What is the pathophysiology underlying Peyronie’s disease?

• A. Bacterial infection
• B. Malignancy
• C. Fibrous scar tissue inside the penis that causes curved, painful erections
• D. Hormonal deficiency

Answer: (C)

Peyronie’s disease arises from fibrous scar tissue forming plaques in the tunica albuginea of the penis. This inelastic scar tissue prevents normal expansion on the affected side during erection, causing curvature, indentation, and often painful erections as the penis bends toward the plaque. The plaques develop after microtrauma and result from abnormal wound healing with excess collagen deposition and ongoing inflammation, sometimes progressing to calcification in chronic cases. This explains why the primary issue is a localized fibrous plaque rather than a systemic infection, cancer, or a hormonal deficiency, which would present with different signs and mechanisms.