What Peyronie's disease is
In Peyronie’s disease, a plaque of scar tissue forms in the sheath of the corpora cavernosa, the structures that fill with blood during erection. The plaque does not stretch like normal tissue, so the penis bends towards the side of the plaque during erection. Sometimes narrowing or shortening also occurs.
The exact cause is unknown; repeated micro-injuries and individual predisposition are thought to play a role.
How it develops
The disease has two phases:
- the active phase (the first months): painful erections, the plaque forms and the curvature may increase;
- the stable phase: the pain goes away and the curvature no longer changes.
Surgery is only discussed once the disease is stable, usually at least 6–12 months after it starts and at least 3 months without change.
When surgery is done
- the curvature prevents intercourse or makes it painful;
- the disease is stable;
- non-surgical treatments have not worked.
Techniques
- Plication shortens the side opposite the plaque to straighten the penis; it suits moderate curvature, with slight shortening.
- Incision or excision of the plaque with a graft, for severe curvature or complex deformity.
- When severe erectile dysfunction is also present, other solutions are discussed together with a urologist.
The operation is done under general or spinal anaesthesia and takes one to two hours.
Recovery
- back to normal activity after 1–2 weeks;
- sexual activity after about 6 weeks.
Risks and things to know
- shortening of the penis, especially after plication;
- residual curvature or recurrence;
- changes in sensation;
- erectile dysfunction, especially after graft techniques.
Results vary from one patient to another.
