Introduction
Curved penis surgery can be an effective treatment for Peyronie’s disease, but it’s not always the answer. Let’s explore the factors to consider when deciding if surgery is right for you. This article will delve into Peyronie’s disease, non-surgical treatment options, and the different types of surgeries available.
What Is Peyronie’s Disease and Does It Cause Erectile Dysfunction?
Peyronie’s disease is one of several connective tissue disorders. It develops when scar tissue, also called plaque, accumulates under penile skin. The plaque tugs on the surrounding tissue and leads to penile curvature.
A bent penis may or may not be painful on its own, but it can lead to problems with sexual intercourse such as painful sex and erectile dysfunction (ED).
Peyronie’s Disease Risk Factors
Factors that lead to a higher risk of Peyronie’s disease include injury to the penis or having an autoimmune disease associated with scar tissue buildup.
The best way to prevent Peyronie’s disease is to avoid overly vigorous sports activities or sexual positions that could injure the penis. Making sure diabetes is under control can also reduce your risk of Peyronie’s disease.
If something unpredictable like an injury from an accident leads to Peyronie’s disease, there’s not much you can do to stop it from happening.
Sometimes, it’s not just one major injury that causes Peyronie’s disease, but rather small chronic injuries that happen over time. Most men don’t remember the original micro-injury to their penis that caused Peyronie’s disease to develop.
Does Every Man with Peyronie’s Disease Need Surgery?
Whether or not your doctor recommends surgery to treat Peyronie’s disease depends upon several factors. If you’re in the early stage of the disease, your symptoms may resolve or not be serious enough to require surgery.
Usually, healthcare professionals only recommend surgery if the penis curvature has stayed stable for at least three to six months or if you’ve had Peyronie’s disease symptoms for a year or more. If the penis is curved to such a degree that it makes penetrative sex difficult or causes ED, a doctor may recommend Peyronie’s disease surgery.
Stages of Peyronie’s Disease
There are two stages of Peyronie’s disease. In the acute phase, plaque builds up, leading to inflammation. Penile curvature becomes more pronounced and your penis may start to hurt even when you’re not having an erection.
As scar tissue develops, erections may become painful. The acute stage can persist for up to 18 months.
The chronic stage of Peyronie’s disease begins after plaque formation, around a year to 18 months after your symptoms begin. During the chronic phase, penile curvature may remain stable and there may be less penile pain, but erectile dysfunction may develop or become more bothersome.
The acute phase of Peyronie’s disease is the stage in which a doctor is most likely to recommend non-surgical medical treatments. At the beginning of this stage, doctors may also choose to monitor Peyronie’s disease to see if it gets any worse rather than implementing any treatment.
Men who don’t need treatment for Peyronie’s disease may include those who have:
- No pain
- Minor curve to the penis
- Small plaque formation
- No erectile dysfunction
- No urinary problems
Non-Surgical Treatment Options
After doctors diagnose Peyronie’s disease and before recommending surgery, they will usually suggest less invasive treatment options.
Oral Medications
There are no oral medications that can treat a curved penis. A type of medication known as potassium para-aminobenzoate is showing promise in a similar condition known as Dupuytren’s contracture and may shrink plaque size in men with Peyronie’s disease.
To reduce pain, your healthcare provider may suggest nonsteroidal anti-inflammatory drugs (NSAIDS) like ibuprofen.
Penile Traction Therapy
A penile traction device stretches the penis to create tension, which remodels the plaque and may reduce the curvature. Men who choose this treatment option wear a penile traction device every day. The devices are made of a plastic support ring, a silicone band, and two adjustable rods. Penile traction therapy may increase the length of the penis and reduce the curvature.
Shockwave Therapy
Doctors use this type of treatment, called low-intensity extracorporeal therapy (Li-ESWT), to direct focused sound waves at the Peyronie’s plaque. Some research indicates it may reduce penile pain and improve erectile function.
Injections
During the acute phase of Peyronie’s disease, healthcare providers may inject medicines directly into the Peyronie’s disease plaques. A common type of medicine used in the injections is collagenase (Xiaflex), an enzyme that helps break down Peyronie’s disease plaques. Disrupting the plaques reduces penile curvature and ED. The only FDA-approved Peyronie’s disease treatment, collagenase is used in men whose penises are curved more than 30 degrees.
