Penile curvature correction surgeries

Peyronie’s disease is not an uncommon condition affecting many men. It refers to a constellation of penile symptoms namely penile pain, length loss, curvature, fibrous plaque and ultimately sexual dysfunction. The treatment options depend on several factors such as duration of symptom, degree of penile curvature, presence of waisting (hour-glass deformity), size of penile plaque (fibrous scar tissue) and presence of erectile dysfunction. It is important to understand that penile curvature can reoccur again due to abnormal underlying penile tissue.

Prof. Chung is recognised as the leading international expert on Peyronie's disease and penile reconstruction and serves as the Chair of the Peyronie's disease, Male Genitalia Trauma and Reconstructive Committee for the 5^th International Consultation of Sexual Medicine (ICSM) by the International Society of Sexual Medicine (ISSM). He has published several guidelines on Peyronie's disease. 

Penile curvature could be corrected with the following surgery

1. Penile plication surgery

1. Advantage - Low risk of erectile dysfunction
2. Disadvantage - Penile length loss

2. Penile graft surgery

1. Advantage- Penile length preservation
2. Disadvantage- Higher risk of erectile dysfunction and penile glans sensory change

3. Penile prosthesis

1. Advantage- Treat underlying (or postoperative) erectile dysfunction
2. Disadvantage- Risks associated with penile prosthesis

What preparation is required?

Since the penile surgery is performed under general anaesthesia, you should have nothing to eat or drink for 6 hours prior to treatment. Regular medications can be taken with a sip of water with the exception of blood thinning agents (eg. warfarin, aspirin, clopidogrel) or non-steroidal anti-inflammatories which need to be stopped for 7-10 days. A mid-stream urine (MSU) test is required to ensure the urine is sterile before treatment is undertaken.

What do I need to bring to surgery?

• All related available imaging such as KUB (kidneys, ureter, and bladder) x-ray, CT scan abdomen, or kidney ultrasound
• Your usual medications

What happens in the operating room?

You will meet your anaesthetist prior to surgery who will take a thorough medical history. Your procedure will be performed under general anaesthesia with an anti-microbial cover. The genital area will be shaved and an alcoholic povidine surgical antiseptic will be applied to minimise microbial skin colonisation.

What are the risks?

When performed by an expert surgeon, penile curvature correction surgery is considered a safe and durable procedure. Surgical complications depend on the complexities of your Peyronie’s plaque size and the type of curvature correction surgery. Some of the common postoperative complaints include:

• Pain
• Bruising or hematoma
• Dysuria following urinary catheterisation
• Skin irritation or mild infection

Potential serious complications include:

• A temporary decrease in sensation to the glans of the penis
• Potential penile shortening
• Injury to the urethra
• Development of erectile dysfunction
• Recurrence of penile curvature (due to abnormal underlying penile tissue)

What to expect afterwards?

You are usually discharged the same day and you can remove the surgical dressing and have a shower the next day. You will be discharged with oral antibiotics antibiotics. At home, you should rest and avoid strenuous physical exertion for 4-6 weeks. During this time, normal spontaneous penile erection is common but any sexual activity is discouraged.

Follow-up

You will have a follow-up appointment with Prof. Chung scheduled at 4-6 weeks postoperatively.