Peyronie's Disease

Urogenital Surgery

MTF Surgery

FTM Surgery

News

Peyronie's disease (also known as plastic induration of the penis) is characterized by the formation of hardened tissue (fibrosis) in the penis that causes pain and bending of the penis. Progression of the disease can lead to shrinking and shortening of the penis and erectile dysfunction.

The cause of Peyronie's disease is unknown, but it is generally accepted that minor repetitive trauma can be an etiological factor. Abnormal healing can result in the development of hard, thickened scar tissue (plaque) in the tunica albuginea. With repetitive trauma, the plaque may develop tough fibrous tissue (fibrosis) or calcium deposits (calcification) and result in the deformity.

Physical examination can confirmed presence of hard plaque inside the penis. It may be necessary to inject medication (prostaglandin E1) into the penis to induce an erection for proper evaluation.

Conservative treatment, such as oral medications and intralesional injections, is usually poorly effective, particularly if severe deformity is present.

Surgical treatment is method of choice for Peyronie’s disease. There are two major options for operative treatment: first – incising the concave side of corpora cavernosa and grafting the defect, and second - excising the plaque and implanting the penile prosthesis with or without grafting. Surgical approach depends on presence of erectile dysfunction and severity of disease. We avoid using of plication techniques since they can provoke further shortening of the penis. In patients with preserved erection our preference is grafting procedure that guarantees satisfactory result in straightening and lengthening of the penis. Using precise geometrical principles in creating and fashioning the graft with appropriate size leads to precise correction with penile lengthening. Postoperative treatment entails physical therapy by vacuum device which is of crucial importance. If significant erectile dysfunction is present simultaneous implantation of penile prostheses is performed to obtain suitable penile rigidity.

Case 1 Peyronies disease – grafting technique (click image for larger view)