Peyronie’s disease is not caused only by microtrauma. Research suggests that genetic factors may influence how some men respond to healing, increasing their predisposition to develop fibrous plaques.
Currently, scientific evidence does not allow Peyronie’s disease to be attributed to an isolated genetic cause. The disease is considered multifactorial and may involve individual predisposition, microtrauma, inflammation, and changes in healing mechanisms.
This distinction is important because it helps explain that no single factor determines whether the condition will develop.
Is Peyronie’s Disease Hereditary?
Heredity and genetic predisposition do not mean the same thing.
A hereditary disease implies that certain genetic changes can be passed between generations according to a recognized pattern.
Genetic predisposition, on the other hand, means only that certain inherited characteristics may increase a person’s susceptibility to developing a particular disease, without making its occurrence inevitable.
In the case of Peyronie’s disease, no defined pattern of hereditary transmission has been identified. Some studies have observed a higher occurrence of the disease in certain families, suggesting that genetic factors may contribute to predisposition in some patients.
However, having relatives with Peyronie’s disease does not mean that a person will necessarily develop it. Conversely, many diagnosed men have no known family history.
In some men, individual characteristics may favor a more intense or abnormal healing response to factors such as microtrauma and inflammation, contributing to the formation of fibrous tissue.
What Role Does Genetics Play in the Development of Peyronie’s Disease?
Peyronie’s disease involves abnormal healing of the tunica albuginea. Genetic research seeks to understand why some men develop this response, with increased formation of fibrous tissue.
A review published in 2024 in Sexual Medicine Reviews, focused on genomics and molecular pathways involved in Peyronie’s disease, describes changes in mechanisms related to TGF-β, SMAD signaling, and the WNT pathway. These pathways are involved in inflammation, fibroblast activation, and collagen production, processes associated with the formation of fibrous plaques.
Nevertheless, current evidence suggests that different genetic factors may increase individual susceptibility together with microtrauma, inflammation, and changes in healing mechanisms.
What Is the Relationship Between Peyronie’s Disease and Other Fibrotic Conditions?
The best-known association is with Dupuytren’s contracture, a fibrosis of the connective tissue in the hand that may cause the fingers to retract. The association between Peyronie’s disease and Dupuytren’s contracture is recognized in international clinical recommendations.
A relationship has also been described with plantar fibromatosis, known as Ledderhose disease.
These conditions belong to the group of fibromatoses, fibrotic diseases characterized by abnormal production and organization of scar tissue. Having Dupuytren’s contracture or Ledderhose disease, however, does not mean that a man will necessarily develop Peyronie’s disease.
What Other Factors Increase the Risk?
Genetics is only one part of the picture. The following factors may contribute to the development of the condition:
- Aging;
- Diabetes;
- Smoking;
- Cardiovascular changes;
- Repeated penile microtrauma;
- Erectile dysfunction.
It is important to note that having a risk factor does not mean that the disease will develop.
Can the Disease Be Prevented When There Is a Genetic Predisposition?
There is no form of absolute prevention of Peyronie’s disease. Even with a family history or other fibrotic conditions, it is not possible to state that the disease will develop.
However, some people may discuss measures related to modifiable factors with a healthcare professional, such as managing metabolic diseases and seeking assessment when new penile changes appear.
Acquired curvature, pain, deformity during an erection, or a palpable plaque justify considering an assessment by a urologist. Timely assessment may help identify signs consistent with an active phase of the disease and monitor its progression.
Are There Genetic Tests to Diagnose Peyronie’s Disease?
At present, genetic tests are not part of the routine clinical assessment of Peyronie’s disease.
In the future, genetic research may contribute to prevention, diagnosis, and the selection of more personalized approaches.
Today, diagnosis continues to be based mainly on the medical history and physical examination, supplemented when indicated by imaging assessment, such as a penile ultrasound.
Can Peyronie’s Disease Affect Other Family Members?
Familial clustering may occur, but this does not correspond to obligatory transmission. If several family members have fibromatoses, this information should be shared with a doctor.
What Does This Knowledge Mean for Treatment?
Knowing that there may be a genetic predisposition to Peyronie’s disease does not, by itself, change the therapeutic indication.
The approach should be individualized and depends on the disease phase, stability or progression of the deformity, degree and type of curvature, presence of pain, erectile function, and impact on sexual activity.
Depending on the clinical picture, different therapeutic approaches may be considered, from clinical follow-up and non-surgical options to reconstructive surgery combined with a penile prosthesis in selected situations.
Genetics May Influence Predisposition to Peyronie’s Disease
Peyronie’s disease has a multifactorial origin. Genetics may influence susceptibility, but not everyone with a predisposition develops the condition.
If there is a family history of Peyronie’s disease or other fibrotic conditions and changes such as penile curvature, pain, difficulty with erections, or palpable plaques appear, a specialist assessment may help clarify the diagnosis and guide discussion of an appropriate approach.