Surgery remains the best treatment for Peyronie’s disease in its stable phase. Conservative treatment may improve pain in the acute phase and slightly improve curvature in the chronic phase, but for patients with curvature that continues to limit sexual relations, surgery will be necessary.
Surgery for Peyronie’s Disease
The goal of surgery in Peyronie’s disease is to achieve a straight penis, with adequate rigidity and stability of the erection, so that the patient can have penetrative sexual intercourse.
Our experts in Peyronie’s disease in Barcelona indicate that, to opt for surgery, the patient must be in a stable phase for at least 3-6 months, except in patients with erectile dysfunction and Peyronie’s disease, in whom we may proceed early to a penile prosthesis implant surgery.
The approach and surgical technique will depend on various factors, such as the degree of curvature, presence of complex deformities (hourglass, marked indentation, hinge effect), penile length, and erectile function. For this reason, it will be essential to perform a Doppler ultrasound of the penis.
Surgical treatments for Peyronie’s Disease
There are three surgical treatment strategies, depending on the characteristics of the patient, the curvature and the deformity: plication-type corporoplasty (shortening of the tunica albuginea), graft corporoplasty (lengthening of the tunica albuginea) and penile prosthesis implantation.
Corporoplasties
At our centre, we perform various non-graft corporoplasty techniques such as Nesbit, Yachia, rotations or 16 DOTS, adjusting the technique to each patient to achieve the best results.
We also perform the graft corporoplasty technique, which consists of making an incision at the point of maximum curvature and then placing a graft to cover the defect. Several types of grafts can be used, the most common at our centre being porcine intestinal submucosa, bovine pericardium, equine collagen and autologous oral mucosa. One advantage of this technique is that it does not cause as much shortening of the penis.
Penile prosthesis
In cases where the patient has erectile dysfunction and Peyronie’s disease, it will be necessary to implant a penile prosthesis. It will also be an option for patients who want a more permanent solution with less loss of penile length or for patients with suboptimal erectile function.
Side effects of Peyronie's surgery
Surgery for Peyronie’s disease is generally a safe and well-tolerated procedure, with a high degree of patient satisfaction. In most cases, recovery is favourable and complications are rare when the procedure is performed by experienced specialists.
In exceptional cases, side effects such as temporary changes in sensitivity, slight changes in penis length, discomfort during the recovery process, or temporary erectile difficulties may occur. These cases are usually treatable and reversible with proper medical follow-up.
