Surgery for Peyronie's disease
Surgery for Peyronie's disease straightens a penis that bends during erections because of scar tissue called a plaque. The main options are folding stitches on the side opposite the bend (plication), cutting the plaque and patching it with a graft, or placing a penile implant and straightening the penis around it.
Also called Peyronie's disease surgery, Penile curvature surgery, Penile straightening surgery, Curved penis surgery, Bent penis operation, Penile plication, Plication surgery, Nesbit procedure
- Where
- Hospital operating room or outpatient surgery center
- Anesthesia
- General or spinal anesthesia, usually with a numbing block at the base of the penis
- Time in the room
- About 1 to 3 hours, depending on the method
- Hospital stay
- Usually same day; sometimes one night after grafting or an implant
- Going home with
- Some men have a catheter overnight; most go home without one
- Back to normal
- About 1 to 2 weeks for daily life; about 4 to 6 weeks before sex
- Back to work
- About 1 week for desk work; 2 to 4 weeks for physical work
Overview
Peyronie's disease is scar tissue, called a plaque, that forms in the tough sleeve around the erectile chambers of the penis. Because the scarred area cannot stretch, the penis bends toward it during an erection. It can also cause a dent, a narrow waist (an hourglass), shortening, and sometimes weaker erections. It is more common than most people think: studies suggest several in every 100 men have it, mostly in midlife and later. It is not cancer and it is not contagious.
The disease usually has two phases. In the early (active) phase, erections may hurt and the curve may change. This phase often lasts 6 to 18 months. Then the disease settles into a stable phase, where pain is gone and the curve stops changing. Surgery is for the stable phase. Guidelines advise waiting until the curve has not changed and erections have not hurt for at least 3 to 6 months, because operating while the scar is still active can let the curve come back.
The goal of surgery is a penis straight enough for comfortable sex. A small remaining bend, under about 20 degrees, is usually considered a good result. There are three main operations. Plication folds the longer side to match the shorter side. Plaque incision and grafting releases the short side and patches it. A penile implant treats both the curve and weak erections. Which one fits you depends on how big the curve is, whether there is an hourglass or hinge, your length, and how firm your erections are.
Surgery cannot give back length that the disease has already taken. Plication often shortens the penis a little more. Grafting shortens it less but carries a higher risk of weaker erections. Knowing these trade-offs before surgery is the key to being satisfied afterward.
The parts of your body involved
The penis has two spongy erectile chambers, the corpora cavernosa, that fill with blood during an erection. Each is wrapped in a tough, stretchy sleeve called the tunica albuginea. In Peyronie's disease, a plaque of scar forms in this sleeve, most often on the top. During an erection the rest of the sleeve stretches but the plaque does not, so the penis bends toward the plaque, usually upward. The nerves that give feeling to the head of the penis, and its blood vessels, run along the top of the shaft right over the most common plaque location. The urethra runs along the underside inside its own spongy chamber.
- Erectile chambers (corpora cavernosa)
Two spongy tubes that fill with blood to make an erection.
- Tunica albuginea
The tough sleeve around the erectile chambers. This is where the plaque forms and where surgeons place stitches or grafts.
- Plaque
A firm patch of scar in the sleeve. Some plaques harden with calcium over time.
- Nerves and blood vessels on top
A bundle running along the top of the shaft that carries feeling to the head. It must be lifted carefully during some repairs.
- Urethra and spongy chamber
The urine tube along the underside, protected during surgery.
- Head of the penis (glans)
The tip of the penis. Its feeling can be dulled for a while after surgery.
Why it’s done
Surgery is offered when the disease is stable and the bend, dent or narrowing makes sex hard or impossible, or causes real distress. It is the most reliable way to straighten the penis.
- Sex is difficult or impossible
A bend can make penetration hard, painful for a partner, or cause the penis to buckle.
- Hourglass, dent or hinge
A narrow waist can make the penis bend or buckle at that point. Grafting is usually best for this.
- A large or complex curve
Curves over about 60 to 90 degrees, or curves in two directions, respond less well to injections.
- Injections are not suitable or did not help enough
Calcified plaques, very large curves, and plaques near the urethra are often better treated with surgery.
- Weak erections as well
If ED pills do not give a firm erection, a penile implant with straightening treats both problems in one operation.
Other options
- Collagenase (Xiaflex) injections
A medicine injected into the plaque in the clinic, combined with stretching, reduces the curve by about a third on average. It is an option for curves between about 30 and 90 degrees with good erections.
- Watching and waiting
Some men's curves stay mild and do not interfere with sex. If the bend does not bother you or your partner, no treatment is needed. A small number of men improve on their own.
- Penile traction therapy
A device worn on the penis for hours a day gently stretches it. Some studies show modest gains in length and a small reduction in curve. It takes daily commitment for months.
- Other injections
Verapamil or interferon injected into the plaque are sometimes offered. The evidence that they help is limited.
