Learn how Peyronie’s surgery is performed and when it’s recommended

How Peyronie’s surgery is performed: shorten the long side or lengthen the short side depending on the curve’s degree and type.

Surgery for Peyronie’s disease is considered when the curvature interferes with penile function. At this stage, the anatomical change can cause pain with erection and hinder or impair sexual intercourse.

The procedure may be indicated to correct penile curvature and can involve shortening the longer side or lengthening the shorter side. Below, learn how Peyronie’s surgery is performed and the characteristics of each method.

What is penile curvature?

Penile curvature occurs when the penis bends beyond what is considered acceptable for its axis. This anatomical change can have two causes: Peyronie’s disease or “young curvature,” also known as congenital curvature.

In Peyronie’s disease, curvature develops after microtraumas to the penis—usually during sex, sports, or even falls. These small traumas create internal scars that compromise the elasticity of the tunica albuginea, a membrane that internally envelops and protects the penis.

As scar tissue forms, the tunica albuginea loses elasticity. This prevents uniform expansion during erection, resulting in a curvature that may point upward, downward, or to the sides.

In congenital curvature, the cause is linked to penile development during gestation. The bend becomes noticeable in puberty, when erections become more frequent.

When is Peyronie’s surgery recommended?

There are two main indications for surgery for penile curvature.

First, when the patient does not respond well to noninvasive treatments such as oral medications, injections into the affected area, or shock wave therapy.

Another recommendation for surgery to align penile curvature is when the deformity makes penetration difficult or impossible.

Types of Peyronie’s surgery

Surgical approaches are grouped into two categories: shortening the long side or lengthening the short side.

Techniques that shorten the long side:

1. Nesbit technique: removing a portion of the longer side so both sides match in length to correct the curvature.
2. Kelami–Nesbit technique: a variation that uses a specific tool to determine where and how much tissue to remove.
3. Lue’s 16-dot technique: parallel plications to balance side lengths.
4. Modified Yachia corporoplasty: a single incision with horizontal closure to equalize sides.
5. Essed–Schroeder plication: often used for ventral curvatures to help avoid lateral bends; four plications on the opposite side of maximal curvature to straighten the penis.
6. Egydio’s STAGE technique: an evolution of Nesbit’s 1965 method, using geometric calculations to define tissue removal sites.

Techniques that lengthen the short side:

1. Devine–Horton dermal graft: excision of fibrotic plaque with a graft to repair the area and help lengthening.
2. Sampaio parallel “I” incision: an opening to stretch and lengthen without tissue removal or grafts.
3. Gelbard relaxing incisions: multiple releases to expand tissue, often when planning a larger Peyronie’s penile prosthesis.
4. Lue “H” technique: expansion using an H-shaped incision.
5. Egydio’s geometric principles: incisions planned with geometric calculations to expand tissues.
6. Sansalone–Egydio technique: geometry-guided precise incisions.
7. Miranda geometric model: applies Dr. Paulo Egydio’s geometric principles with computer assistance to enhance precision.
8. Gaffney lengthening strategy: several incision patterns to stretch tissue while preserving nerves and urethra.
9. Geometric no-graft Egydio method: stretching stiffened tissues to regain flexibility, enabling placement of a Peyronie’s penile prosthesis.

How much does the surgery cost?

The cost of Peyronie’s surgery varies.

Pricing depends on factors such as:

• type of prosthesis;
• length of hospital stay;
• surgical team costs;
• technique employed;
• revision surgery;
• patient’s clinical history.

Is Peyronie’s surgery available through the public health system?

Yes, in Brazil the SUS covers surgery for penile curvature, but the waitlist can be long.

Coverage applies to specific situations, such as erectile dysfunction after radical prostatectomy for prostate cancer.

Regarding the prosthesis type, the public system commonly uses a malleable device.

How Peyronie’s surgery is performed

Surgeons can either shorten the long side or lengthen the short side. Each technique has pros and cons, and the urologist chooses based on individual findings.

When explaining how Peyronie’s surgery is performed, lengthening approaches expand penile tissue through planned incisions. Egydio’s Geometric Principles are an example of this strategy.

Shortening approaches adjust total length from the longer side. The Nesbit technique is a classic method in this group.

Preoperative preparation

Simple measures help reduce risks such as delayed healing or infection, which could contribute to recurrence of penile fibrosis. Pre-op steps include:

• Blood/urine tests, cardiology clearance, and glucose control;
• Pubic hygiene with antibacterial soap for two days before surgery;
• 8-hour fasting for food and liquids;
• Good sleep the night before.

 

What happens on surgery day?

Patients usually arrive in the morning, with ID and insurance card (if applicable). Having a companion is recommended.

Before the procedure, the physician reviews how Peyronie’s surgery is performed and then begins preparation.

Pubic hair clipping is done in the operating room by the medical team—no need to worry beforehand.

Typical operative time is 2–3 hours; if recovery is satisfactory, discharge usually happens the same afternoon.

Inside the Egydio Technique

Egydio’s Technique is one approach aiming to correct curvature while seeking to preserve penile length within anatomical limits.

The surgeon performs controlled incisions opposite the curvature to release stiffened areas and realign the shaft.

Fibrotic tissue is reconstructed to straighten the penis and may help preserve length, depending on the case.

What are the risks?

Main risks include anesthesia reactions and infection. Following medical guidance before and after surgery helps minimize complications.

Recovery after Peyronie’s surgery

Recovery time varies by technique and individual response; initial convalescence is usually 7–14 days.

Full recovery often takes 45–60 days, after which sexual activity is typically resumed.

Can Peyronie’s be treated without surgery?

In early stages—before anatomical function is compromised—medications may be used.

Nonsurgical options aiming to reduce curvature include:

• Injection of medications such as colchicine directly into the affected area;
• Use of penile traction devices.

Treatment choice is individualized after urologic evaluation and may be adjusted as symptoms evolve.

What if Peyronie’s disease is not treated?

Untreated curvature can make erections painful or even prevent rigidity, significantly affecting sexual and emotional quality of life.

In severe cases, deformity may become permanent.

Questions about treatment? Book a consultation with Dr. Paulo Egydio

Outcomes vary according to technique and surgeon experience.

Dr. Paulo Egydio is a urologist specializing in Peyronie’s disease with extensive surgical experience.

If you have questions, schedule a visit or complete the pre-analysis form to receive personalized guidance.

See also:

• Does Penile Traction Therapy improve Peyronie’s? Understand!
• Ultrasound in Peyronie’s Disease: learn more about this exam
• How much does Peyronie’s surgery cost?
• Complementary therapies for Peyronie’s: the 5 main options
• How to reverse unsuccessful Peyronie’s surgeries?
• Peyronie’s Surgery Video: geometric principles
• Surgical treatment for congenital curvature: 8 benefits
• Peyronie’s surgery risks: the 7 main ones
• Penile Fibrosis: 3 ways to identify this condition
• Male Pelvic Physiotherapy: benefits and treatments
• Penile Fibrosis: symptoms, causes, and treatments
• Peyronie’s treatment: what you need to know