Penile plication is a procedure used to treat Peyronie’s Disease, or penile curvature.
Penile plication involves tightening the side of the penis opposing the curvature with stitches in order to straighten the penis. This stitching can typically be accomplished through a small incision along the side of your penis.
When to ask a Urologist about Penile Plication
You should speak with a Urologist about penile plication if you are bothered by a less than 90-degree curve to your penis that has not changed for at least three months.
Typically covered by most insurances (although coinsurance and deductibles may apply). Coverage will be verified prior to proceeding. If you do not have insurance, our office will be able to give you an out-of-pocket cost estimate.
Penile plication can provide immediate curvature resolution. Over 40 studies report between 90 to 100% improvement in curvature with penile plication.
Possible Side Effects
Few patients report changes to erectile function or penile sensation. The knots of the stitches may be palpable underneath the skin permanently. About 80% of patients have less than 1.5 cm decrease in stretched penile length while 20% experienced more than 1.5 cm decrease in penile length. Another study reports an average loss of length of 0.36 cm. Typically this is not an issue because patients are more easily able to engage in sexual activity with a straightened penis.
Alternatives to penile plication surgery include observation without treatment, penile modeling with vacuum erection devices or traction devices, intralesional injections (Xiaflex), plaque incision and grafting surgery, and penile prosthesis surgery.
What to do to Prepare for Surgery
You will receive detailed instructions from the surgical schedulers regarding any necessary testing or appointments prior to surgery. In general, you should temporarily stop blood-thinning medications prior to surgery (when to stop depends on the type of blood thinner). Prescription blood-thinning medications should be stopped following clearance from the doctors that prescribed them though other medications that thin the blood including fish oil and pain relievers such as ibuprofen should be stopped as well.
On the day before surgery, you will receive a phone call alerting you to the time that you should arrive, and you should wash the surgical area with an antibacterial soap.
You should not eat or drink anything after midnight on the day of surgery, but you may take approved home medications in the morning before surgery with a small sip of water.
What to Expect after Surgery
Patients are sent home following the procedure. There will be a dressing wrapped around the penis designed to limit swelling that can be removed after 24 hours. There can be tenderness, bruising and swelling that dissipates over 1-2 weeks. There should be no intentional sexual activity for at least 6 weeks.