Peyronie’s disease treatment without implant is possible when the curvature is controlled and when erectile dysfunction is mild or nonexistent.
Peyronie’s disease is characterized by the formation of fibrous plaques on the penis, which reduce elasticity and can cause curvature during erection.
Treatment does not always involve the use of an implant. In some cases, the urologist may recommend penile curvature correction techniques without the need for an implant.
Below, understand when Peyronie’s surgery without implant is indicated, what techniques are available and the expected results.
When is Peyronie’s surgery without implant indicated?
Surgery is indicated when the curvature compromises penile functionality, making sexual intercourse difficult or impossible.
It is also considered when medical treatment does not produce satisfactory results.
How does Peyronie’s surgery without penile implant work?
Surgical treatment for Peyronie’s disease without implant aims to correct penile curvature. Recovery of functionality will depend on individual clinical evaluation and each patient’s response to the procedure.
Correction can be achieved through plication techniques, which shorten the side opposite the curvature, or by lengthening the shortened side using a graft.
The choice of technique depends on evaluation by a specialist urologist, who considers the individual characteristics of each patient.
Main techniques for Peyronie’s surgery without implant
| Technique | Basic Principle | Acts on Which Side | Graft Use | Main Indication | Impact on Size | Important Observations |
|---|---|---|---|---|---|---|
| Nesbit (Plication) | Reduces the long side | Long side | No | Mild to moderate curvatures | May reduce | Simple technique; risk of thinning |
| Plication | Shortens the long side with sutures | Long side | No | Mild to moderate curvatures | May reduce | More simple; more widespread |
| Excision and Suturing | Removes segment and sutures | Long side | No | More defined curvatures | May reduce | More invasive than plication |
| Incision and Graft | Lengthens the short side; multiple graft techniques | Short side | Yes | Severe curvatures and deformities | Better preservation | Indicated in complex cases |
| STAGE Technique | Multiple incisions and grafts | Both | Variable | Deformity cases | Variable | Comprehensive but more time-consuming |
| Egydio Technique | Geometric principles; incision on the short side | Short side | Usually yes | Complex curvatures | Preserves length | Precise realignment with minimal length loss |
Nesbit Technique (Plication)
The Nesbit technique is indicated for smaller curvatures and aims to correct penile deviation through intervention on the long side, that is, in the region not affected by Peyronie’s disease.
The surgeon performs small excisions (tissue removal ) on the longer side and then this tissue is folded and sutured to promote alignment.
The characteristics of this technique include its simplicity and widespread use. The effectiveness in correcting curvature varies according to each clinical case.
However, penile plication may involve a reduction in length, especially in more pronounced curvatures. Furthermore, the technique does not correct thinning.
Graft (Incision)
The graft technique in Peyronie’s disease acts on the short side and is indicated for curvatures above 60° or hourglass deformity, in patients with good penile rigidity.
It consists of incisions to lengthen the shortened side, which creates an opening that is closed with a graft, fixed by suture or glue.
In mild cases, the graft may be dispensed with, but in more pronounced curvatures greater use of material is necessary.
Bovine pericardium is one of the grafts used. After proper processing, it is considered appropriate for surgical use.
This material undergoes treatment, cleaning and sterilization processes, in accordance with safety standards for surgical use.
Plication
Plication is a Peyronie’s surgery without implant, but is often confused with the Nesbit technique.
In common, both techniques act on the long side. The difference is that, while Nesbit performs incisions in ellipses that need to be closed, plication does not involve cuts.
Therefore, plication consists of passing the thread through the long side, without reaching the tunica albuginea, forming folds that pull the penis and, consequently, reducing its size.
Excision and Suturing
The excision and suturing technique is indicated for curvatures above 60°, usually with calcified fibrosis.
It consists of removing the hardened tissue responsible for the curvature, followed by suturing to promote penile alignment.
STAGE Technique
The STAGE technique is based on geometric principles and is indicated for curvatures without complex deformities.
It aims to promote penile alignment with minimal length loss, usually without the need for a graft.
The procedure consists of superficial excisions on the long side, with oval incisions, followed by closure with small and precise sutures.
Egydio Technique
Small and carefully planned incisions allow tissue relaxation and expansion. Length loss varies according to each clinical case.
Which technique is most suitable for each case?
Treatment of Peyronie’s disease without the use of an implant presents several options, and the choice of the most appropriate technique depends on individualized evaluation.
The specialist urologist analyzes the degree of curvature and the patient’s erectile function.
Based on these factors, the most appropriate method is defined for each individual case.
Expected results of surgery
Risks and possible complications
Like any surgical procedure, treatment of Peyronie’s disease without penile implant presents risks and possible complications.
Among them, the following stand out:
1 ) Changes in sensitivity
After the procedure, there may be a reduction in penile sensitivity. It is usually temporary, but if it persists, it is important to consult the surgeon for evaluation.
2) Recurrence of curvature
There is a possibility of partial or total return of the curvature, especially in techniques such as Nesbit.
3) Erectile dysfunction
Although uncommon, it can occur in some cases, and medical evaluation is essential if it occurs.
What is recovery like after surgery?
The recovery from Peyronie’s surgery varies depending on the technique used.
- Recovery time: usually 7 to 10 days, a period in which the patient can return to work if the activity does not require physical effort.
- Return to sexual activity: normally allowed between 45 and 60 days after the procedure.
- Post-operative care: includes keeping the area clean and dry, performing proper dressing changes, using prescribed medications correctly, respecting rest and sexual abstinence, and attending follow-up appointments.
When to consider a penile implant?
A penile implant is indicated in cases of pronounced curvature that compromises penile functionality, especially when there is associated erectile dysfunction.
It is also recommended when the patient does not show a satisfactory response to medical treatment.
Importance of evaluation with a specialized urologist
Evaluation by a urologist with extensive experience in Peyronie’s disease is important for adapting the procedure to each case.
Three aspects are especially important:
- Diagnosis: clinical evaluation allows identification of the degree of curvature, assessment of whether fibrosis is calcified, and determination of the impact on sexual function.
- Choice of technique: there are several techniques for Peyronie’s surgery without penile implant. The selection of the most appropriate method depends on individualized clinical evaluation of each case.
- Treatment safety: the urologist’s experience in surgeries reflects their knowledge of safety practices, reducing the risk of post-operative complications.
Penile curvature can be treated. The results of treatment depend on a correct diagnosis and individualized clinical evaluation.
Learn more:
- Ultrasound in Peyronie’s Disease: learn more about this exam
- How Much Does Penile Curvature Surgery Cost?
- Peyronie’s Complementary Therapies: Know the 6 Main Ones
- Penile Disuse: Causes of Impotence and Treatments
- Peyronie’s Surgery Video: Learn about geometric principles
- Surgical Treatment for Congenital Penile Curvature: 8 Benefits
- Penile Fibrosis: Symptoms, Causes and Treatments
- Male Pelvic Physiotherapy: Benefits and Treatments
- Penile Fibrosis: Symptoms, Causes and Treatments
- Penile Traction Therapy Improves Peyronie’s? Understand!
