Sexual Health Q&A

What surgical treatments are available for Peyronie’s disease?

Surgical treatment for Peyronie’s disease is usually considered when a man is in the stable phase. At this point, the curvature has reached a plateau – not worsening, but not getting better.

Physicians will also consider the type of curvature and degree of erectile function when making decisions about surgery.

The most common surgical treatments for Peyronie’s disease include the following:

Nesbit Procedure (Tunica Albuginea Plication). The tunica albuginea is a thin layer of tissue that envelops the corpora cavernosa – two chambers of spongy tissue that fill with blood during an erection. Plaques caused by Peyronie’s disease form in the tunica albuginea.

During this procedure, the surgeon straightens the penis by folding small portions of the tunica albuginea on the opposite side of the curve. (Sometimes, these small portions are removed.) The surgeon then stitches the area, keeping the penis straight.

Plaque Incision and Grafting. Men with more severe cases of Peyronie’s disease may benefit from this technique. To straighten the penis, the surgeon cuts into the actual plaque and then fills the space with replacement tissue called a graft. The graft could come from another part of the patient’s body or from another human or animal.

For more details about plaque incision and grafting, please see the following Q & A links:

Peyronie’s disease and grafts: What is a graft?
How can grafts help men with Peyronie’s disease?
Where might graft material for Peyronie’s disease procedures come from?
Which men are good candidates for a graft procedure for Peyronie’s disease?
What are some complications of a graft procedure for Peyronie’s disease?

Penile Prosthesis (Implant). Men who have both Peyronie’s disease and erectile dysfunction may decide to have a penile prosthesis, or implant. This procedure involves removing the corpora cavernosa and replacing them with cylinders, which straighten the penis.

Most penile implants are inflatable and include the cylinders, a reservoir of fluid, and a pump, which is placed in the scrotum. When a man wants to have an erection, he activates the pump, which releases fluid from the reservoir to the cylinders. When he no longer wants an erection, the fluid will flow back to the reservoir.

Please click here to see more questions and answers about penile implants.

Depending on the type of surgery and the man’s anatomy, there might be some penile shortening or loss of penile sensitivity after these procedures.

For men who have the Nesbit procedure or plaque incision and grafting, problems with erections could develop.

Concerned patients should ask their doctors about these issues. Resulting erectile dysfunction (ED) is usually treatable.