Peyronie’s Disease Surgery in London: Options, Recovery and Risks
Updated: Aug 18
Key point: surgery is usually considered only when Peyronie’s disease is stable and the deformity compromises penetrative sex or causes significant functional difficulty. The operation is chosen according to curvature, penile length, erection quality, complex deformity and the patient’s priorities.
Who may be suitable for surgery?
Before surgery, the clinician confirms that deformity has stopped changing, pain is minimal or resolved, and intercourse is impaired by curvature, narrowing, hinge instability or associated erectile dysfunction. Photographs or an induced erection may be used to measure the deformity objectively.
Assessment should document penile length, rigidity with and without medication, curve direction and severity, hourglass or hinge deformity, previous procedures and patient expectations. Penile Doppler ultrasound may be useful when erectile blood flow is uncertain or prosthesis surgery is being considered.
What can surgery realistically achieve?
The aim is a functionally straight penis that permits sexual activity—not a promise of perfect geometry or restoration of lost length. Consent should cover likely straightening, possible shortening, changes in sensation, erectile function, palpable sutures, recurrence and the chance of further treatment.
Tunical shortening or plication procedures
Plication and related shortening procedures straighten the penis by shortening the longer, convex side. They are commonly considered when erections are sufficiently rigid, penile length is adequate, curvature is less severe and there is no major hourglass or hinge deformity.
Advantages include a shorter operation and lower risk of postoperative erectile dysfunction than more extensive reconstructive surgery. The main trade-off is perceived or measurable shortening. Sutures may be palpable, and residual or recurrent curvature can occur.
Tunical lengthening with incision and grafting
Lengthening procedures incise the plaque-side tunica and cover the defect with a graft. They may be considered in selected men with good preoperative erectile function, severe curvature, inadequate length or a complex deformity such as hourglass narrowing.
This is more complex surgery and carries a higher risk of postoperative erectile dysfunction, altered sensation and graft-related problems. No graft material has proved universally superior; technique and selection should be individualised.
Penile prosthesis for Peyronie’s disease with erectile dysfunction
When erectile dysfunction does not respond adequately to medication and Peyronie’s deformity is present, penile prosthesis implantation is the preferred surgical option. Cylinder placement may correct much of the curve; modelling, plication or incision and grafting can be added if needed.
A prosthesis treats rigidity and can improve deformity, but it is an implant operation with risks including infection, mechanical failure, erosion, pain and future revision. Device choice and expectations should be discussed carefully.
Why operative choice must be individual
The same degree of curvature can affect two men differently. A man with good length and rigidity may prefer the lower erectile-risk profile of plication, while another with severe narrowing or limited length may accept the greater risk of grafting. Men with medication-resistant erectile dysfunction need a different pathway centred on prosthesis surgery.
Recovery after Peyronie’s surgery
Recovery instructions depend on the operation. Swelling, bruising and discomfort are expected early. Patients are normally advised about wound care, pain relief, activity, return to work and when sexual activity can resume. Some procedures use postoperative stretching or cycling protocols, but these must follow the operating surgeon’s instructions.
Contact the surgical team urgently for fever, increasing redness or discharge, severe worsening pain, inability to pass urine, device concerns or rapidly expanding swelling. Follow-up checks healing, erection quality, residual curvature and rehabilitation.
Questions to ask before deciding
Ask which operation is recommended and why, how your current length and erection quality affect that choice, the expected amount of straightening and shortening, the surgeon’s complication and revision pathway, alternatives to surgery, and what happens if erectile function worsens.
If you are still clarifying the diagnosis, read Peyronie’s disease symptoms and assessment or review the main penile curvature treatment page.
Frequently asked questions
Can surgery restore the penis exactly as it was before Peyronie’s disease?
Usually not. The aim is functional straightening. Existing loss of length, narrowing or erectile changes may not be fully reversible.
Which operation has the lowest risk of erectile dysfunction?
Plication generally has a lower postoperative erectile-dysfunction risk than grafting, but it can shorten the penis. Individual anatomy and preoperative rigidity determine whether it is appropriate.
Can shockwave therapy prevent the need for surgery?
Shockwave treatment may reduce pain in some men but has not shown reliable correction of curvature or plaque size. It should not be promoted as a substitute for indicated straightening surgery.
Is surgery performed during the active phase?
Guidelines recommend surgery only when disease is stable and intercourse is compromised. Operating while deformity is changing increases the risk that the result will not remain appropriate.
Peyronie’s surgery consultation in London
A consultation can document curvature, length and erectile function, explain non-surgical alternatives and determine whether plication, grafting or prosthesis surgery is appropriate. Book a confidential appointment or email info@holisticandrology.com.
Clinical source
About the author
Prof Fabio Castiglione, MD, PhD, FECSM, FEBU, Urologist (ITA). Consultant Urologist and Andrologist — King’s College Hospital NHS Foundation Trust; Hon. Reader, King’s College London, UK; Academic Lead of Urology; GMC 7542824; Director and Founder of Holistic Andrology.
Medical information is educational and does not replace an individual consultation, examination or diagnosis.
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