At a glance
- Anaesthesia
- General
- Duration
- 60 minutes (plication) · 120–180 minutes (with graft)
- Hospital stay
- 24–48 hours
- Recovery
- Desk work from day 3 · sex after 1 month
Most cases (especially in younger men) are due to the particular way the penis formed before birth (congenital) and are usually not a clinical problem, only an aesthetic one. However, when curvature appears in men aged 40 to 70, the bent penis is almost always accompanied by a hard plaque developing in some area of the penis, and is described as Peyronie’s disease.
Symptoms of Peyronie’s disease
- The hard plaque prevents that part of the penis from expanding during an erection, so the penis bends towards the side of the lesion.
- In many cases there is pain during erection (more rarely constant pain), especially in the early phase of the disease.
- Erectile function is progressively affected, while in some cases the lesion regresses and improves (it is mainly at these cases that the initial attempt at conservative treatment is aimed).
Penile curvature: treatment
Treatment of penile curvature can be:
- Conservative
- Surgical
Conservative treatments for straightening the penis
Various conservative treatments have been tried, such as vitamin E, antioxidants, drug injections into the plaque, ultrasound or shock-wave therapy, without particularly encouraging results.
In the past year, the US Food and Drug Administration approved collagenase clostridium histolyticum (Xiaflex) for the treatment of Peyronie’s disease. Clinical studies with injections into the established plaque give encouraging results. At our centre, to treat penile curvature we use injection therapy into the lesion combined with medication and hyperbaric oxygen.
Surgery to correct penile curvature
The only proven treatment for penile curvature is surgery
- Either by placing sutures (plication) on exactly the opposite side of the lesion (only for small curvatures)
- Or by truly reconstructing the geometry of the penis: an incision over the plaque, removal of part of it and plastic repair of the wall of the corpus cavernosum with a graft
For large lesions with established erectile dysfunction, simultaneous placement of a penile prosthesis is recommended.
The surgery
- A circular incision below the glans, preparation of the skin and dartos, and degloving of the penis
- Identification and protection of the neurovascular bundle and the urethra
- Artificial erection, marking of the point of maximum curvature, planning of where the sutures will go (simple plication) or of the part of the corpus cavernosum to be prepared for the graft
- Closure in layers & repair of the foreskin
What kind of anaesthesia is needed?
Penile straightening surgery is performed under general anaesthesia.
Length of surgery
Penile curvature correction takes:
- 60 minutes with simple plication
- 120 to 180 minutes when a graft is used
- 180 to 240 minutes when combined with a three-piece penile prosthesis
Result
The penis is straightened, and the hardening is removed when a graft is used. The result is immediate and impressive.
After the surgery
- Antibiotics are prescribed
- The patient stays in hospital for 24 to 48 hours
- The patient can be up and about 6 hours after the end of surgery
- An elastic bandage is applied for 3 to 4 days
Frequently asked questions
Are there complications?
Complications after penile curvature correction may include swelling and haematoma (with an extensive procedure using a graft, erections may possibly be affected).
Is the surgery very painful?
Patients do not report significant pain.
When can I have sex after penile curvature correction?
After 1 month.
When can I go back to work?
If your work is sedentary, you can return from the third day. Otherwise after about 1 week.
This information is for general guidance only. The right treatment is decided only after a clinical examination. The cost depends on the type of procedure and the patient's clinical picture. For this reason, please contact the doctor personally.