Peyronie’s disease, evaluated objectively
Curvature, pain, and plaque can affect comfort, erections, and confidence. The starting point is measurement — not a sales pitch.
George W. Carroll, MD Florida license ME48111NPI 1073644985 Men’s sexual medicine since 1992
What Peyronie’s disease is
Peyronie’s disease is scar tissue (plaque) in the elastic covering of the penis that can cause curvature, indentation, shortening, pain, or difficulty with erections. It moves through an early active phase, when things are still changing, into a stable phase — and the right approach depends on which phase you are in, how the plaque behaves, and what bothers you most.
How we evaluate it
Evaluation here is objective: a duplex Doppler ultrasound study assesses blood flow and the plaque, and any curvature is examined and documented — so decisions and follow-up rest on recorded findings, not recollection. Erectile function is assessed at the same time, because Peyronie’s and ED frequently travel together and treatment must account for both.
Treatment pathways — including the ones we refer out
Care at our office
Depending on the evaluation, in-office care may include pressure-wave therapy — what other clinics advertise as soundwave or shockwave therapy — and managing the erectile component with oral medication or injection therapy, adjusted for curvature. What has a role in your case — and what doesn’t — is discussed openly after the evaluation, including what the evidence for each one actually supports.
Collagenase (Xiaflex) injections
Orlando Sexual Medicine does not administer Xiaflex; when collagenase injection is the right pathway for you, we refer you to an outside specialist who performs it, and coordinate the hand-off. It is a significant investment and typically not covered by insurance — we tell you that up front.
Surgery — a later-line option, not a first move
Dr. Carroll generally recommends evaluating appropriate nonsurgical options before considering surgery. For many men, surgery is best reserved for stable disease that remains significantly bothersome after less invasive approaches have been considered — it is a recognized option for the right patient at the right time, not a first move. Orlando Sexual Medicine does not perform surgery; when it is the appropriate next step, we refer you to a surgeon and stay involved in the rest of your care.
Shockwave and Peyronie’s pain — what we’ve observed, and what research shows
In Dr. Carroll’s three decades of men’s sexual-medicine practice, pain reduction has been the most consistent outcome he has observed among the Peyronie’s patients he has treated with pressure-wave therapy. That is a documented clinical observation from one practice — not a controlled study — and individual results vary.
Independent randomized trials — conducted with focused shockwave devices, a related but distinct technology from the radial device used in our office — support this direction: they show meaningful reductions in Peyronie’s pain, and the American Urological Association guideline states clinicians “may offer” shockwave therapy for penile pain. Two honest caveats: shockwave therapy has not been shown to reliably straighten curvature or shrink plaque, and Peyronie’s pain often improves on its own as the disease moves from its active to its stable phase.
Key research: Wang et al., BMC Urology (2023) meta-analysis of 4 randomized trials; Li et al., BMC Urology (2024) meta-analysis of 7 studies; AUA Peyronie’s Disease Guideline, Statements 14–15.
Common questions
- Do I need treatment at all?
- Not always. Some men mainly need an accurate assessment, monitoring through the active phase, and treatment of the erectile component. That is a legitimate outcome of an honest evaluation.
- Will you just try to sell me a package?
- No. This is a physician’s practice, not a franchise clinic. Recommendations come after the evaluation, with the reasoning and the alternatives — including referral options we don’t profit from.
- Is Peyronie’s disease dangerous?
- It is not malignant and it is more common than most men think. The main stakes are comfort, function, and confidence — all of which deserve proper evaluation.
- Can Peyronie’s disease be treated at home?
- Parts of care can be handled remotely — consultations, medication for the erectile component, and follow-up by telemedicine for Florida patients. The measurement that decisions depend on happens in the office.
- What does treatment cost?
- It depends entirely on the pathway your evaluation points to. Office visits and diagnostics are billed to insurance where your plan covers them — we verify benefits by procedure code before your visit and quote cash prices up front for anything that isn’t covered.
- What are the success rates?
- Honest answer: published results vary widely by treatment, disease phase, and how improvement is measured, so we don’t quote a universal percentage. What we can give you is an objective baseline measurement and a realistic, personal picture of what each option could do in your case.
Care provided by George Carroll, M.D.
Medically reviewed by George W. Carroll, MD (Florida license ME48111) · Reviewed August 2026
Have it looked at properly
Even if you choose to do nothing, it’s worth knowing what’s going on. Dr. Carroll will tell you, and the decision stays yours. One call to our office starts it — no obligation, no pressure, and no one pushing you toward a decision.
Office hours: Mon–Fri 9:00 AM – 5:00 PM. Callbacks are returned the same business day — the next business day for requests made after hours.