A curved penis can be corrected through traction therapy, injections, or surgery, depending on how severe the curve is and what’s causing it. Most penile curvature in adults is caused by Peyronie’s disease, a condition where scar tissue (called plaque) forms inside the penis and pulls it to one side during erections. The right fix depends on whether the condition is still changing or has stabilized, and how much the curve affects your sex life.
Why the Curve Happens
Peyronie’s disease is the most common cause of new curvature in adults, typically showing up in men in their 50s and 60s. The plaque forms in the tough lining around the erectile tissue, likely triggered by repeated minor injuries during sex in men who are genetically susceptible. The scar tissue doesn’t stretch the way normal tissue does, so when the penis fills with blood, it bends toward the plaque.
Some men have had a curve their entire lives. Congenital penile curvature is usually first noticed during the teenage years and doesn’t involve any scar tissue or plaque. It stays the same over time and doesn’t cause pain. This distinction matters because the treatments are different. If your curve appeared suddenly in midlife, especially with pain or a hard lump you can feel, that’s Peyronie’s. If it’s been there since puberty and hasn’t changed, it’s congenital.
Active Phase vs. Stable Phase
Peyronie’s disease goes through two stages, and knowing which one you’re in determines what treatment makes sense. The active phase is when the plaque is still forming. The curve may be getting worse, erections can be painful, and the shape of the penis may still be changing. This phase typically lasts 12 to 18 months from when symptoms first appear.
Once symptoms have been unchanged for at least three months, the disease is considered stable. Most surgical and injectable treatments require stable disease before they’ll be offered, because operating on a moving target risks poor results. The standard threshold for surgery is at least 12 months of symptoms with a stable curve for 3 to 6 months. During the active phase, traction therapy and pain management are the main options.
Traction Devices
Penile traction therapy uses a mechanical device to gradually stretch the scar tissue and reduce curvature over time. It’s the least invasive option and can be started during the active phase. The RestoreX device is the most studied option and requires about 30 minutes of daily use, a significant improvement over older traction devices that required 2 to 9 hours a day.
In a clinical trial, 77% of men using RestoreX saw curvature improve by an average of 17.2 degrees after three months. At six months, improvements ranged from about 17 to 21 degrees, representing roughly a 33 to 36% reduction in curvature. Men who used the device for at least 15 minutes daily saw 18 to 21% improvement. Traction won’t eliminate a severe curve entirely, but it can make a meaningful difference for mild to moderate cases, and it’s often used alongside other treatments.
Injectable Treatments
For men with stable Peyronie’s disease and a curve of 30 degrees or more, injections directly into the plaque can break down scar tissue without surgery. The most effective injectable is collagenase clostridium histolyticum (sold as Xiaflex), an enzyme that dissolves the collagen in the plaque.
Treatment involves a series of injection cycles. Each cycle includes two injections spaced a few days apart, followed by a mandatory waiting period. You can’t have sex between the two injections in a cycle, and you need to wait at least four weeks after the second injection (and until any pain and swelling resolve) before resuming sexual activity. In clinical comparisons, Xiaflex achieved a median curvature improvement of about 54% at three months. That’s less than surgery (which achieved around 84% in the same comparison), but it avoids the risks that come with an operation.
The medication itself is often covered by commercial insurance, with most eligible patients paying nothing out of pocket for the drug. However, the office visit fees, copays, and injection administration costs are billed separately and may not be covered under the same terms.
Other injectables like interferon alpha-2b have shown some ability to reduce curvature and preserve length. Verapamil, a calcium channel blocker sometimes injected into plaques, has performed well in smaller studies but lacks the robust evidence behind it that collagenase and interferon have. European urology guidelines note that strong conclusions can’t yet be drawn for verapamil.
Surgical Options
Surgery is the most effective way to straighten the penis and is typically reserved for men with stable disease, significant curvature, and cases where less invasive treatments haven’t worked well enough. There are three main approaches, and the right one depends on the severity of the curve and whether erectile function is intact.
Plication
This is the simplest surgical option. The surgeon places stitches on the longer side of the penis (opposite the plaque) to shorten it so it matches the scarred side. This straightens the curve but does result in some penile shortening. It works best for curves under 60 degrees in men who have good erectile function. The tradeoff is straightforward: reliable correction with minimal risk to sensation, but the penis will be somewhat shorter.
Plaque Incision and Grafting
For more severe curves, the surgeon cuts into or removes the plaque and patches the gap with a graft. This approach can correct larger deformities while preserving more length. The downside is a higher risk of sensation changes. Studies show that men who undergo grafting procedures are significantly more likely to experience some loss of sensation compared to those who have plication. Some shortening still occurs with grafting, and patient-reported shortening rates are similar between the two procedures.
Penile Prosthesis
When Peyronie’s disease coexists with erectile dysfunction that doesn’t respond to medication, an inflatable penile implant can solve both problems at once. During implant surgery, the surgeon inflates the device and manually bends the penis in the opposite direction of the curve, holding it for 90 seconds at a time to rupture the fibrous plaque. This is repeated until the residual curve is under 30 degrees. Patient satisfaction rates for prosthesis implantation range from 72 to 100%, with partner satisfaction around 89%.
What Doesn’t Work for Curvature
Low-intensity shockwave therapy is marketed for Peyronie’s disease, but the evidence for curvature correction is discouraging. Across multiple randomized controlled trials, shockwave therapy failed to reduce curvature. In the largest trial of 102 men, curvature actually worsened in 40% of the shockwave group compared to 24% in the placebo group. Where shockwave therapy does show benefit is pain relief during the active phase, with statistically significant reductions in two large trials. If your primary complaint is pain rather than curvature, it may have a role. For straightening, it does not.
How Doctors Decide Which Treatment Fits
Before recommending a specific treatment, your urologist will likely perform an ultrasound of the penis during an erection (induced with medication in the office). This imaging reveals the size and location of the plaque, whether it contains calcium deposits, and how well blood flows through the erectile tissue. Heavily calcified plaques respond poorly to injections and traction, often making surgery the better path. The ultrasound also identifies men whose blood flow is too compromised for a straightening procedure alone, pointing instead toward a prosthesis.
The degree of curvature matters too. Mild curves under 30 degrees that don’t interfere with sex may not need any treatment. Curves between 30 and 60 degrees are candidates for injections or traction. Curves beyond 60 degrees, or those that make penetration impossible, generally need surgery.
Congenital Curvature Treatment
If you’ve had a curve since adolescence with no plaque and no pain, the fix is different. There’s no scar tissue to dissolve, so injections don’t apply. Traction therapy has limited evidence for congenital cases. Surgery, specifically plication, is the standard treatment when the curve is severe enough to cause problems with sex. Because there’s no plaque involved, the procedure is generally more straightforward with predictable outcomes.