Penile Plication for Treatment of Penis Curvature Caused by Peyronie’s Disease
Dr. Alex Shteynshlyuger is a board-certified urologist in NYC who specializes in treating men with Peyronie’s disease. He performs penile plication as well as other surgeries for treatment of Peyronie’s disease.
What is Penile Plication?
Penile plication is a surgical procedure used to correct penile curvature. Penile plication applies counter-tension with permanent sutures on the side opposite of where the curvature occurs to mechanically straighten the penis.
Penile plication can be used to correct both ventral curvature (penis points and curves down) and dorsal curvature of the penis (penis curves up).
Penile Plication for Treatment of Penile Curvature (Bent or Curved Penis)
Penile plication is a well-established surgical procedure for the treatment of penile curvature. There are a number of different surgical approaches to penile plication with names such as “Nesbit plication” and “16-dot technique” among others. At New York Urology Specialists, we perform both Nesbit plication and 16-dot plication technique depending on the patient’s situation.
What Type of Anesthesia is Used for Penile Plication?
Depending on the severity of the problem and patient characteristics, local or general anesthesia can be used for penile plication. We often are able to perform plication in the office under local anesthesia. The procedure usually takes 1 to 1.5 hours to perform.
How Effective is Penile Plication for Treatment of Curvature Associated with Peyronie’s Disease of the Penis?
Plication is a very effective treatment option for correcting curvature caused by Peyronie’s disease in particular for a penile curvature of fewer than 60 degrees. Some men with curvature greater than 60 degrees may also be candidates for penile plication. Penile plication results in the functionally straight penis (residual curvature of fewer than 20 degrees) in 80-90% of patients. Patient satisfaction ranges from 75-90%.
Many men with stable Peyronie’s disease who do not improve with injection therapy, are good candidates for penile plication.
Penile plication is not usually a good choice for a man with erectile dysfunction caused by Peyronie’s disease if medications such as Cialis, Viagra, and Stendra do not allow him to achieve an adequate erection.
When Is Penile Plication Performed?
Penile plication is a good surgical treatment option for many patients with a penile curvature of 30-70° who have good erections and do not have significant narrowing of the penis (“hourglass” appearance). Men with minor narrowing of the penis (minor ‘hourglass’ appearance) may still be candidates for penile plication. It is important for men to understand the risks and benefits of penile plication as well as other treatment options for penile curvature.
Recovery after penile plication is fairly short.
Who is NOT a Good Candidate for Penile Plication (Nesbit or 16-dot procedure)?
Men with erection problem for whom medications such as Viagra or Cialis do not work well and who are unwilling to use penile injections (Trimix) or if Trimix does not work either are not good candidates for penile plication.
While penile plication will fix the curvature, a straight penis without an erection is of limited use. In men with ED, penile implant surgery often in conjunction with penile plication or penile plaque excision and grafting is necessary to fix both CURVATURE and ERECTILE DYSFUNCTION.
Men with severe narrowing of the penis are also not good candidates for penile plication as it does not treat narrowing. Depending on the quality of erection, plaque incision/excision with grafting or penile prosthesis is advised.
What To Expect From Penile Plication
Penile plication procedure aims to straighten the penis to what we call a “functionally” straight penis. It is nearly impossible to make the penis completely straight as gravity can contribute to mild penile curvature and deviation. In addition, it is not always advantageous to try to make the penis perfectly straight as that may require additional surgical maneuvers that may not necessarily justify the risk of complications. Some men may experience loss of penile length of 0.5-1.5 cm, depending on the severity of the curvature. Some men report feeling the permanent sutures that are used for surgical fixation.
Typically, we consider a functionally straight penis and a good result if the curvature of less than 20% is achieved.
What are the Advantages of Penile Plication?
Penile plication is a minimally invasive surgical procedure with the least amount of complications among surgical treatment options for penile curvature including curvature caused by Peyronie’s disease and congenital penile curvature.
