Peyronie’s Disease Surgery

Do you have a bent penis?

If you have a bend in your penis when you get an erection, you may have a condition called Peyronie’s disease. The bend could be upwards, downwards or to either side. Of course, no man’s penis is perfectly straight. A natural curvature is normal. With Peyronie’s disease, the bend is very noticeable and it makes sexual intercourse more difficult, in some cases impossible, and very often painful.

Peyronie’s disease is not an uncommon condition; it affects around 9% of adult men. While sexually active men of any age can find themselves with Peyronie’s disease, it usually is a condition that is more prevalent in older men.

We can treat Peyronie’s disease for you. At Moorgate Andrology we offer Peyronie’s disease treatment for all cases of the condition. All patients are able return to a healthy sex life given expert treatment has been provided.

Peyronie’s disease causes:

Peyronie’s disease is caused by a formation of scar tissue inside the penis, known as a plaque. Peyronie’s disease causes are not exactly known, but it is thought that the plaque can be formed after trauma or repeated injury to the penis, such as bending. In some cases it is through attempting sexual intercourse without the penis being fully erect, that can lead to plaque formation. Most men will notice a curve and pain in the penis on erection. Over time this pain can subside but the bend can get worse, especially over the first year.

Whether you only have a slight curvature of the penis, or a severe curvature and pain on erection, it all depends on the location and size of the scar tissue. If you think you have any severity of the symptoms, contact Moorgate Andrology for a consultation to discuss how we treat Peyronie’s disease and to learn how we can help you.

Peyronie's disease is a condition which causes the curvature or bending of the penis.

Peyronie’s disease treatment:

Our team of Uro/Andrologists use the latest surgical procedure, The Stage Technique, for the correction of penile curvatures. The Stage Technique stands for “Superficial Tunica Albuginea Geometric-based Excision.” This is a significant advancement on the Peyronie’s disease treatment offered by the NHS, called the Nesbit procedure, which generally results in significant penile shortening. Whereas the latest Peyronie’s disease cure of the Stage technique results in minimal loss of penile length.

In Moorgate Andrology’s Peyronie’s disease treatment geometric principles are used to straighten the penis. This is achieved by making very small, multiple incisions just underneath the skin surface at the maximum point of the curvature.

Surgical Peyronie’s disease treatment is usually advised and considered primary for patients who have a more severe curvature, and whose penile curvature is preventing them from having satisfactory sexual intercourse. Other methods of Peyronie’s disease treatment is available at Moorgate Andrology should the patient prefer non-surgical options.

peyronies disease surgery

Peyronie's Disease Surgeon

Dr. Nenad Djakovic’s expertise in Peyronie’s disease goes back as far as 1992. It was then that he began performing new, innovative techniques to treat this condition with procedures such as plaque incision and grafting.

This experience was under the guidance of a world-famous Urologist, Professor Sava Perovic, with whom Dr. Djakovic worked closely.

Later, he took this experience in Peyronie’s disease to the University Hospital of Heidelberg as head of the department in reconstructive Urology.

His experience in the treatment of Peyronie’s disease is considerable.

Now, he is performing the following numbers of Peyronie’s disease procedures each year.

  • 50 Plaque incision and grafting
  • 60 Stage Procedures
  • 40 Nesbit procedures

He is also a Consultant Paediatric Urologist at Muhldorf hospital in Germany.

His experience is renowned worldwide in Reconstructive Urology, Urological-oncological surgery, Paediatric Urology, and Andrology.

Dr. Djakovic receives referrals for Peyronie’s disease from across the United Kingdom, Scotland, and Ireland.

He has written and co-written many papers on Peyronie’s disease some of which have been published in the British Journal of Urology. These include:

S Perovic, M Djordjevic, N Djakovic (1997)

A NEW APPROACH IN THE TREATMENT OF PENILE CURVATURE. Journal of Urology. 160(3pt2) 1123-7 1998

Kuehass F.E, Weibl P, Georgi T, Djakovic N, N Herwig R,

Peyronie’s Disease: non surgical treatment options, Rev Urol. 2011: 13 (3) 139-46

If you are looking for advice or help to treat your Peyronie’s disease, give us a call today and arrange a free video consultation with Dr. Nenad Djakovic.

