What is Penile Plication?

Penile plication is a surgical procedure aimed at correcting a curved penis by reducing the length of the longer side of the penis. It consists of putting permanent sutures on the convex (longer) side of the curve on the tunica albuginea (the fibrous covering of the erectile tissue) that shortens the tissue by essentially cinching or folding it to minimise the bend.

Who is an appropriate candidate for penile plication?

Penile plication is generally reserved for men with stable penile curvature (i.e., the curvature has not changed for at least 3-6 months) with adequate erectile function and a curve that mainly presents cosmetic discomfort or that impacts sexual intercourse. It is usually preferred for curvatures less than 60-70 degrees and without significant shortening of the penis or hinge effect.

In what ways is penile plication different from other treatments for Peyronie's disease?

Penile plication is a procedure different from non-surgical treatments for Peyronie's disease, such as Xiaflex injections (collagenase clostridium histolyticum), vacuum erection devices, or traction therapy, which treat the actual plaque remodelling. Other operation possibilities involve incision/grafting (cutting the plaque and filling in the defect with a graft, frequently utilised for more serious curves or shortening) or penile prosthesis implantation (for the most severe cases with erectile dysfunction). Plication is less invasive than grafting and maintains normal erectile function.

What happens before the penile plication surgery?

You will have a consultation with a urologist before the surgery. This consists of a physical exam, medical history, and usually a penile Doppler ultrasound to determine blood supply and confirm the type of curvature. You may be requested to take photos of your erection to show the curvature. Your physician will explain the procedure's risks, benefits, and alternatives. You'll also be instructed on fasting and medication changes before surgery.

How is penile plication done?

Penile plication can usually be done under general anesthesia, but regional anesthesia can also be used. The surgeon incises, typically circumcising (around the penis head) or longitudinally on the underside of the penis, to expose the tunica albuginea. The surgeon induces an artificial erection (usually with a saline injection) to be able to see the curve.

Small sutures are then placed in the tunica albuginea of the convex side of the curve, folding or pleating it. The size and location of sutures vary according to the size and direction of the curvature. After straightening the penis, the incision is closed. The duration of the procedure varies from 1 to 2 hours.

What kind of sutures are employed?

Permanent, non-absorbable sutures are employed to correct the curvature in the long run.

What are the advantages of penile plication?

The significant advantage is the correction of the curvature of the penis, which may enhance the appearance of the penis and enable comfortable sexual intercourse. It is usually a less invasive operation than grafting, maintains natural erectile function, and has a proportionally good success rate for straightening the penis.

What are the risks and complications of penile plication?

Generally safe, but potential risks are:

Penile Shortening: The most frequent and usually irreversible side effect, as the surgery straightens the penis by shortening the longer side. The extent of shortening is variable but is generally tolerable.
Numbness or changed sensation: Temporary or, in rare cases, permanent changes in sensation of the penis, particularly the glans.
Palpable sutures: The sutures can sometimes be palpable under the skin. Occasionally, they can be painful or extrude.
Recurrence of curvature: Although rare, the curvature may recur after some years.
Erectile Dysfunction (ED): Although erectile function is preserved during the procedure, new-onset or worsening ED may occur, but it is not frequent.
Bleeding, infection, swelling, and bruising are common to all surgeries.
Cosmetic dissatisfaction: Although straightening is successful, a few men may not be fully satisfied with the cosmetic result.

How long does it typically take to recover from penile plication?

Immediate Post-Op: There will be some pain, swelling, and bruising, which can be controlled with medication. There will be a dressing.
First Few Weeks: To allow proper healing, avoid strenuous activities, heavy lifting, and sexual activity for at least 4-6 weeks. Keep the surgical site clean and dry. Your doctor will provide specific instructions on wound care.
Return to Activity: Most men can return to light activities within a few days to a week. Full recovery and resumption of sexual activity typically take 4-8 weeks.
Swelling Resolution: Swelling can last for several weeks or even months, which will slowly resolve.

What type of pain will I have during recovery?

You should feel some pain and discomfort, especially in the initial few days. Pain medication will be prescribed to control it. The pain is typically mild to moderate and decreases greatly in the first week.

How is the prognosis after penile plication?

The prognosis for penile plication is usually excellent for well-selected patients. Most men have a good decrease in curvature and can achieve satisfactory sexual intercourse. While a small amount of penile shortening occurs, it is generally tolerated by patients considering the straightening of the curve. Long-term satisfaction is high. Follow-up with your urologist is essential to assess your recovery and address any questions or concerns.

When do I call the doctor following penile plication surgery?

Call your urologist right away if you have any of the following:

Infection symptoms: Fever (temperature above 100.4°F or 38°C), chills, growing redness, heat, swelling, or pus-like discharge from the wound.
Severe worsening pain: Pain not relieved by medications your doctor has prescribed.
Heavy bleeding: Soaking through dressings very quickly.
Struggling to urinate: Not being able to urinate or severe pain while urinating.
Severe numbness or alteration in sensation that is bothering or appears to be getting worse.
New or worsening erectile dysfunction.
Any new or unexplained symptoms that bother you.

Why choose Tender Palm Super Speciality Hospital for Penile Plication Surgery in Lucknow, India?

Tender Palm Super-Speciality Hospital is one of the best hospitals for Penile Plication Surgery in Lucknow, India. Our experienced Urologists uses advanced technology, and provides patient-focused care, the hospital ensures safer procedures, quicker recovery, and improved long-term outcomes.