Plication
A shortening technique may be suitable when length is sufficient, erections are preserved and the deformity is less complex.
06 / Peyronie's disease · curvature · reconstruction
Peyronie's disease and reconstructive surgery in Krasnoyarsk
The goal of Peyronie's disease treatment is to restore function and the ability to have sex, rather than to create a geometrically perfect result. Management depends on the disease stage, the type of deformity, penile length and erection quality.
- Peyronie's disease
- Curvature
- Reconstruction
This material was prepared by a doctor using Russian clinical guidelines and EAU guidance. It does not establish a diagnosis, prescribe treatment or replace an in-person consultation. The choice of method depends on investigations, coexisting conditions and individual risks. A surgical outcome cannot be guaranteed in advance.
- First
- determine whether the disease is in the active or stable phase
- Choosing a method
- shape, length and erectile function
- Goal
- straightening sufficient for function
01 / Indications
When surgery may be discussed
- stable Peyronie's disease
- deformity interferes with intercourse and causes significant distress
- severe or complex curvature, hourglass deformity or hinge deformity
- congenital curvature after puberty, if it interferes with function
- Peyronie's disease combined with erectile dysfunction that does not respond to conservative treatment
02 / Decision
No single operation is best for everyone
The assessment covers disease duration, pain, changes in shape, length, the degree and direction of curvature, erectile function and the patient's expectations. The deformity must be documented objectively, using safely taken home photographs or a medical test.
Grafting
Incision or partial incision of the tunica albuginea with grafting is discussed for severe or complex curvature with preserved erections.
Prosthesis implantation
In severe erectile dysfunction, an implant can provide rigidity while also allowing the deformity to be corrected.
03 / A separate question
Rapid ejaculation is not automatically an indication for surgery
First, the type and duration of the problem, ejaculatory control, erectile function and inflammatory or other possible causes are clarified. Treatment usually centres on explanation, behavioural options and medication when indicated.
Selective dorsal neurectomy should not be presented as a standard service: current guidelines point to insufficient evidence on long-term safety.
04 / Preparation
What to prepare for an in-person assessment
- a description of the duration and progression of the curvature
- photographs of the erection from several angles, without the face or other identifying details
- information on pain, erection quality and the ability to have intercourse
- ultrasound or Doppler ultrasound results, if already performed
- information about previous treatments and operations
- a list of medicines and specific treatment goals
05 / Surgery
How the methods differ
Plication shortens the longer side. Grafting lengthens the shorter side and covers the defect with graft material. In severe erectile dysfunction, an implant both provides rigidity and allows correction of the deformity.
The method is chosen after discussing the expected straightening, change in length, and risks to erections and sensation. Neither perfect straightness nor preservation of the original length can be guaranteed.
Clinical practice
Reconstructive surgery in clinical practice
The photographs show reconstructive surgery in clinical practice. The method is chosen after assessing the deformity, erectile function, expectations and alternatives.
Insertion of a three-piece penile prosthesis as one option when deformity is combined with severe erectile dysfunction
06 / After surgery
Recovery and restrictions
Swelling, bruising and soreness are expected. Temporary changes in sensation are possible. When you can return to work, physical activity and sexual activity depends on the operation chosen and the findings at follow-up.
07 / Risks
Realistic expectations
- residual or recurrent curvature
- shortening and palpable knots under the skin
- numbness or altered sensation
- worsening erectile function, particularly after grafting
- infection and wound-healing problems
08 / Urgent care
When urgent assessment is needed
After surgery: a rapidly enlarging haematoma, active bleeding, high fever, purulent discharge, wound separation or urinary retention.
An injury to an erect penis with a cracking sound, sudden severe pain, bruising and abrupt loss of erection requires emergency assessment.
Patient questions
Frequently asked questions
When is Peyronie's disease considered stable?
When pain and the shape of the deformity have stopped changing over an observation period. The exact duration and signs of stability are established at an in-person consultation.
Can preservation of length be guaranteed?
No. Different methods affect length, erections and sensation differently. These trade-offs are discussed before choosing an operation.
Does every patient need Doppler ultrasound?
No. It can be useful in erectile dysfunction and when planning complex reconstruction, but the extent of the assessment is determined individually.
Verifiable evidence
Sources
This page explains general guidance in plain language. Decisions for an individual patient are made after an in-person assessment and cannot be reduced to a single guideline recommendation.
In-person assessment and a clear plan