Sometimes, it may present directly in the second phase.
Usually it starts in the fifties but it can rarely start in the twenties.
Curvature can be in any direction. Usually, upward or downward curvature can be less bothersome compared to lateral curvature. The latter can interfere more with sexual intercourse.
Diagnosis depends on the history and the physical examination (palpation of the plaque). Sometimes, your doctor might need the help of an ultrasound or an MRI of the penis.
It is essential NOT to consider radical treatment till the process of plaque formatuion is stabilized for a minimum period of 6 months. Attempting to correct the deformity BEFORE THAT could lead to recurrence afterwards. It is also important to note that as long as the curvature is not causing difficulty in vaginal penetration, treatment should not be initiated.
The most effective treatment for peyronies's disease is surgical correction of the curvature. However, there are number of medical treatments that are proposed and under study, such as Vit. E, injectable corticosteroids, calcium channel blockers as well as shock wave lithotripsy.
But the take-home message remains, unless the curvature is interferring with a proper sexual intercourse, no treatment is advised.