- Pills and vitamins
Most pills and vitamins studied, such as vitamin E, have not been shown to straighten the penis. The AUA guideline advises against several of them.
- Penile implant
For men with weak erections as well as a curve, the implant described on its own page also corrects most bends.
Getting ready
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Weeks before
The week before
The day before
The morning of
In the operating room, step by step
Press play or pick a step. Each drawing shows what your surgeon is doing at that moment. Your team may do some steps differently.
1. Anesthesia
You lie on your back and receive general anesthesia (fully asleep) or a spinal anesthetic (numb from the waist down). A numbing block at the base of the penis helps with pain afterward. The skin is cleaned and covered with sterile drapes.
After the operation
Right afterward
- Waking up
The penis is wrapped in a snug dressing and is often numb from the block. Ice packs help with swelling.
- Passing urine
If you have a catheter, it usually comes out the same day or next morning. You need to pass urine before going home.
- Pain plan
You get a plan for pain medicine. Start it before the numbing block wears off.
- Going home
Most men go home the same day. Men who had a graft or an implant sometimes stay one night.
At home
- Dressing
Keep the snug dressing on as instructed, usually 1 to 3 days, then remove it. Soaking it in the shower helps.
- Swelling and bruising
Bruising can spread across the shaft and scrotum and look dramatic. It usually fades over 2 to 3 weeks.
- Pain
Acetaminophen and ibuprofen are enough for most men after the first few days. A short course of stronger medicine may be given.
- Night-time erections
Erections pull on the repair and can hurt. Ice and getting up to walk help. The repair is designed to hold through normal erections.
- Penile rehabilitation
After grafting, many surgeons recommend a daily low-dose ED pill, gentle stretching or a traction device for some weeks to help healing and limit shortening. Follow your surgeon's plan.
- Showering
Showering is usually fine after 48 hours. Avoid baths, pools and hot tubs until the skin is healed.
- Activity
Walk every day. Avoid heavy lifting, hard exercise and cycling for about 4 weeks.
- Driving
Drive once you are off strong pain medicine and can brake comfortably, often after a few days.
- Sex
Most surgeons ask you to wait about 4 to 6 weeks, and until there is no pain or open wound.
- Work
Desk work after about a week. Physical work after 2 to 4 weeks.
Recovery timeline
- Day 0Surgery
Most men go home the same day with a snug dressing.
- Days 1 to 3Dressing off
Swelling and bruising peak. The dressing comes off as instructed.
- Week 1Easing up
Pain improves. Many men go back to desk work.
- Weeks 2 to 3First check
A wound check. Bruising fades, and stitches start to dissolve.
- Weeks 4 to 6Back to sex
Most men are cleared to have sex. Go gently at first.
- 3 monthsEarly result
Swelling has settled. Your surgeon may measure the curve again.
- 6 to 12 monthsFinal result
Scar tissue has matured, numbness has usually improved, and the long-term straightness and length are clear.
What it feels like
Peyronie's disease often affects confidence, mood and relationships, and many men carry it quietly for a long time. Surgery is usually a sore couple of weeks. The emotional side, including worries about length, appearance and sex, deserves as much attention as the wound.
Deciding
Many men feel embarrassed or low, and some feel the disease has changed their sex life and relationship. It can be hard to talk about.
What helpsThese feelings are very common with Peyronie's. Talking with your partner, and sometimes a counselor or sex therapist, helps. Your surgeon should leave room for your questions.
Waking up
The penis is tightly wrapped and numb. Some men are anxious to see how it looks.
What helpsThe dressing is snug on purpose to limit swelling. The appearance in the first week is not the final result.
The first erections
Night-time erections can be painful and frightening, and men worry they will break the stitches.
What helpsThis is expected. Ice, emptying your bladder before bed, and getting up to walk help. The repair is made to hold.
Seeing the bruising
The penis and scrotum can be swollen and purple, which can be upsetting.
What helpsBruising after this surgery is normal and fades over a few weeks. Call if swelling is hard, growing quickly or very painful.
Feeling the knots
After plication, you may feel small bumps under the skin where the stitches are tied.
What helpsThey usually become less noticeable as swelling goes down and tissue softens over months.
A numb or tingly head
The head of the penis may feel numb or different, which can be worrying.
What helpsThis is common in the first weeks and usually improves over several months as the nerves recover.
The first time having sex
Many men are nervous about pain, about the result, and about how it will feel for their partner.
What helpsWait until you are cleared, use lubricant, and go slowly. Most men find sex much easier once the bend is corrected.
How well it works
Success means a penis straight enough for comfortable sex, with erections as good as before surgery. Most men who have surgery for stable Peyronie's disease end up with a functionally straight penis, though a small bend can remain.
- Straightness
Most men are straight or have a small bend under about 20 degrees, which does not interfere with sex. In a minority, the curve partly returns over time.
- Length
Plication usually shortens the erect penis a little, often by about 1 to 2 centimeters (about half an inch to three quarters of an inch). Grafting usually shortens it less. Neither restores length already lost to the disease.
