Does the way men masturbate influence penile curvature? Evidence from a case–control study

OBJECTIVES: Peyronie’s disease (PD) involves fibrotic plaque formation within the tunica albuginea, resulting in penile deviation. Although repetitive mechanical microtrauma has been implicated in the pathogenesis of PD, whether masturbation-related behaviors and hand dominance are associated with deviation characteristics remains unclear. The aim of this study is to investigate the association between masturbation-related behaviors, hand-use patterns, and penile deviation direction and degree in men with PD compared with healthy controls. MATERIAL and METHODS: This cross-sectional case-control study included 49 men with chronic stable-phase Peyronie’s disease and 51 healthy controls who presented between November 2024 and October 2025. Only patients with chronic, stable-phase PD of at least one year were enrolled. Data on hand dominance, masturbation hand, hand mismatch, ejaculation, coital and masturbation frequency, and lubricant use were collected based on habitual behavior over the preceding five years. Associations between sexual behavior variables and deviation direction or degree were analyzed. RESULTS: Baseline characteristics were largely comparable between groups. Dominant hand (p=0.004) and masturbation hand (p=0.007) distributions differed between PD patients and controls, whereas lubricant use (p=0.324) and hand mismatch rates (p=0.191) were similar. Deviation direction was not associated with dominant hand (p=0.262), masturbation hand (p=0.647), or hand mismatch (p=1.000). Median deviation degree was 40° (IQR 30–50) and showed no correlation with ejaculation (p=0.672), coital (p=0.955), or masturbation frequency (p=0.522), nor with masturbation hand (p=0.995) or lubricant use (p=0.641). CONCLUSION: In chronic PD, masturbation habits, hand dominance, hand mismatch, and sexual activity frequency are not associated with penile deviation direction or severity, indicating that habitual sexual behaviors do not independently influence deviation characteristics in the stable disease phase.