Penile Narrowing “Waist” or “Hourglass Appearance” of Peyronie’s Disease

by Alex Shteynshlyuger MD

If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call 1-(646) 663-4050.

Hourglass Deformity of the Penis or “Penile Narrowing”

A narrowing of the penis (penile shaft) can occur either on one side of the penis or circumferentially (less common).  Narrowing of the penis has also been described as a narrow “waist” or hourglass deformity of the penis.

A common symptom associated with thinning and narrowing of the penis is a poor quality erection. Typically, the area just before or after the narrowing does not get sufficiently hard when erect with noticeable softness in the penis.

Peyronie's treatmentTreatment of Penile Narrowing

Penile narrowing ‘hourglass appearance” associated with Peyronie’s disease is one of the most challenging symptoms of Peyronie’s to treat.

While it may respond to injectable therapy, typically treatment of severe narrowing would require excision and grafting of the plaque, often combined with insertion of a penile prosthesis.   Dr. Alex Shteynshlyuger is an experienced surgeon who treats men with narrowing of the penis caused by Peyronie’s disease.

What is the Cause of Penile Narrowing?

Penile narrowing is caused by scar formation in the penis. This scar is called “Peyronie’s plaque” when it can be felt. Scarring process that results in penile plaque formation also pulls on surrounding tissue, a process called ‘scar contraction.’  As a result, narrowing of the penile circumference and an indentation on the penis occurs.

Penile Narrowing without Curvature – Is it Peyronie’s?

Some men only have penile narrowing and no visible curvature. This can occur early in the disease process and often but not always curvature will develop within a few months.  Often men can feel a lump in the penis where the narrowing or hourglass appearance is.  

Some men with poor erections may not notice much curvature because often a very strong erection is necessary to fully visualize the curvature that is present.

Usually, when there is smoke, there is fire.  Similarly, when there is penile narrowing, often there is associated Peyronie’s disease. 

Penile Hourglass Deformity and Erection Softness

Indentation of the penis causing narrowing of the penis is often associated with loss of erection hardness.  This apparently is caused by scar affecting blood vessels and blood flow in the penis.  Erectile dysfunction is a common symptom associated with Peyronie’s disease.

Penile Instability when Penis is Erect as a Result of Penile Narrowing.

When penile narrowing is significant and circumferential, it often causes the penis to bent severely when erect during penetration.  When penis instability occurs with erections, usually surgical treatment is the preferred treatment option to correct symptoms of Peyronie’s disease. 

If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call 1-(646) 663-4050.

Dr. Alex Shteynshlyuger is a board-certified urologist in NYC who specializes in treating men with Peyronie’s disease.