- Erections
Erection quality usually stays the same after plication. After grafting, some men develop weaker erections, which can often be helped with ED pills.
- How it is checked
Your surgeon reviews the curve, length and erections at follow-up, often at about 3 months and again at 6 to 12 months, sometimes with a repeat in-office erection.
Risks
Every operation has risks. These are the ones people ask about most, with honest odds where good numbers exist. Your surgeon’s own results matter more than averages.
Common
Plication usually shortens the penis a little because it tucks the longer side. Grafting causes less shortening. Some length loss is from the disease itself.
Very common and can be dramatic, but usually fades over 2 to 3 weeks.
Common in the first weeks, especially after degloving or grafting. It usually improves over months; a few men have a lasting change.
After plication, knots can often be felt under the skin. They are usually not painful and become less noticeable.
Less common
More likely after grafting than after plication, and more likely if erections were already borderline before surgery. Many respond to ED pills; some men eventually choose an implant.
A bend that remains or partly returns can happen, especially if surgery is done before the disease is stable. A second procedure is sometimes needed.
Blood can collect under the skin. Most settle on their own.
Wound infections are uncommon and usually treated with antibiotics. An infected implant usually needs to be removed.
Some men have pain with erections for a few months, especially from stitches. It usually fades.
Rare
Damage to the urine tube is rare and is usually repaired at the time of surgery.
Very rarely, the skin or the head of the penis loses blood supply and needs further care.
Rarely a graft bulges, shrinks or causes a new dent.
Clots in the legs or lungs are rare after this surgery.
Call your care team or go to the emergency room if
- Bleeding that soaks the dressing and does not stop after 10 to 15 minutes of firm pressure
- Swelling that grows quickly, turns tense and dark, or becomes very painful
- Fever of 101°F (38.3°C) or higher, or shaking chills
- Spreading redness, pus or a bad smell from the wound
- You cannot pass urine for 6 to 8 hours
- The head of the penis or skin turns dark, black or very pale
- A sudden pop or crack with loss of the erection and new swelling or bruising
Questions to ask your surgeon
- Is my disease stable enough for surgery now?
- Which operation do you recommend for me, and why?
- How much length should I expect to lose with each option?
- What is my risk of weaker erections after each option?
- How will you measure my curve before and during surgery?
- Should I be circumcised at the same time?
- If you graft, what material will you use?
- Will I need ED pills, stretching or a traction device after surgery?
- How many of these operations do you do each year?
- What happens if the curve comes back?
Words you may hear
- Peyronie's disease
- Scar tissue in the sleeve of the penis that causes a bend, dent or narrowing during erections.
- Plaque
- The patch of scar tissue that causes the bend.
- Tunica albuginea
- The tough sleeve around the erectile chambers where the plaque forms.
- Active phase
- The early period when erections may hurt and the curve may change.
- Stable phase
- The later period when pain is gone and the curve has stopped changing for at least 3 to 6 months.
- Plication
- Stitches that fold the longer side of the penis to straighten it.
- Nesbit procedure
- A type of plication that removes small wedges of the sleeve opposite the plaque.
- Graft
- A patch used to fill the gap after the plaque is cut or partly removed.
- Hourglass deformity
- A narrow waist in the erect penis caused by scar around the shaft.
- Degloving
- Sliding the skin of the shaft down to reach the sleeve underneath.
- Modeling
- Bending an inflated implant firmly against the curve to straighten the penis.
- Traction therapy
- Wearing a device that gently stretches the penis for hours each day.
Common questions
Why do I have to wait 3 to 6 months?
While the disease is active, the scar is still changing. If you operate too soon, the curve can come back or change direction. Waiting until it has been stable for at least 3 to 6 months gives a more lasting result.
Will I lose length?
Plication usually shortens the penis a little, often about 1 to 2 centimeters. Grafting shortens it less. Surgery cannot restore length the disease has already taken. Your surgeon can measure you before surgery so you know what to expect.
Will my erections be affected?
Plication rarely changes erection quality. Grafting carries a higher risk of weaker erections. If your erections are already weak, a penile implant may be a better choice.
Can the curve come back?
It can, but in most men it does not when surgery is done after the disease is stable. Small changes over time are possible.
Do I need to be circumcised?
Not always. If the skin is opened near the head and you are uncircumcised, many surgeons recommend circumcision at the same time to avoid painful foreskin swelling. Ask your surgeon.
Is Peyronie's disease cancer or something I can pass on?
No. It is a benign scar problem. It cannot be spread to a partner.
Sources this page draws on
- American Urological Association, Peyronie's Disease: AUA Guideline
- European Association of Urology, EAU Guidelines on Sexual and Reproductive Health
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), Penile Curvature (Peyronie's Disease)
- Urology Care Foundation, Peyronie's Disease
Written November 2026. This page explains what usually happens. It is not medical advice and does not replace a conversation with your own surgeon, whose plan for you comes first.