PEYRONIES DISEASE SURGERY
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Peyronie’s disease surgery is something to consider only if a patient meets four criteria:
 1. Severity. The most important factor. Only when PD seriously limits sexual function is it worth the risks and rewards – and expense – of surgery.
 2. Time and opportunity. At least 12 months from the start of PD should have lapsed for healing and repair to occur.
 3. Non-response to therapy. During the 12 months wait a man can use a variety of drug and natural therapies to assist healing.
 4. Stability. Surgical outcomes are best for men whose condition has not improved or worsened for a while.

Peyronies disease surgeon performing a grafting procedure into the penile tissue

Peyronie’s disease surgery overview
Usually, Peyronie’s disease surgery is performed on an outpatient basis under general anesthesia, and can last up to two and a half hours. A second doctor, a plastic surgeon, may be needed when specialized grafting techniques are used. Surgery for Peyronie’s disease is a major event to a very sensitive part of the body with a large nerve supply, so do not expect an easy walk in the park.

Risks of Peyronie’s disease surgery
Martin K. Gelbard, MD, states, “Unfortunately, surgery does not offer a cure for Peyronie’s disease. The scarring in men with deformity severe and persistent enough to warrant an operation represents an irreversible loss of connective tissue elasticity. Though surgical restoration of sexual function can be both effective and reliable, potential candidates need to understand the compromise inherent in this approach.” Compromise means that after surgery some degree of the old problem and limitation usually remains, and new problems can occur in spite of the best effort of the Peyronie’s disease surgeon.

Every surgical procedure has risk; none are totally safe or foolproof. Peyronie’s disease surgery does not restore the penis to its former condition. Some surgery shortens the penis more than others. Some are more effective in straightening curvature. Every surgery carries the risk of less than perfect straightening. Excess scar formation can occur from the surgery. Lastly, surgical side-effects are possible loss of rigidity (hardness) or inability to maintain an erection (impotence), due to permanent surgical alteration of blood flow in the penis.

Want to do something about your PD?
 


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Peyronie’s Disease Surgery Options:

Nesbit Plication This technique or one of several variations involves gathering or pinching (plicating) tissue on the side of the penis opposite the plaque, to cause a bending force that straightens the curve. See, Anatomy of the Penis. Good candidates for this procedure are those with ample penile length, and simple curvature without associated deformity (bottle-neck, hinge or hour-glass effects). This procedure reduces the length of the penis on average from one to two inches, but it is not as likely to result in erectile dysfunction as other procedures such as tissue grafting; for this reason it has the highest patient satisfaction rating. Success rates of 50-60% have been reported with this technique. It is used when the bend is moderate with no loss of penile girth, and to correct congenital curvature.

Tissue Grafting This technique is the most popular removal of a Peyronie’s plaque (excision). Recently, grafts have been used to expand the scar (incision). Excision results are disappointing with 20-70% success rates, and 16-70% erectile dysfunction from damage to the erectile nerves. Incision results have not yet been studied very long, although there are reports of prolonged loss of penile sensation in approximately 10% of men. Grafting is best suited for severe curves and reduced penile girth.

Prosthesis Implant Small bio-compatible plastic cylinders, either solid or inflatable, are surgically inserted in the penis to make it firm. Once rather popular, implants are used less frequently since the introduction of erectile drugs (Viagra, Cialis), although they remain an option when drugs do not work.

Even with many recent improvements in PD surgical techniques, the ideal surgical procedure has not been discovered or perfected. This is especially true in cases of particularly severe and complex penile curvature surgery. Recent studies of various current surgical approaches have raised concern about the long term benefits of PD surgery in relation to the risks involved.

Peyronies disease surgery is only one option of treatment. We recommend it cautiously because, unfortunately, it can’t fix everything about PD and can sometimes take a bad situation and make it worse. For these reasons, it makes good sense that Peyronie’s disease surgery should be used only as an absolute last resort after a very prolonged course of conservative therapy is applied in an aggressive manner. For information about non-surgical treatment, Peyronie’s disease treatment.

 

Peyronie's Disease Institute
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Peyronie's Disease Institute
504 North Plum Grove Road
Palatine, IL 60067
Toll Free (877) 878-8188

Date last modified:  December 21, 2007

 

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