Penile plication is associated with the least risk of postoperative difficulty with erections and changes in sensation compared to penile plaque excision with grafting.
Penile plication can be performed in the office under local anesthesia. Most patients are able to go back to work within a few days.
Is it Possible for Curvature to Recur after Penile Plication?
While the intent of penile plication is to permanently fix and correct penile curvature, in about 10-15% of patients curvature may worsen over time after penile plication. Typically, recurrence results in partial worsening of curvature. In other words, if 60° curvature was corrected to 10°, over time the curvature may worsen in some men to 20-30°.
Other reasons why curvature may recur after correction of penile curvature with plication.
- Sometimes, the disease process progresses after surgery leading to worsening penile curvature.
- Loosening of the suture used for penile plication could also lead to a partial worsening of penile curvature after plication over time.
- In rare circumstances, suture failure may occur which can lead to complete reversal of penile plication.
Insurance Coverage for Penile Plication Surgery
Most insurances including Medicare, UnitedHealthcare, Anthem BCBS, Empire BCBS, AETNA, CIGNA and Oxford among others cover the cost of penile plication surgery.
Why Choose New York Urology Specialists for Treatment of Peyronie’s Disease?
- All treatment is performed by a board-certified urologist experienced in treating men with symptoms of Peyronie’s disease including penile curvature, narrowing of the penis, shortening of the penis, pain in the penis, and ED.
- We are one of the few practices in the region to offer a full range of options for treatment of Peyronie’s disease, sexual and erection problems in men.
- We offer diagnostic testing in our office which avoids hospital costs.
- Extensive Experience: Thousands of men have treated successfully using medical therapy (Xiaflex, Verapamil injections, Interferon), shockwave therapy for penile pain, penile plication, plaque excision and grafting, and penile implant surgery.
- Confidential and Understanding Care. We understand that most of our patients desire privacy. We see patients with a variety of urological problems. Your reason for visiting us is entirely confidential.
Scheduling Appointments for Peyronie’s Treatment at New York Urology Specialists
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Peyronies Disease and ED Are Treatable in Nearly Every Man
At New York Urology Specialists, our urologists are specially trained in the evaluation and treatment of Peyronie’s disease and erectile dysfunction. We understand the challenges that Peyronie’s disease and ED create for our patients, their relationships and their self-esteem. We help you find a treatment for Peyronie’s disease that fits your needs, your lifestyle and your preferences.
Urologists are doctors specializing in the treatment of men with sexual problems including Peyronie’s disease and erectile dysfunction. By the virtue of our experience and skill, we are able to offer an effective treatment option for nearly every man who desires an effective treatment for ED. We offer medical and surgical treatment for Peyronie’s disease and erectile dysfunction.
We Treat Some of the Most Complex ED Problems Including:
- Hourglass narrowing of the penis
- Shortening of the penis and loss of penile length
- Penis curvature with worsening erections
- Peyronies disease in men with diabetes and weak erections in men with diabetes.
- Peyronie’s disease and erectile dysfunction in men with prostate cancer after radical prostatectomy
- Erectile dysfunction in men with Peyronie’s disease
- Erectile dysfunction in men for whom Viagra and Cialis do not work.
Schedule an Appointment with Dr. Shteynshlyuger:
Dr. Alex Shteynshlyuger is a fellowship-trained board-certified urologist with expertise in evaluation and treatment of sexual and erection problems in men using modern effective and proven treatment methods. We offer inflatable penile implant, shockwave therapy for ED and treatment for Peyronie’s disease.
He is highly recommended by top primary care physicians in the New York area. If you or someone you know has been experiencing urological symptoms, make an appointment to take advantage of Dr. Shteynshlyuger’s expert advice. Please feel free to contact us with any questions.
We offer affordable, highest-quality urology care with or without insurance. Find out our office hours or directions to our office. We offer weekday, weekend and evening office hours.