Although medical research does not provide an exact estimation, certain studies indicate that about 3-9% of men, especially those over 40 are mostly affected by this condition of the male reproductive system known as Peyronie's disease. It essentially causes an erect penis to bent more than usual, and pain in the area. And this may give rise to unpleasant situations during sexual intercourse, and stress and anxiety in the affected person, as well. What Characterizes the Condition? The disease is marked and identified by the development of scare tissue (plaque), which usually occurs in the length/shaft of the penis. This area that develops the plaque contains tissues that are responsible for the erection of the penis. This plaque usually begins as a localized swelling, and develops into a hardened scar or a thickened area. In some people, the plaque may not be visible, but the effect that it has on the penis sure is. So during an erection, this hard tissue causes the penis to bent or curve in a way that is not considered normal. A common symptom in most men, is the penis arcing upwards, and less commonly, sharply downward or to one side. Because the disease forces the penis to form such extreme curves, the affected person experiences pain during an erection. However, in most cases, the pain reduces with time. Flexibility of the penis is greatly reduced due to this disease, which can surface overnight or develop gradually. What Causes the Condition? Peyronie's disease, at this point of time, remains an idiopathic condition. Meaning, doctors have not been able to determine the exact cause of the problem. However, assumptions are that a trauma inflicted to the penis during sexual activity or in other situations, could be a major contributor to the development of the scar tissue. The penis achieves an erection when the corpus cavernosa (tube-like chambers in the penis; responsible for erection) are filled with blood, stimulated by sexual arousal. And these very chambers have a sheath of elastic tissue that stretches and makes the penis erect. So it might happen that an injury may damage this very elastic tissue causing inflammation. If the injury heals properly, then there are essentially no problems whatsoever, but otherwise, a scar tissue may get formed in the sheath, thus making it less flexible. And this, eventually causes the penis to bend in an abnormal way. In addition, some consider the same disease to be genetically inherited in nature. And there are a few studies which purport that it may be a side effect of certain medications, although no clinical evidence supports this. Treatment Options Having a condition such as the Peyronie's disease, can be intimidating for the sufferer. But the good news is, it is completely treatable. In fact, people who experience mild or no pain at all during sexual activity or any difficulty in their sexual function, can do well even without treatment. Also, the doctor is less likely to recommend any treatment in a case wherein the penis's bent is not severe nor worsening. Often, in all such cases, the condition resolves on its own. However, if the deformity of the penis is so severe that it is causing extreme pain to the person, or keeping him from indulging in sexual activity, then Peyronie's disease treatment might include invasive procedures such as a surgery. However, before suggesting for a surgery, the doctor may evaluate the condition of the patient that has been in the last 6 months; whether any changes have occurred in the curvature of the penis, or has the problem remained pain-free all this time. Now, there are various treatment options for Peyronie's disease, when it comes down to surgery. And these options depend on the severity of the scar tissue, and also the penis length of the patient.

• For someone with a severe form of the problem or a shorter penis, the surgery is performed on the part that has developed the scar tissue. The surgeon makes several incisions in the plaque so as to help the elastic tissue to stretch out thus, helping the penis achieve a straight erection. After the incisions have been made, the operated site is replaced by a tissue patch.
• In a case, wherein the person has an adequate penis length, and a deformity not so severe, Peyronie's disease is treated by operating the side of the penis opposite to the one that has the scar tissue. The surgeon removes a part of the unaffected side, and this cancels out the bend, resulting in a relatively straight erection.
• Another option that some patients may be recommended to undergo is a penile implant. The implant is a replacement of the corpus cavernosa, which can be manipulated at will. The person may choose to bend it down, and up as required. This option, however, is reserved for people who not only have the Peyronie's disease, but also the problem of erectile dysfunction.

If we go by theoretical findings, then experts are with the opinion that consuming vitamin E may help in reducing the scar tissue or inhibit it from forming. However, as I said, these findings are only limited to theoretical grounds, and are still debated when it comes to practical application. To summarize, most people do not require to undergo all such treatment procedures to manage Peyronie's disease, as the condition is self-limiting. Patients are usually advised by their doctor to follow a wait-and-watch procedure first. It is only in extreme cases that surgeries are suggested, given their high risk of causing side effects such as erectile dysfunction or shortening of the erect penis.