Dr Nenad Djakovic - Peyronie's disease

Plaque incision and grafting

  1. This procedure is best performed when the disease is in the chronic phase and there have not been any changes in the penile curvature for three months. With this technique, surgery is performed on the short side of the penis, not the long side, as with the Nesbit procedure.

When the penis is opened to make it straight, a gap is left which is filled with a special graft that acts as a matrix, or scaffold for the formation of new collagen and tissue.
This procedure will not only make your penis straight again but also protect its length.

The surgery takes around two hours and in most cases you can go home on the same day.

At Moorgate Andrology, plaque incision and grafting surgery is a very common procedure, most of our curvature cases are corrected with this technique. It is particularly useful in severe curvature where the Nesbit procedure would result in significant shortening of the penis.

peyronies disease surgery uk

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Latest Peyronie’s disease cure: The Stage Technique

There are a number of key principles that are adopted in the Stage Technique. These are as follows:

  • To protect or increase penile length and girth
  • To straighten the penis and remove or minimise any bend
  • Maintain or improve your erection
  • Minimise risks of complications in the straightening of your penis

The procedure is performed under general anaesthetic and takes around one hour. In most cases, you can go home on the same day after Peyronie’s disease treatment. Depending on the type of work you do, please arrange to take one to two weeks off work.

Peyronie’s disease surgery Stage Technique

The Stage Technique vs The Nesbit Procedure

The Stage Technique has significant advantages over traditional Peyronie’s disease treatment methods, such as the Nesbit procedure used by the NHS.

  • High risk of penile length loss with Nesbit, minimal length loss with Stage.
  • Higher risk of haematoma following Nesbit surgery. This risk is very low with the Stage Technique.
  • There is a much lower risk of loss of glans sensitivity with the Stage Technique when compared to Nesbit.
  • Much lower risk of recurrence of Peyronie’s disease with the Stage Technique.
  • 99.1 % straightening rate with the Stage Technique compared to only 76.2% with the Nesbit procedure.
Peyronie’s disease surgery nesbit Technique

FAQs

Can surgery cure Peyronie's disease?

Peyronies disease is a very distressing condition that affects many men. Men with Peyronie’s disease have an unnatural curvature to the penis when it is erect due to scar tissue build up. The penis may bend upwards or to the left or right. In worst cases, it may be impossible to penetrate a partner due to the angle of the erect penis. In many cases, sexual activity can be painful for the sufferer and/or his partner.

Surgery is often an option to cure Peyronie’s disease. It is normally considered when conservative options have failed to improve the condition, or where the curvature is such that conservative options are not going to improve the condition enough. In the national health service a procedure called ‘The Nesbit procedure’ is performed. This procedure makes the penis straight but leads to penile shortening, which can be an unattractive and unwanted outcome for many men. With the Nesbit procedure the worse the curvature the more the shortening of the penis.

There are procedures offered in the private sector that focus on length preserving aspects. The penis is made straight again with minimal loss of length. An example of these innovative approaches would the so-called ‘Stage Technique’ and ‘plaque incision and grafting’.

These procedures are performed when the disease is in the chronic phase, sometimes referred to as the stable phase. Urologists need to make sure that there have been no changes in the curvature for a period of three months prior to any surgery being carried out or that any more scar tissue has formed. Adopting this approach minimises the chances of the disease returning. It can take up to one year for Peyronie’s disease to move from the acute phase to the chronic phase.

To help diagnose Peyronie’s disease, it can be a good idea for patients to take photos of the penis each month during the acute phase to monitor the progression of the disease. This can be very helpful for the Urologist in the overall assessment of the case.

Peyronies disease surgery is performed under general anaesthetic and takes around two hours. In most cases, patients can go home on the same day.

Is surgery for Peyronie's disease painful?

The actual surgical procedure to correct Peyronie’s disease is performed under general anaesthetic. This means you would be asleep for the duration of the procedure and you would not feel anything.

This would be true of anything we procedures we perform when treating Peyronie’s disease such as the Nesbit procedure, the stage technique, and the plaque incision and grafting technique.

