Conditions & Treatments
If symptoms of Peyronie’s disease are severe or worsen over time, a doctor may recommend medications or surgery. A number of oral medications have been tried to treat Peyronie's disease, but they don't appear to be as effective as surgery. In some cases, drugs injected directly into the penis may reduce curvature and pain associated with Peyronie's disease. The patient will likely receive multiple injections over several months and will be given a local anesthetic to prevent pain during the injections. Evidence on the effectiveness of penile injections is limited.
If the deformity of the penis is severe or prevents the patient from having sex, a doctor may suggest surgery. Surgery usually isn't recommended until the curvature of the penis stops increasing, and erections have been pain-free for at least six months.
Common surgical methods include:
- Shortening the unaffected side. A variety of procedures can be used to shorten the longer side of the penis (the side without scar tissue). The shortened side of the sheath and the less elastic, scarred side of the sheath end up being about the same length when the penis is erect. This results in a relatively straight erection. However, this procedure usually shortens the overall length of the penis. It's generally used in men who have adequate penis length and a less severe curvature of the penis. Nesbit plication is an example of this type of procedure. In some cases, this type of surgery causes erectile dysfunction.
- Lengthening the affected side. With this type of surgery, the surgeon makes several cuts in the scar tissue, allowing the sheath to stretch out and the penis to straighten. The surgeon may have to remove some of the scar tissue. A piece of tissue (graft) is sewn into place to cover the holes in the tunica albuginea. A graft may be tissue from your own body, human or animal tissue, or a synthetic material. This procedure is generally used if a man has a shorter penis, severe curvature or a complicated deformity. This procedure runs a greater risk of erectile dysfunction than does the shortening procedure.
- Penile implants. Surgically inserted penile implants replace the spongy tissue that fills with blood during an erection. The implants may be semirigid—manually bent down most of the time, and bent upwards for sexual intercourse. Another type of implant is inflated with a pump implanted in the groin or scrotum. Penile implants may be considered if a man has both Peyronie's disease and erectile dysfunction. When the implants are put in place, the surgeon will likely make some cuts (incisions) in the scar tissue to relieve tension on the tunica albuginea.
The type of surgery used will depend on the patient’s condition. The doctor will consider the location of scar tissue, the severity of the symptoms and other factors. If a man is uncircumcised, the doctor may perform a circumcision during surgery.
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