3) Surgical treatment
Doctors delay the choice of surgery until the disease enters the chronic phase where the plaque stops growing, the penile curve becomes stable, and the pain disappears. Also, surgery is only for those who have a severe condition and can’t have sex.
Before surgery, the doctor may examine your penis by ultrasound during its erection to see the blood flow inside it and decide the best surgical procedure for your condition.
Surgical procedures for Peyronie’s disease include:
- Plication (suturing): In this procedure, the surgeon will induce an artificial erection then he will make an incision in the outer skin of the penis. Then, he will straighten the penis, pinch the scar tissue together, and suture it. The final length depends on the length of the scarred part. The shortening of the penis approximately equals 1 cm for each 15-degree correction of the curving. Thus, this procedure is more useful in less severe conditions.
- Grafting: In this procedure, the surgeon makes an incision in the skin of the penis to expose the tunica albuginea. Then, he will remove the scarred part of tunica albuginea and replace it with a graft. He may take the graft from another part of your body during the operation, such as the saphenous vein (a lower limb vein) or temporalis fascia (the skin behind the ear). Also, the graft may be a synthetic material made from human or animal sources. There is no penile shortening with this procedure, but it is harder to do and may worsen erectile dysfunction. Thus, this procedure is done only in severe cases.
- Penile implants: The surgeon inserts a bendable and inflatable cylindrical tube into the corpora cavernosa. This implant takes the direction of the curve in the relaxed state. During the erection, it swells, erects, and straightens the penis to become stiff enough for sexual intercourse. This choice is useful for patients with Peyronie’s disease and erectile dysfunction. If the implant doesn’t correct the erection enough, the surgeon may combine it with an additional surgical procedure to straighten the penis more.
Other treatments for Peyronie’s disease are still under clinical research, such as:
- Iontophoresis: A technique uses an electrical current to apply the verapamil and steroid to the scar tissue through the skin without an injection.
- Shock wave therapy: It is a technique that uses sound waves to destroy the scar tissue.