instruction: hello doctor I am a 24 year old male I have noticed that my penis gets really narrow in the middle like an hourglass and bends in a weird way when half erect or in the process of getting erect it gets completely normal when fully erect though and there is no pain this happens once every few days should I be worried I have tried searching online and the closest result is peyearonie however in peyearonie the erect penis gets the hourglass shape with pain but in my case erections are just fine any help would be greatly appreciated as I am quite worried
output: hi after reviewing your history it seems to me peyearonies disease but I need pictures flaccid partial and complete erection from you to confirm it presentation is secondary to fibrosis in tunic albuginea causing curvature of penis on erection to variable degrees it starts with inflammation and pain but will stabilize and become painless with time over approximately six months its causing factors are not exactly known but related to microvascular injury and healing with fibrosis is more common in diabetics and might be secondary to autoimmune diseases diagnosis is made purely on clinical grounds by history examination and pictures treatment ranges from medications to local injections to surgery which is reserved for significant deformity and curvature I would be grateful to further diagnose and follow up on you please send me pictures to support the diagnosis before I make a strategy for your treatment provide pictures