Peyronie’s Disease & Plication
The surgical management of penile curvature with the plication technique is a simple procedure using multiple-paired sutures placed through the full thickness of the Tunica Albuginea (TA)*.
During plication of the penis, an artificial erection is initiated from either injection of a saltwater solution or a selected medication. Then the outer skin of the penis is pulled back, the penis is straightened, and the excess tissue on what had been the outer side of the curve is cinched together by placing a series of stitches or “tucks.”
The final penile length following surgery depends on the length of the shorter side before surgery, the side with the scarring from Peyronie’s disease. As a result, most men will lose about 2cm penis length. They may also complain about the under skin stitches and loss of penile sensitivity during intercourse.
Some patients have reported a mild residual curvature after surgery while a number have reported penetration issues due to a severe persistent curvature and curvature recurrence.
Since 2006 there has been modified TA plication in use, known as the TAP procedure, where the TA is plicated in a vertical mattress fashion to bury the knots and several stitches are used to reinforce the plication. This technique also avoids circumcision and possible loss of penile numbness.
If you elect for penile plication surgery you should discuss the implications of the surgery fully with your doctor, consultant or surgeon before going ahead. It might also be sensible to discuss this with your partner.
The alternative to penile plication is Shockwave therapy. This avoids invasive surgery and stitch problems while reducing curvature or eliminating it completely without any loss of penis length and sensitivity.
* The tunica albuginea is the fibrous envelope that extends the length of the corpora cavernosa penis (containing erectile tissue) and corpus spongiosum penis (containing the male urethra). It is a bi-layered structure that includes an outer longitudinal layer and an inner circular layer.
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