Peyronie’s disease is a condition in which scar causes the penis to curve up, down, or sideways. The scaring occurs in the elastic tissue (tunica albuginea) surrounding the corpora cavernosa (erection chambers) of the penis. The scar tissue usually produces a firm area or plaque, which causes the penis to bend. The penis bends towards the scar tissue, which is usually upward. The penis can become shorter and thinner if the scarring is progressive. The cause of Peyronie’s disease is usually trauma during sexual intercourse but it may result from unknown causes. About one-third of the patients improve, one-third remains the same, and one-third get progressively worse. Surgical correction of Peyronie’s disease is required when the curvature makes sexual intercourse uncomfortable or impossible. Some men want correction due to psychological distress. Peyronie’s disease is often associated with physical impotence, necessitating a penile implant.
Straightening is performed by shortening the uninvolved longer side or by releasing the restrictive scar tissue on the shorter or concave side. When shortening is performed, the operation is rather simple and is performed as an outpatient. When the convex side is lengthened,, incisions are made in the Peyronie’s plaque, and the gaps are filled with either dermis (skin), vein graft, cadaver tissue (pericardium), or fascia. This procedure is more extensive but is also very successful. If the man cannot achieve a firm erection, an implant is inserted which straightens the penis.