Surgical indication for Peyronie’s occurs when patients report impairment in their sexual life — when to operate on Peyronie’s is defined by medical evaluation.
The surgery for Peyronie’s disease aims to restore, as far as possible, the penile anatomical and functional characteristics, according to medical assessment. However, not everyone with penile deformities is a candidate for this treatment.
Surgical indication for Peyronie’s is considered when the condition directly affects sexual quality of life and even mental health, without the possibility of stabilization by other means, as determined by a physician.
Knowing the right time to consider surgery is essential to increase the likelihood of a successful management, since the decision depends on the disease stage. Learn more details and understand when to operate on Peyronie’s and when penile surgery may be appropriate.
What is Peyronie’s disease?
Peyronie’s disease is a curvature of the penis in the erect state caused by differences in tissue elasticity between sides of the penis, due to fibrotic plaques that harden the tissues.
These fibroses may be formed by trauma or repetitive microtrauma over time. Therefore, men over 40 years of age are more likely to develop the condition.
Because of the curvature—which may reach up to 90 degrees—the penis can also appear shorter. In some cases, one or more areas of narrowing can occur.
The two phases of Peyronie’s disease
Peyronie’s phases are classified according to fibrosis progression:
- Acute phase: from the onset of fibrosis formation until stabilization. In this phase, the penis may deform and the patient may feel pain during erection. It usually lasts about six to twelve months.
- Chronic phase: the fibrosis is stabilized. This means the curvature tends not to worsen, although new fibrotic points may appear at any time in other penile areas.
Symptoms of Peyronie’s disease
Peyronie’s symptoms are usually noticed by the patient and include:
- Changes in penile characteristics: curvature, loss of length, or areas of narrowing;
- Pain during erection;
- Penile “slippage” during intercourse;
- Difficulty finding a comfortable position for penetration;
- Erectile dysfunction.
When to operate on Peyronie’s: in which cases is surgery indicated?
The surgical treatment for penile curvature follows guidance from major international medical societies.
In general, signs of when to operate on Peyronie’s include loss of penetrative capacity—i.e., when the penis slips during intercourse, movements are limited, or the patient cannot achieve or maintain an erection—even after oral or injectable therapies.
Dr. Paulo Egydio discussed with Turkish physicians Dr. Ege Şerefoğlu (Editor-in-Chief, International Journal of Impotence Research) and Dr. Ahmet Albayrak (urology and penile aesthetics), who confirmed that criteria for surgery in Turkey are similar.
When surgery is not indicated
Peyronie’s disease does not always require surgical intervention. Mild curvature or patients at high procedural risk should generally avoid surgery.
When penile curvature is mild—less than 30 degrees—does not impair penetration and does not cause pain, regular clinical follow-up may be appropriate. This scenario often corresponds to a stable fibrosis phase, without curvature progression.
Men with conditions that increase the risk of invasive procedures—such as severe heart disease, advanced renal or hepatic failure, or those who cannot suspend anticoagulants—are usually not candidates for surgery.
It is possible to operate on patients with diabetes with additional preventive care to reduce infection risk. Older men may also undergo surgery, provided they are in good overall health.
Frequently asked questions
What happens if Peyronie’s is not treated?
If untreated, Peyronie’s disease can interfere with penetration during sexual activity and lead to erectile dysfunction.
How can the Peyronie’s plaque be dissolved?
Xiaflex is an injectable medication that aims to act on penile fibrosis, while verapamil, betamethasone and dexamethasone are topical options used to avoid plaque worsening.
A physician can determine whether these alternatives are appropriate for each case.
How much does Peyronie’s surgery cost?
Surgery for Peyronie’s may be available through the public system (SUS). In private settings, the cost of surgery varies widely.
This variation depends on several factors, such as the hospital, case complexity, the need for a penile prosthesis, prosthesis type/model, possible grafting, and the medical team involved.
Questions about Peyronie’s disease?
The decision about when to operate on Peyronie’s should be made only after evaluation by a urologist.
For more information, Dr. Paulo Egydio has over 25 years of experience treating penile curvature with techniques based on geometric principles of tissue reconstruction, as described in the medical literature.
If you present penetrative dysfunction, speak with a urologist to receive individualized guidance and understand—under medical supervision—whether clinical management is still feasible or whether surgical treatment is indicated.
