Christian Seipp MD PhD
Consultant Urological Surgeon
Which corrective procedure is best depends on a number of factors that need to be assessed prior to any operation:
Surgical treatment aims at correcting the deformity while preserving the erectile capacity of the penis in the chronic phase of Peyronie's disease.
Current surgical management consists of reconstructive surgery by either lengthening the concave side with incision with incision or partial excision of the plaque and grafting or shortening of the convex side.
It is widely accepted that shortening procedures are ideal for men with adequate penile length, curvatures of less than 60 degrees and no hourglass deformity or hinge effect.
Patients with diminished erectile function should consider penile implants that do not only allow straightening of the penis but will also restore adequate erectile function.
Ultimately, optimal surgical treatment dictates an individualised approach respecting the patient's expectations and taking into account the particular anatomical and physiological abnormalities caused by the condition.
Patients will need to be aware of possible complications. Depending on the type of surgery the procedures can either be performed as day case surgery or with a short overnight stay in hospital. Sexual activity will need to be put on halt for about three months after the procedure.
Patients are often under the impression the penile deformity can be corrected if the plaque were removed. However, the plaque is not just adherent to the penis, - it is an integral part of the tunica, the membrane that surrounds the erectile cylinders inside the penis. Simple removal would create a large open defect in the substance of the penis that would make future erections impossible.
Hence, the principal of all corrective surgery is not plaque removal; simply speaking the penile curvature is caused by one side of the penis being longer than the other. This disparity can be corrected by making the short side longer or the long side shorter!