What is the hallmark finding in Peyronie’s disease?

• A. Fibrous plaque in tunica albuginea causing curvature
• B. Venous leak
• C. Urethral stricture
• D. Testicular atrophy

Answer: (A)

Penile curvature from a fibrous plaque in the tunica albuginea is the hallmark of Peyronie’s disease. The tunica albuginea encases the corpora cavernosa, and when a plaque forms there, it becomes stiff and pulls one side of the penis as it eracts, causing a bending deformity. On exam you may feel a firm, non-tender plaque along the shaft, often on the dorsal side, with a curvature that worsens with erection. This fixed deformity differentiates Peyronie’s from venous leak, which mainly causes trouble achieving or maintaining an erection, and from urethral or testicular issues, which present with urinary symptoms or testicular findings rather than a penile plaque and curvature.