Plication surgery involves operating on the healthy, longer side of the penis to make it shorter, while grafting techniques are based on the exact opposite principle; the surgeon operates on the Peyronie’s penile plaque(s) so as to restore lost elasticity (created by plaque) on the affected side of the penis. During an erection, both sides will stretch to the same size, hence eliminating the curvature.

For this reason, grafting can restore lost penile length due created by Peyronie’s disease and also correct any type of deformities such as an hourglass effects or complex multi-planar curvatures.

From a technical point-of-view, grafting procedures are more challenging and only a limited group of urogenital surgeons can perform them. These surgeons are usually reserved for severe cases. Candidates for this procedure are patients with the following characteristics:

• Intact erectile function or responding to pharmacotherapy

• Curvature in excess of 60 degrees

• Complex deformity

• Destabilising hinge

• Extremely short penis length

When this type of operation was first introduced, the approach involved excising (removing) the Peyronie’s plaque completely – this is called the excision and grafting approach. However, complete plaque excision has been associated with high prevalence of postoperative erectile dysfunction because when the plaque is excised healthy erection tissue is also damaged.

For this reason, instead of excising, it is preferable to perform a relaxing incision on the plaque – this is the incision and grafting procedure and our preferred approach. This does not result in any damage to the erectile tissue and at the same time corrects the penile curvature completely, whilst restoring the penis to original length.

Various modifications of this technique have been proposed including the Lue and the Egydio techniques. The Egydio technique, the approach that our surgeons follow at International Andrology, is more advanced in the sense that it uses exact geometrical principles to define the incision points on the penis and also the sizing of the graft, which is used to cover the defect created by the incision. The advantages of the geometrical principles approach are the following:

• No penile shortening – significant penis length and girth restoration can be achieved (average of 3cm)

• Any type of curvature can be corrected using this technique

• Due to the precise nature of the surgical technique, the risk for curvature recurrence is extremely low – over 90% success rate from the first surgery

• Grafting and cover of the tunica defect is performed in a very precise surgical manner, minimising the probability of post-operative erectile dysfunction and scaring

• Careful and standardised mobilisation of the neuro-vascular bundle ensures that surgical complications are minimised.

Overview of the Geometrical Principles Incision and Grafting Technique

As our surgeon have performed some of the highest numbers of this geometrical surgery, we have developed this technique through experience.

To find out more about the surgical treatment of Peyronie’s disease, then please contact our Patient Co-ordination team on 02030513060 or read our Frequently Asked Questions here.

I am suffering from a what I suspect is Peyronies disease, what should I do next?

If you believe you are suffering from Peyronies and it causes you significant concern we advise you to see a specialist urologist/andrologist.

Our doctors have vast experience treating Peyronies and our clinic is an international referral centre for patients suffering from this condition. We would be happy to review your case and treat you in our clinic.