Surgical Treatment of Peyronie’s Disease
Peyronie ’s disease is a toughening of the spongy body of the sponge like cavernous body of the penis (corpora cavernosa) where fibrous tissue (“plaque”) disrupts the natural tissue compromising structure and blood flow. If applied three to six months after the onset of the disease, non surgical treatment can be effective in stopping and even reducing the plaque formation.
Non surgical treatment of Peyronie’s disease consists mainly of vitamin E supplementation and para-aminobenzoate tablets (B- complex substance) which may be taken for several months. Chemical agents such as a calcium channel-blocker (verapamil), an enzyme that breaks down connective tissue (collagenase), and steroids (cortisone) may be injected into the plaque or delivered by iontophoresis*. One possible side effect of this treatment method is tissue atrophy, and the over all success is not well documented and not satisfactory.
If non surgical treatment fails to resolve the plaque or if left untreated, Peyronie’s disease can progress and result in severe penis curvature with shortening and ultimately erectile dysfunction. In case of non responsiveness to the aforementioned treatment options, surgery might be the last course of action to remove the plaque and straighten the penis.
Procedures involve the removal (excision) of hardened tissue (plaque) and skin grafts, the removal or pinching (plication) of tissue opposite the plaque to reduce curvature (Nesbit procedure), a penile implant, or a combination of these three options.
Dr. Elist offers all of the aforementioned treatments for patients suffering from Peyronie’s disease. If chemical treatment is not effective, Dr. Elist corrects Peyronie’s disease by excising abnormal fibrous tissue on the dorsal aspect of the penis. The removal of plaque requires a skin graft from another area of the patient’s body and may result in a partial loss of erectile function (less rigidity). The Nesbit procedure reduces the length of the erect penis.
Penile implant involves implanting a device in the corpora cavernosa that increases rigidity. This procedure may be combined with incisions and skin grafts, or plication, to effectively reduce curvature.
During the recovery period, patients are prescribed medication preventing them from having an erection. Additionally, they are advised to avoid sexual activity. Antibiotics are also prescribed to reduce the risk of infection.
Procedure Description: Removal of Peyronie’s Plaque
Peyronie’s disease is a toughening of the spongy body of the penis. Dr. Elist corrects Peyronie’s disease by excising abnormal fibrous tissue on the dorsal aspect of the penis. After an incision is made around the penis, Dr. Elist retracts the skin to expose the abnormal tissue on the underlying normal spongy tissue. Avoiding critical nerves and blood vessels, with the penis erect the defective tissue is excised. The skin is closed by suturing.
*Iontophoresis is a painless method of delivering medication to localized tissue through an electrical current. A positive charge applied to a positively charged solution repels the medication into the tissue.