Checking for Peyronie’s disease starts with looking for its hallmark signs: hard lumps under the skin of the penis, a new or worsening curve, pain during erections, or changes in shape like narrowing or shortening. The condition affects roughly 3 to 9 percent of men, though underreporting likely makes the true number higher. Most men are diagnosed around age 59, but it can develop as early as the 30s. Here’s how to evaluate yourself at home and what to expect if you see a urologist.
What You’re Looking For
Peyronie’s disease is caused by flat, hardened scar tissue (called plaque) that forms inside the penis. This plaque isn’t visible from the outside, but it can often be felt through the skin as a firm, ridge-like lump. It typically sits along the top or side of the shaft rather than at the tip. The plaque prevents the affected area from stretching normally during an erection, which is what creates the curve.
The main signs include:
- Hard lumps on one or more sides of the penis, felt through the skin
- A curve in the penis during erection that wasn’t there before, or a curve that’s getting worse
- Pain during erections or intercourse
- Shape changes like an hourglass narrowing, indentation, or noticeable shortening
- Erection problems, which affect 40 to 60 percent of men with the condition
You don’t need all of these signs. Some men notice only a curve. Others feel a lump but have no pain. Pain is actually more common early in the disease and often fades over time.
How to Examine Yourself
The easiest time to feel for plaque is when the penis is in a relaxed, flaccid state. Gently roll the shaft between your thumb and fingers, working from the base toward the tip. You’re feeling for anything firm, flat, or ridge-like under the skin. Plaque can range from a small pea-sized spot to a longer band of tissue. It often sits on the upper surface of the shaft but can appear on either side or even underneath.
To evaluate curvature, you need to observe the penis while erect. Look at it straight on from above and from each side. Note which direction the curve goes (up, down, left, or right) and roughly how severe it looks. A mild curve of 15 to 20 degrees is common and may not cause problems. Curves beyond 30 degrees often interfere with intercourse.
UCSF Health recommends photographing the erect penis from above and both sides using a phone or camera. These images give a urologist objective information that’s hard to describe in words, and they prevent the awkwardness of needing to produce an erection in a clinic. Take photos on more than one occasion if you suspect the curve is changing.
Peyronie’s vs. Normal Curvature
Not every curve is Peyronie’s. Some men have a slight natural bend that has been present since puberty. This is congenital penile curvature, a structural variation you’re born with. The key difference is timing: congenital curvature has always been there, while Peyronie’s develops later in life and often progresses over weeks or months. Congenital curvature also doesn’t involve palpable lumps or plaque, and it doesn’t cause pain.
If you’ve always had a mild curve and it hasn’t changed, that’s almost certainly not Peyronie’s. If the curve is new, worsening, or accompanied by hard spots you can feel, Peyronie’s is much more likely.
The Two Phases of the Disease
Peyronie’s disease progresses through two distinct stages, and knowing which one you’re in matters for treatment decisions.
The acute (active) phase typically lasts 6 to 18 months. During this window, the plaque is still forming, the curve may be changing, and pain is common. Pain usually improves or resolves within the first 12 months. The plaque may feel softer during this phase because the scar tissue hasn’t fully matured.
The chronic (stable) phase begins once the curvature has stayed the same for at least three to six months and pain has subsided. At this point, the plaque is fully hardened and may contain calcium deposits. Erection difficulties are more common in this phase because the mature scar tissue presses on the erectile tissue more firmly. Most surgical treatments are only offered once the disease has clearly stabilized, so tracking your symptoms over time is important.
What Happens at a Urologist Visit
A urologist will start with a physical exam, feeling for plaque along the shaft in the same way you would at home, but with trained hands that can better assess size, location, and texture. They’ll ask about when symptoms started, whether the curve is changing, and how it affects sexual function. This is where those photographs become genuinely useful, since they show the urologist exactly what the erection looks like without needing to induce one in the office.
If the diagnosis isn’t clear from the physical exam alone, or if the urologist needs more detail before recommending treatment, they may order a penile ultrasound. This is a quick, noninvasive imaging study that shows the exact location and size of the plaque, whether calcium has built up inside it, and how blood flows through the erectile tissue. The ultrasound helps distinguish whether erection problems are caused by the plaque itself or by a separate vascular issue. It’s considered the most cost-effective and informative diagnostic tool for Peyronie’s.
Your urologist may also have you fill out a standardized questionnaire that covers three areas: the physical and psychological impact of your symptoms, pain severity over the past 24 hours (rated on a 0 to 10 scale), and how much the symptoms bother you in daily life. This gives a baseline score that can be compared at future visits to track whether the disease is progressing or improving.
Why Erection Problems Happen
Erection difficulties are one of the most common and frustrating parts of Peyronie’s. The plaque doesn’t just bend the penis. It also disrupts the internal mechanics of an erection. Normally, the tissue inside the penis expands evenly in all directions to create rigidity. When stiff scar tissue blocks part of that expansion, the result is an erection that may be firm in some areas but soft in others. This uneven rigidity makes the penis more likely to buckle during intercourse, which can cause further injury and potentially more plaque formation.
Between 40 and 60 percent of men with Peyronie’s experience some degree of erectile dysfunction. It can develop at any point but becomes more common once the disease reaches the chronic phase. If you’re noticing erection changes alongside any of the other signs, that combination strongly points toward Peyronie’s rather than normal aging or other causes of erectile dysfunction.
Tracking Your Symptoms
Because the distinction between active and stable disease drives treatment decisions, keeping a simple log of your symptoms is one of the most useful things you can do before and between doctor visits. Note the date, whether you have pain (and how severe), the approximate direction and degree of curvature, and whether erections feel different. Photograph the curvature periodically under the same conditions. This record helps your urologist determine which phase you’re in and whether interventions are appropriate yet.