In around 30% of cases, the initial anxiety can evolve into a deeper state of depression. This depression can have major consequences:

• Almost total loss of libido.
• Social withdrawal and isolation.
• Abandonment of usual activities and loss of interest in life.

These symptoms can lead to serious situations, with reported cases of suicide linked to the psychological suffering induced by the disease.

Why is Lapeyronie’s disease often misunderstood?

One of the main reasons for this is the misrepresentation of the disease in the media and on the Internet. The disease is often associated solely with upward curvature, which does not correspond to the clinical reality encountered by the majority of patients.

Furthermore, some doctors, unfamiliar with this pathology, tend to minimize symptoms or fail to make the connection between patients’ complaints(loss of height, erectile dysfunction, pain) and Lapeyronie’s disease.

It is therefore crucial to raise awareness among both healthcare professionals and the general public of the variety of manifestations of this disease, in order to improve diagnosis, management and patient support.

How do you approach diagnosis and management?

1. Specialized consultation and in-depth clinical examination

Diagnosis is based above all on careful listening to symptoms and a detailed clinical examination. Additional tests, such as ultrasound, may be required to visualize the fibrous plaque and assess the extent of the lesions.

Referral to an experienced urologist-andrologist is often essential for accurate diagnosis and the most appropriate treatment.

2. Medical and surgical treatments

Treatment depends on the severity of symptoms and the impact on sex life:

• Anti-inflammatory and antifibrotic drugs can be prescribed in the early stages.
• Local injections of specific drugs to reduce plaque.
• Surgical intervention in severe cases, notably when the deformity prevents sexual intercourse or when pain is severe.
• Penile implants for severe erectile dysfunction.

3. Psychological support

Given the major psychological consequences, psychotherapeutic or sexological support is often recommended. This helps patients to manage their anxiety, restore their self-confidence and improve their quality of sexual life.

Conclusion: Lapeyronie’s disease is more than just a curvature

Lapeyronie’s disease is more than just a visible deformity of the penis. Its physical consequences are manifold: variable curvature, loss of elasticity, shrinkage, erectile instability and sensitivity disorders. But above all, this disease has a profound psychological impact, which is often underestimated, and can even lead to severe depression.

It’s essential to go beyond the clichés and simplistic images found on the Internet to better understand this complex pathology. Early diagnosis, appropriate treatment and psychological support are the keys to improving the quality of life of affected men.

If you think you may be affected by Lapeyronie’s disease, don’t hesitate to consult a specialist. Treatment is available and can considerably alleviate symptoms and their consequences.

To learn more about male sexual health, I invite you to follow my dedicated content, where I regularly cover Lapeyronie’s disease, erectile dysfunction, fertility, and many other topics.