The Peyronie’s Treatment Roadmap: What the Urologists Say—And What I Learned the Hard Way

Still here. Still standing. Not broken.Peyronie’s disease doesn’t just curve your body. It curves your life. And when it hits, you don’t get a roadmap. You get silence, shame, and a long Google history of bad advice.

In 2018, the Canadian Urological Association published one of the most practical treatment flowcharts I’ve seen. It lays out what to do, depending on what stage you’re in. This post breaks that chart down—and I’ll tell you where it makes sense, where it misses, and what they don’t say out loud.

Step 1: What Phase Are You In?

Acute (Active) PhaseThis is when the disease is still evolving. You’ve got pain. Your curve is changing. Erections are uncomfortable or impossible.Urologists recommend:- Pentoxifylline (Trental): an anti-inflammatory, maybe slows progression.- Vitamin E: has some antioxidant value, but no strong data behind it.- Traction therapy: daily stretching devices (like RestoreX).- Xiaflex injections: enzyme-based treatment to dissolve plaque.

Here’s the truth:I tried pentoxifylline. I paid $150 for verapamil gel. I bought traction devices. I endured six Xiaflex injections—until one of them caused a massive hematoma that ended it all. These treatments might help early on—but they come with pain, cost, and frustration. Most men are never told how rough the process can be.

Step 2: Chronic (Stable) Phase

Eventually, the disease stops progressing. The pain goes away. The curve “stabilizes.”

Sounds good, right? Not so fast.

If you’ve got severe curvature or your erections don’t function like they used to, this is where surgery comes into play.

Urologists recommend:- Plication – Shortens the longer side of the penis to straighten it. Works well if erections are strong and curve is mild.- Plaque incision/excision + grafting – For more severe curves, this tries to preserve length.- Penile prosthesis (implant) – For men who have significant ED or deformity that can’t be corrected otherwise.

Here’s the truth:I did all of this. I ended up with a penile implant. I didn’t want it. But I needed it. And it gave me my life back. Not overnight. Not painlessly. But I came back.

And I’m still here.

What the Flowchart Leaves Out

Here’s what you won’t see on the official guideline:- The emotional wreckage.- The impact on self-worth.- The fear of never being able to connect again.- The silence that most men carry while this disease rewrites their body.

The urologists give you a technical map. I’m giving you the real one.

You’re Not Alone.

This blog exists to fill the silence. And I’ve launched The Not Broken Project podcast to talk about all of this—honestly, unfiltered, and without shame.

Episode 1 is already live. It walks through what I tried, what worked, and what didn’t.

There is a path forward. It’s not pretty. But it’s real.You’re not broken. You’re still here.Let’s talk about it.