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Surgical Treatment for Penile Curvature

Surgical Treatment for Peyronie's Disease

Permanent and Effective Solutions for Penile Curvature

Peyronie's disease is a significant male sexual health problem that can cause penile curvature, shortening, and deformity—and, in some patients, severe loss of sexual function—due to hard, fibrous plaques that develop within the penile tissue.

Although medical and injection therapies may be considered in the early stages of the disease, surgery is the most effective and long-lasting treatment for advanced-stage Peyronie's disease.

In this article, surgical treatment for Peyronie's disease;

  • in which patients it is necessary,

  • surgical techniques used,

  • preoperative evaluation,

  • the postoperative period,

  • success rates,

  • potential risks

  • and managing patient expectations

are discussed under these headings.

What Is Peyronie's Disease? (The Basis for the Path to Surgery)

Peyronie's disease results from hard, inelastic plaques that develop within the tunica albuginea of the penis. Because these plaques cannot stretch when the penis becomes erect, they cause:

  • Curvature

  • Abbreviation

  • Narrowing (hourglass deformity)

  • Notching

  • Pain during an erection

leads to problems such as these.

The course of the disease is divided into two main phases:

Active (inflammatory) phase

  • Pain is the main concern

  • The curvature may progress

  • The record may be soft

  • Surgery is definitely not recommended

Stable (chronic) phase

  • The pain usually goes away

  • The curvature is fixed

  • The plaque has hardened

  • Surgical treatment is planned during this period

When Is Surgery Necessary for Peyronie's Disease?

Not every patient with Peyronie's disease is a candidate for surgery. When the right patients are selected, surgical treatment yields excellent results.

General criteria for surgical treatment

  • The condition has persisted for at least 12 months

  • No progression of the curvature in the past 3–6 months

  • A curvature of the penis that makes sexual intercourse difficult or impossible

  • Insufficient benefit from medical and injection treatments

  • The patient's postoperative expectations should be realistic

📌 Surgery is not always necessary if the only issue is a deformity and sexual intercourse is possible.

Goals of Surgical Treatment for Peyronie's Disease

The primary goals of surgery:

  • Reducing penile curvature to a functional level

  • To provide an anatomical structure that allows for sexual intercourse

  • Maintaining erectile function

  • To achieve an aesthetically acceptable result

📌 The goal isn’t a perfectly straight penis, but a functional and satisfying sex life.

Surgical Treatment Methods for Peyronie's Disease

Choice of surgical technique;

  • Degree of curvature

  • Penis length

  • Erectile function

  • Plate placement

  • The patient's expectations

It depends on many factors, such as...

Penile Plication Surgeries (Shortening Surgeries)

Penile plication is one of the most commonly used techniques in Peyronie's surgery.

What is plication?
The penis is straightened by placing sutures in the healthy tissue on the opposite side of the curvature. The plaque is not removed; the curvature is corrected by shortening the penis.

Who is it suitable for?

  • The curvature is generally less than 60 degrees

  • Penis size is adequate

  • Erectile function is normal

  • Patients without an hourglass deformity

Advantages

  • The surgery is brief

  • The complication rate is low

  • The risk of erectile dysfunction is minimal

  • The hospital stay is short

Disadvantages

  • There may be some reduction in penis length

  • It may not be sufficient for severe curvatures

Plate Incision or Excision + Grafting (Lengthening Surgeries)

This method is preferred for advanced cases of Peyronie's disease.

How is it applied?

  • The plaque is cut or partially removed

  • The resulting gap is filled with graft material

  • Curvature is corrected without shortening the penis

Who is it suitable for?

  • Curvature greater than 60 degrees

  • People with severe deformities

  • Patients with a short penis

  • Patients in a stable phase

Types of Grafts Used

  • Autologous grafts (the patient's own tissue)

  • Biological grafts

  • Synthetic grafts

Advantages

  • Penis size is preserved

  • It is effective in cases of severe deformities

Disadvantages

  • The surgery is more complex

  • The risk of erectile dysfunction is higher than that of plication

  • It requires extensive surgical experience

📌 These surgeries require advanced surgical experience.

Penile Prosthesis Surgery (Advanced Cases)

If Peyronie's disease is accompanied by severe erectile dysfunction, the best option is a penile prosthesis.

Who is it suitable for?

  • Erectile dysfunction that does not respond to medication

  • Severe curvature

  • Patients for whom sexual intercourse is not possible

Advantages

  • Erectile dysfunction and curvature are treated simultaneously

  • Patient satisfaction is high

Preoperative Evaluation

A detailed evaluation is required before Peyronie's surgery:

  • Detailed medical history

  • Photos of the penis during an erection

  • Pharmacological erection test, if necessary

  • Doppler ultrasound

  • Objective Assessment of Erectile Function

📌 Prof. Dr. Volkan İzol bases his surgical planning on a personalized approach.

Postoperative Process

  • Usually a 1-night hospital stay

  • 4–6 weeks of sexual abstinence

  • Mild pain and swelling are normal

  • Penile rehabilitation may be recommended when necessary

Possible Risks and Complications

As with any surgical procedure, Peyronie's surgery also carries risks:

  • Decrease in penis length

  • Erectile dysfunction

  • Sensory changes

  • Although rare, infection

📌 Risks are minimized with proper patient selection and an experienced surgeon.

Success Rates in Peyronie's Surgery

  • Plication surgeries: 85–90% patient satisfaction

  • Grafting surgeries: 75–85% patient satisfaction

  • Penile prosthesis surgery: Over 90% patient satisfaction

The Psychological Aspect of Surgery for Peyronie's Disease

Peyronie's disease affects patients not only physically but also psychologically. In many patients following surgical treatment:

  • Increased self-confidence

  • A noticeable improvement in sex life

  • Improvement in partner relationships

is observed.

Conclusion and Overall Assessment

Surgical treatment for Peyronie's disease yields extremely successful results when performed on the right patient, at the right time, and using the right technique.

There is no single correct approach for every patient. Therefore, the treatment plan must be tailored to each individual.

Prof. Dr. Volkan İzol offers safe and effective solutions through his modern, scientific, and patient-centered approach to the surgical treatment of Peyronie's disease.

Ali Şahin Design