Peyronie's Disease

Peyronie's disease is a condition where scar tissue (plaque) forms inside the penis, causing curvature, pain, shortening, and sometimes erectile dysfunction. The curvature typically occurs during erection and can make sexual intercourse difficult or impossible.

The exact cause is unclear, but it's believed to result from repetitive minor trauma to the penis during intercourse or physical activity. Some men have a genetic predisposition. Risk factors include age, smoking, diabetes, and certain medications.

Some cases stabilize or improve spontaneously, especially in the acute phase (first 6-12 months). However, most cases persist or worsen without treatment. Early consultation helps determine the best treatment approach and timing.

Surgery is typically recommended when the disease has stabilized (no changes for 3-6 months), curvature prevents intercourse, or erectile function is significantly impaired. The timing depends on your specific symptoms and goals.

Options include plication procedures (shortening the longer side), plaque excision with grafting (lengthening the shorter side), and penile prosthesis implantation (for men with erectile dysfunction). The best option depends on curvature severity, penile length, and erectile function.

Most surgical techniques achieve significant straightening, though some residual curvature (typically less than 15-20 degrees) may remain. The goal is functional straightness that allows comfortable intercourse. Complete straightness isn't always achievable without compromising other aspects of function.

Peyronie's disease itself doesn't affect fertility or sperm production. However, severe curvature may make vaginal penetration difficult. Successful treatment typically restores the ability to have intercourse and father children naturally.

Surgical treatment for Peyronie's disease achieves significant straightening in 85–95% of cases, depending on the procedure performed. Plication procedures have high success rates for mild to moderate curvature, while plaque excision with grafting offers the best results for more severe cases.

Surgery for Peyronie's disease typically takes 1–3 hours, depending on the procedure. Plication is generally shorter, while plaque excision with grafting takes longer due to the additional reconstruction involved.

Recovery depends on the type of procedure. Simple plication typically allows return to normal activities in 2-4 weeks. Plaque excision with grafting requires 4-6 weeks of restricted activity. Sexual activity is typically resumed at 6 weeks minimum post-operatively for all procedures.

Surgical correction of Peyronie's disease achieves significant penile straightening in 85-95% of cases. Patient satisfaction rates are high when the procedure is matched to the specific anatomy, curvature severity, and erectile function. Penile prosthesis implantation combined with straightening achieves over 90% satisfaction.

Recurrent curvature is uncommon after successful surgical correction. However, Peyronie's disease itself is a chronic condition, and new plaques can rarely form in previously unaffected areas. Long-term follow-up with your reconstructive urologist is recommended.

Surgery performed by experienced reconstructive urologists preserves erectile function in most patients. In cases where Peyronie's disease is accompanied by significant erectile dysfunction, placement of a penile prosthesis simultaneously addresses both the curvature and the ED.