Peyronie’s Plaque Excision and Grafting for Treatment of Peyronie’s Disease
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Plaque Excision and Grafting for Peyronie’s Disease
What You Need to Know About Plaque Excision and Grafting.
Peyronie’s plaque excision and grafting is a well-established treatment option with a high success rate when he comes to the treatment of ventral Peyronie’s curvature, dorsal Peyronie’s curvature, lateral Peyronie’s curvature as well as complex Peyronie’s curvature. Plaque excision with grafting can also correct hourglass appearance (narrowing) of the penis.
Is important to understand that only a small number of surgeons in the United States (fewer than 5%) have significant experience with the treatment of Peyronie’s disease with plaque excision and grafting. As a result, this option is rarely offered to most men with Peyronie’s disease.
At New York Urology Specialists, Dr. Alex Shteynshlyuger has extensive experience treating men with plaque excision and grafting either as a solitary treatment option or in combination with the penile implant procedure.
What is Plaque Excision? Who is a Candidate for Plaque Excision and Grafting?
Peyronie’s plaque excision refers to the surgical removal of the scar tissue that causes the symptoms of Peyronie’s disease. This procedure can be performed on men with a palpable or detectable Peyronie’s plaque with relatively focal scar tissue. Typically, men with more severe Peyronie’s disease and good quality of erection function considered good candidates for plaque excision and grafting.
Plaque excision cannot be performed on men with Peyronie’s disease caused by extensive scarring to the penis that often occurs after priapism or extensive and severe penile fracture. The need to remove a very large plaque is associated with a very high risk of postoperative erectile dysfunction and neuropathy. Typically, a penile implant with possible focal excision of plaque at the point of maximum curvature is the preferred treatment in these situations.
After the plaque it is excised who removed, the area is covered by graft tissue. A variety of different graft tissue substitutes have been used with most commonly used currently being material such as Tutoplast bovine pericardium as well as Equine collagen fleece (Tachosil).
What are the Advantages of Plaque Excision?
There are a number of advantages to plaque excision with grafting over other treatment options for Peyronie’s disease.
Plaque excision can treat severe curvature more effectively than other treatment options such as penile plication and injectable medications such as Xiaflex, verapamil, and interferent.
Plaque excision can correct hourglass appearance (narrowing) of the penis that is often a major symptom of Peyronie’s disease.
Plaque excision is not associated with significant penile shortening when adjusted for the severity of the disease compared to other treatment options. Most men maintain their preoperative penile length.
How Does Plaque Excision Compare to Xiaflex injections, Verapamil injections, and Interferon Injections?
Surgical treatment of Peyronie’s disease with plaque excision and grafting offers a more predictable and consistent improvement of Peyronie’s disease symptoms than do injections with Xiaflex, verapamil, or Interferon. In addition, surgical treatment tends to be less likely to recur.
How does Peyronie’s Plaque Excision Compare to Penile Plication?
Peyronie’s plaque excision can be used to treat penile curvature of greater than 60 degrees. Typically, curvature greater than 60 degrees is not treated with penile plication due to significant risk of penile shortening in this situation.
Plaque excision with grafting can correct the hourglass appearance of the penis. Penile plication does not correct penile narrowing of the hourglass appearance.
Effectiveness of Peyronie’s plaque excision and complication rates.
Excision of Peyronie’s plaque with the insertion of graft tissue is a very effective treatment for the symptoms of Peyronie’s disease including the correction of penile curvature and hourglass narrowing. Success rates range from 75% to over 90%.
The major risks of plaque excision include worsening or development of new erectile dysfunction that occurs in 20 to 30% of men. For this reason, the procedure is typically offered only to men with excellent erection quality at the baseline.
Other common significant risks of the procedure include numbness of the penis caused by stretching of the nerves during the procedure which is typically transitory and recovers over time.
The risks of bleeding and infection are small and similar to other surgical procedures.
Penile shortening is not a common side effect of plaque excision with grafting but graft contraction can occur and as a result, the graft is usually slightly oversized.
What to Expect Before and After Plaque Excision and Grafting?
Plaque excision and grafting surgery is typically performed in the hospital under general anesthesia. Most men go home from the hospital on the same day or the next day after the procedure.
Most men are able to go back to work within 2 to 3 days after the procedure.
New York Urology Specialists, we advise patients not to go to the beach swimming or biking for 2 weeks after the procedure. Men should not engage in sexual activity for at least 6 weeks after the procedure.
Most men have minimal pain after the procedure and many men do not require pain medication stronger than over-the-counter Motrin.
Insurance Coverage of Plaque Excision and Grafting.
Most insurances including commercial health plans such as United Healthcare, Cigna, Aetna, GHI, and Medicare cover the cost of penile plaque excision and grafting.
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 been 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 fit your needs, lifestyle, and your preferences.
Urologists are doctors specializing in the treatment of men with sexual problems including Peyronie’s disease and erectile dysfunction. By 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 medications 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.