Another injectable medicine for treating Peyronie’s disease is verapamil, a drug used to treat high blood pressure that’s also used to improve penis pain and reduce curvature in men with Peyronie’s disease.
In some cases, doctors use interferon-alpha 2b to relieve pain, curvature of the penis, and plaque size. This medicine uses interferon, a protein manufactured by white blood cells.
Types of Peyronie’s Surgery
Penile Plication
This type of surgery involves removing a piece of the tunica albuginea from the side of the penis that’s opposite the plaque. This treatment is a way to straighten the penis. Penile plication surgery is less likely to cause numbness or erectile dysfunction compared to other Peyronie’s disease surgeries, but it can cause the penis to shorten.
Grafting
In a grafting procedure, a urologist directly removes the penile plaque and replaces it with a graft. The graft can be:
- A patch of tissue removed from another part of your body such as a piece of skin or a vein from the leg
- Grown in a lab
- From organ donors
This penile reconstruction treatment can straighten the penis curve and add length if your penis was shortened due to Peyronie’s disease.
Penile Implant Surgery
Your doctor may recommend this approach if Peyronie’s disease leads to severe penile curvature and erectile dysfunction that doesn’t improve after oral medications, interfering with sexual intercourse and making sex uncomfortable.
The surgical treatment involves implanting an inflatable device (also known as a penile prosthesis) into the penis to straighten the penis and promote rigid erections. Penile implants aren’t visible and when you’re done with sexual activity you can deflate it.
Risks of Peyronie’s Surgery
Each type of curved penis surgery has risks. Plication can lead to a shorter penis. Grafting may cause penile numbness and erectile dysfunction.
With penile implant surgery, there’s a risk of mechanical failure, which is when the implant stops inflating, leading to surgical removal and replacement of the device. Rarely, infections also can occur after this type of surgery. Another rare occurrence is when the implant is incorrectly sized.(5) When it’s too short, the head of the penis may droop and when it’s too long it can cause tissue erosion.
Another risk of inflatable penile implant surgery is that reservoir migration may occur. This is when the reservoir that holds the saline water shifts. When this happens, you’ll need surgery to move the reservoir back to its proper location.
FAQs About Peyronie’s Disease Surgery
Is Peyronie’s Surgery Painful?
You will suffer from mild pain and discomfort after Peyronie’s surgery, which can be worse and longer-lasting with more invasive procedures. You can use oral over-the-counter painkillers to treat the pain. Some men may experience painful erections for a few days after surgery. Talk to your doctor about what to expect after your procedure and the best way to deal with pain.
How Much Length Do You Lose from Peyronie’s Surgery?
It depends upon the type of surgery. Plication shortens the penis on the far side of the curve so it can be tugged straight. This means you will lose some penile length. However, grafting increases penis length rather than shortening it. In a successful grafting procedure, the length of the short side of the penis is equivalent to the long side.
What Happens if Peyronie’s Is Left Untreated?
Mild cases of Peyronie’s disease may improve without treatment. In untreated severe cases of the disease, symptoms may remain stable or get worse. Your doctor can recommend the best approach for you.
How Long Does It Take to Recover from Peyronie’s Surgery?
Recovery time can depend on the type of Peyronie’s surgery. Plication is usually an outpatient procedure and you can recover at home. For five days after the surgery, you’ll need to change your dressings. Most men resume work within a day or two of the procedure.
With an excision and grafting surgery, the procedure is more invasive and usually requires an overnight hospital stay. The recovery period is longer compared to plication and you’ll have to wait longer before returning to work or to resume sexual activity.
Penile implant surgery also involves an overnight hospital stay. It involves more tissue than grafting alone, so expect a longer recovery time. It can take one to several weeks before you’re ready to return to work.
Conclusion
Peyronie’s disease can be a frustrating condition, but there are treatment options available to help manage symptoms and improve your quality of life. While curved penis surgery can be an effective solution in some cases, it’s not always necessary. Talking to your doctor about the severity of your condition and your individual needs is crucial.
Remember, there are effective non-surgical treatments like penile traction therapy, injections, and shockwave therapy that can address curvature and pain. If these methods don’t prove successful and your Peyronie’s disease significantly impacts sexual function, then surgery might be a viable option.
Ultimately, the decision of whether or not to pursue surgery for Peyronie’s disease rests with you and your doctor. By openly discussing your concerns, treatment options, and potential risks and benefits, you can make an informed choice about the best course of action for your situation.