Upon discharge from the hospital after such a procedure you would be given antibiotics and pain relief medication.

In the first week or two you should expect some discomfort. This is normal and to be expected in the initial healing phase. Your penis will be swollen and quite bruised. You will most likely have a compression dressing on the penis at first which may feel quite tight.

To ease discomfort it is important to take the pain relief medication and takes things steady in the first week or two. You must avoid all strenuous activity for up to six weeks after surgery. This includes Gym and sporting activities. If you undertake these too soon they can increase swelling and increase pain as a result. Similarly, you must avoid all sexual activity including masturbation for six weeks.

As the swelling and bruising settle down in the following weeks so will the discomfort. Those with a sedentary job may only need to take a few days off work, whilst those in more physical jobs may need to take on a week off.

If you experience increasing pain after the surgery you should contact your Urologist as this could be a sign of infection.

Most patients who undergo the surgery tolerate the post-operative discomfort without any problems. It is very important to follow the advice of the Urologist to the letter after the procedure as some of this advice will be to help to ensure the most comfortable recovery possible.

What happens if Peyronie's disease is left untreated?

Men with Peyronie’s disease notice an unnatural curvature to their penis when it is erect due to excess scar tissue causing a bend. When the penis is flaccid this curvature may not be noticeable.

Most guys have never heard of Peyronie’s disease when they encounter this condition. To see their penis suddenly bending can be quite shocking and upsetting. It affects relationships and in the worst cases can make sexual intercourse virtually impossible.

Peyronies disease goes through two phases, known as an acute phase and a chronic phase.

In the acute phase, there is often pain during an erection and the start of bending of the penis. The penis may bend upwards towards the body, or left or right. In this acute phase, the patient can just wait and see how the disease develops over the following nine to twelve months before it enters the chronic phase.

However, there is the option to try conservative treatments in this acute phase to attempt to limit the extent of the curvature and promote the healing of the damaged tissues.

This conservative treatment may consist of therapies such as tadalafil medication which oxygenates the penis by encouraging blood flow. This helps in the healing process. Alongside tadalafil, other therapies include a vacuum pump and traction device to help with the remodeling of the penis. It cannot be determined how much these therapies will help, time will tell, but in the acute phase, there is evidence that they do help and patients generally feel better that they are making an effort to improve the situation.

When the disease enters the chronic phase then an assessment will need to be made of the extent and impact of the curvature. If the conservative therapies have helped, it might be that the patient can live with a moderate degree of curvature without any major impact on their sexual performance. If however, the curvature has worsened over the previous year, surgery will need to be considered to make the penis straight again. Indeed in significant curvature, this is really the only option. The NHS carries out a procedure known As ‘The Nesbit procedure’ which will straighten the penis but leave it shorter than before. Now there are more advanced procedures available privately that straighten the penis whilst protecting its length. Such procedures include the so-called ‘Stage Technique’ and ‘plaque incision and grafting’.

If the penis is left untreated at the chronic phase with a significant curvature, there is a risk of a penile fracture.

Is surgery for peyronie's disease a permanent fix?

Surgery for peyronie’s disease is common in cases of significant bending of the penis, usually where more conservative treatments in the acute phase have failed to have any reasonable impact.

In Peyronie’s disease the condition moves from an acute phase into a chronic, or sometimes called, a stable phase.

This transition is very important when considering the timing of surgery for Peyronie’s disease. In the acute phase the patient will notice a progressive bending of the penis. This bending may be upwards towards the body, or it may be to the left or right. Urologists usually advise patients to take photos of the penis at the same angle once a month, to help monitor the changes in the penile curvature.

The disease tends to move into the stable phase at around nine to twelve months. The patient will notice no change in the curvature. The Urologist will want to see a period of three months with no changes to the angle of curvature before considering Peyronie’s disease surgery. This is very important because if the surgery is carried out too soon, for example when the disease is in the acute phase, there is a higher risk that the disease may return after the surgery.

By waiting until the disease moves into the stable phase there is much less risk of the curvature returning after surgery. It should be mentioned that there is a very small risk of a recurrence of Peyronie’s disease after the surgery, but this is rare.