Peyronie’s disease is a tissue disorder involving the development of fibrous plaques inside the penis. More specifically, the scar tissue forms in the tunica albuginea, which is the tissue around the corpora cavernosa. Peyronie’s disease symptoms include pain, erectile dysfunction, abnormal curvature, loss of girth, indentation, and shortening. Peyronie’s disease affects around 10% of all men.

The following are the common peyronies surgical and non-surgical treatment options:

1. Extracorporeal shock wave therapy
Extracorporeal shock wave therapy (ESWT) is to apply the high pressure, but low frequency sound waves to the peyronie’s plaque with the purpose to break down scar tissue as well as calcification in the area via causing trauma so that it could stimulate the healing process. ESWT is a safe procedure, which has a low complication rate. However, as the treatment for peyronie’s disease, unfortunately, ESWT has not been proven to be a very effective option.

2. Verapamil injections
Verapamil is a drug usually applied to treating high blood pressure, and the drug appears to interfere with the production of collagen, which is a protein that might play a big role in the formation of the scar tissue of peyronie’s disease. Also, the drug may reduce pain and is well tolerated. Verapamil injections have demonstrated the promising success rate in treating peyronie’s disease. The other way to use Verapamil is topically, which is to apply the drug to the surface of penis directly, but it has not been demonstrated to be as effective as injections.

3. Placation surgery
Placation surgery is to placate the unaffected side of the penis. There are a variety of procedures that could be used to placate the longer side of penis, which is the side with no scar tissue. The surgery could result in the straightening of penis, even though it is usually limited to the less severe curvatures. There are several placation techniques that could be used, but generally they result in the similar success rates, very much depending on the surgeon’s preference and experience.

4. Grafting surgery
With grafting surgery, the surgeon usually makes one or more cuttings in the scar tissue of the penis to allow the sheath to stretch as well as the penis to straighten. In addition, the surgeon might cut off some scar tissue too. A piece of tissue is usually sewn into the place for covering the holes in tunica albuginea, which could be from your own body, or others like animal tissue, or synthetic material. Generally, the procedure is applied to the more-severe curvature. The procedure is connected to more risks of worsening erectile compared to the placation procedures.

5. Penile prosthesis surgery
Penile prosthesis surgery to place penile prosthesis (implants) into the spongy tissue that will be filled with blood during erection. The prosthesis might be semirigid, which manually bent down at most of time but bent upward when having sexual intercourse. The other type of prosthesis is inflated with the pump implanted in scrotum. This surgery could be considered if the patient has both peyronie’s disease as well as erectile dysfunction. When the prosthesis is put in place, your surgeon might also perform more other procedures to better the curvature if they are needed.