What to Expect From Peyronie's Disease Surgery

There are several different types of surgery for Peyronie's Disease

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In This Article

Peyronie's disease is a condition of the penis that results in the formation of scar tissue. The scarring causes the penis to become less flexible. The condition is characterized by a curvature of the penis.

If someone has Peyronie's disease, the penis curves towards the scar during an erection. The curvature can be, but is not always, painful.

Even if the curvature itself doesn't cause pain, it can make sexual penetration uncomfortable or, in severe cases, impossible.

Xiaflex is a medication approved by the U.S. Food and Drug Administration (FDA) for Peyronie's disease, but it's not available nor the right treatment for every person with the condition.

In certain cases, surgery can be a more appropriate option for treating Peyronie's disease.

Before Surgery

Peyronie's disease does not always require surgery. Early signs of Peyronie's disease may resolve on their own or never become severe enough to warrant surgical correction.

Surgery for Peyronie's disease is generally only recommended if:

  • The curvature of the penis has been stable for at least three to six months
  • Symptoms have been present for at least a year

For people who enjoy penetrative sex, surgery may be recommended if the degree of penile curvature makes penetrative intercourse difficult.

People seeking care for Peyronie's disease will undergo a detailed sexual history, which includes discussing symptoms and how their sex life has been affected.

A doctor will also need to perform physical examinations both when the penis is flaccid and when it is erect.

A person may not be able to get an erection for the exam. Medication can be used to cause an artificial erection, which allows the doctor to observe the extent of penile curvature as well as the nature and location of any scarred areas.

Plication

Plication is the least invasive form of surgery for Peyronie's disease. In this procedure, stitches are placed on the penis opposite the areas of scarring.

The goal is to shorten the penis on the far side of the curve, allowing it to be pulled straight. Essentially, the penis is shortened the same amount on both sides—once by scarring and once by plication.

Plication is generally only recommended if the curvature of the penis is less than 60 degrees.

A benefit of plication is that the risk of serious side effects, such as nerve damage or impotence, is relatively low. However, the penis is also shortened by the procedure.

Plication is usually done as an outpatient procedure. It's performed under sedation rather than general anesthesia. A local anesthetic is also used to numb the area and prevent pain.

After surgery, a person can usually recover at home. Before discharge, they will be taught how to change their dressings, which they will need to do for five days after the procedure. Most people can return to work within a day or two of surgery.

Plication has some limitations. For example, it cannot be used to treat hourglass deformities or indentations.

Other potential issues with plication include:

  • Decreased sensation in the penis
  • Persistent pain after surgery
  • Bumps or lumps in the penis
  • Less rigid erections
  • Indentations in the penis will remain
  • The penis can become curved again

Excision and Grafting

An excision and grafting procedure (also called incision and grafting, or just grafting) can also be used to treat Peyronie's disease. The procedure is typically used when the penile curvature is greater than 60 to 70 degrees.

During the procedure, the scarred area of tissue is cut out of the penis and replaced with a tissue graft. The type of tissue used for the graft depends on several factors, including the surgeon performing the procedure.

Surgical grafting is a much more invasive treatment than plication. The procedure takes longer and usually requires general anesthesia or an epidural.

Surgical grafting reverses the curve of the penis in the opposite way from how plication works. Grafting restores length to the penis rather than shortening it. The goal is to make the short side of the penis the same length as the long side.

An incision and grafting procedure is more invasive and may require multiple incisions depending on the type of graft. An overnight hospital stay is usually required and the recovery period is longer.

Compared to plication, people who have had surgical grafting will need to wait longer to return to work or resume engaging in sexual intercourse.

During recovery, penile stretching and massage may be recommended to restore shape and length. A person may also be instructed to use a penile traction device.

The risks of excision and grafting, such as nerve damage and impotence, are higher than with plication. However, unlike plication, grafting procedures can be used when the penis is indented or the penis is at risk for bending around a destabilized area (such as a hinge).

Penile Implant

Plication and grafting are generally best for people who are still able to get an erection (even if medication or a vacuum pump is required).

However, if someone with Peyronie's disease is unable to get an erection (even with assistance) a penile implant may be the only option.

Penile implants are inflatable balloons placed inside the penis and controlled by a pump in the scrotum.

If someone has Peyronie's disease, the implant is sometimes enough to straighten the penis. However, placing an implant is often combined with additional surgery to straighten the penis—which can be either plication or grafting.

As with grafting, penile implant surgery is usually done under general anesthesia or with an epidural. Patients can expect to stay in the hospital overnight.

The surgery involves removing the corpora cavernosa of the penis and replacing them with implants. The procedure affects much more tissue than grafting alone, so the recovery period is generally longer.

After getting a penile implant, it may take several weeks before someone is ready to return to work.

Once an implant is placed, it must be used in order to get an erection. There is also a risk of implant failure.

The benefit of penile implant surgery for Peyronie's disease is that it can restore erectile function to someone who is otherwise unable to have penetrative sex.

The device may need to be replaced, especially in younger people and those who are more sexually active. Implants can also lead to ongoing issues with curvature and, as with plication, may shorten the length of the penis.

A Word From Verywell

A curved penis doesn't always require medical treatment. A slight curve to the penis (less than 20 degrees) may have little to no impact on sexual function. However, if the curvature impairs sexual function for someone who enjoys penetrative sex, surgery may be needed.

If you have Peyronie's disease, it's important to find a doctor who understands the condition and with whom you can comfortably discuss your sexual health.

After discussing your symptoms with your doctor, they can help you understand the risks and benefits of each treatment option for Peyronie's disease.

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Article Sources

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