Peyronie’s disease is a connective tissue disorder that causes a permanent curvature in the penis. Trauma to the penis can lead to a buildup of scar tissue. This can give the penis a curved or hourglass shape. For some men, the penis becomes shorter. 

There are several nonsurgical treatments for Peyronie’s disease, including penile injections (Xiaflex®) that break down scar tissue. But some men have severe Peyronie’s disease symptoms that require more intensive corrective treatment like surgery.

Who needs surgery for Peyronie’s disease?

Most men with Peyronie’s disease receive treatment from a urologist. This medical doctor specializes in conditions that affect the urinary tract and reproductive system. Your doctor may recommend surgery if the penile curvature doesn’t improve after 9 to 12 months of nonsurgical treatments and the curvature is:

• chronic (the curvature persists for more than 12 months without getting better or worse)

• contributing to erectile dysfunction (inability to have an erection)

• severe enough that sex is difficult or impossible

• stable (the curvature hasn’t gotten worse for at least nine months)

What should you expect before surgery for Peyronie’s disease?

There are different surgical treatments for Peyronie’s disease. To determine the best one for you, your doctor may need information about your penile erections prior to the onset of Peyronie’s disease. For instance, you should tell your doctor if you had problems with erectile dysfunction or orgasms before getting Peyronie’s disease. Some men with erectile dysfunction may need to take erectile medications before surgery to make sure that erections are possible.

You will also get some preoperative physical exams like:

• penile measurement (usually done with a ruler while the flaccid penis is manually straightened)

• penile sensitivity test to measure sexual sensory nerve responses

• penile ultrasound to check blood flow to the penis and look for signs of erectile dysfunction

For the ultrasound, you receive an injection that causes a temporary erection. In addition to checking blood flow, your provider will measure the degree of the penile curvature while erect.

What are the types of surgical treatments for Peyronie’s disease?

Surgical treatments for Peyronie's disease include:

• grafting using tissue from a donor or another part of the body

• penile implants, devices that inflate and deflate the penis via a pump inside the scrotum or flexible implants placed inside the penis

• plication to shorten one side of the curved penis to match up with the other side

Plication is typically an outpatient procedure. You will go home the same day. For grafting or penile implant procedures, you will likely spend one night at the hospital.

What should you expect after surgery for Peyronie’s disease?

It’s important to follow your doctor’s directions for postsurgical care. After surgery, you might still have a catheter (thin, hollow tube) in the penis to drain urine from the bladder and into a pouch. A healthcare provider will remove the catheter before you leave the hospital.

Recovery from penile surgery can take up to six weeks, sometimes longer. Pain, swelling, and inflammation should improve after the first week. Your doctor will use glue or sutures (commonly called stitches) that will dissolve over time.

What recovery steps should you take after surgery for Peyronie’s disease?

It’s important to follow your doctor’s directions. In general, after surgery, you should:

• Leave the light gauze (dressing) on the penis to promote healing, keep out germs, and prevent infection for 24 to 48 hours, depending on your doctor’s recommendation.

• Take prescription antibiotics for the specified period of time to lower the risk of infection. It’s important to take all antibiotics as prescribed even if you feel good.

• Take over-the-counter pain relievers and anti-inflammatory medicines to ease swelling and pain. 

• Apply antibiotic ointment to the incision site for a few days.

• Apply an ice pack wrapped in a towel to the groin. 

• Tuck a rolled towel between the legs and underneath the scrotum to elevate it.

• Wear the surgical jockstrap provided by the hospital or tight-fitting underwear to support the scrotum.

• Massage and stretch the penis five minutes a day starting two weeks after grafting surgery or as instructed by your doctor.

You should not:

• Shower for at least 48 hours after surgery.

• Soak in a tub or pool for at least four weeks.

• Drive for one week after surgery.

• Have sex (or get an erection) for at least six weeks after surgery.

• Lift anything weighing more than 20 pounds for at least four weeks.

What steps should you take after penile implant surgery?

If you get an inflatable penile implant, your doctor will inflate the device 2 to 4 weeks after surgery. Afterward, you may need to inflate and deflate the device once a day at home for a specified period of time. This step helps to stretch tissue inside the penis, making enough room for the implant.

You may experience some soreness during inflation for up to one year after getting a penile implant. See your doctor if you have concerns, but this mild pain is usually not a sign of a problem. Most penile implants last 15 to 20 years before replacement surgery is needed.

From the community: “Most men return to light duty after about 2 weeks. Walking around the next day is advised. Be aware of how you sit for a while. Most ware a jock strap for about a week. I used Jockey Pouch Briefs for support the rest of the time, they also helped me hold my penis up for the recommended 4-6 weeks. You should be able to return to regular duty and have sex in about 6 weeks.With the proper diagnostic codes your insurance should pay for the procedure and your doctor. The pump is like a third testicle. You can not look and tell you have it. It does not interfear with the normal expansion and contraction or the sack. Once the swelling of surgery goes down it is not noticable and does not bother your testicles. You would have a better chance of getting struck by lightening than the implant rupturing during sex.” – Inspire member

How successful is surgery for Peyronie’s disease?

Often, the goal of surgery is to achieve a curvature of no more than 20 degrees. Surgery rarely results in a completely straight penis. It’s estimated that 16% of men still have penile curvature after surgery, or the penile curvature comes back.

What are the risks of surgery for Peyronie’s disease?

With any surgical procedures, there’s a risk of complications. Surgery for Peyronie’s disease may result in:

• decreased sexual sensation

• erectile dysfunction or impotence

• infection

• penile implant malfunction (requiring another surgery)

• persistent or recurring penile curvature

• shortened penis length

• softer rigidity

What other steps can you take after surgery for Peyronie’s disease?

Living with Peyronie’s disease can be physically and emotionally challenging, even after corrective surgery. You and your partner may benefit from seeking help from mental health professionals. You can also join the free Inspire Peyronie’s Disease Support Community to connect with others who have this condition.

Sources

• Peyronie's disease. American Urological Foundation. September 2020.

• Surgery for Peyronie’s disease. Asian Journal of Andrology. January 2013.

• Peyronie’s disease. Cleveland Clinic. August 2020.

• Recovering from penile implant surgery. EDCure.org. January 2018.

• Five things to know if you’re considering a penile implant. Houston Methodist. February 2020.

• What surgical treatments are available for Peyronie’s disease? International Society for Sexual Medicine. 

• Penile curvature (Peyronie's disease). National Institute of Diabetes and Digestive and Kidney Diseases. August 2019.

• Surgical treatment for Peyronie’s disease. University of California San Francisco. 

• After your penile implant surgery. University of Iowa Hospitals and Clinics. October 2020.

• Grafting surgery for Peyronie’s disease. University of Utah. 

• Peyronie’s disease. University of Virginia Department of Urology. 

• Surgery for Peyronie’s disease. Weill Cornell Medicine Center for Male Reproductive Medicine and Microsurgery.

Disclaimer

Member comments are lightly edited for length and to remove identifying information but are otherwise reproduced as they appear in the community as part of public posts.

This content is for general informational purposes only and does not necessarily reflect the views and opinions of any organization or individual. The content should not be used as a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider about any questions you may have regarding a medical condition.