Grafting Surgery
For Men With Peyronie's Disease

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Grafting surgery is surgical procedure that uses grafts to straighten bent penis and offers good cosmetic correction for men with severe penile deformity.

However, there are some long-term risks associated with the grafting procedure, e.g. of curvature recurrence and new onset of erectile dysfunction. Meaning long-term follow ups tend to show low patient satisfaction with this procedure.

What Is Penile Grafting Surgery?

Grafting is a surgical procedure that involves replacing or expanding scarred penile tissue with healthy tissue (grafts).

It straightens the bent penis by adding tissue (graft) to the shorter side where the plaque is most prominent. As you might remember, grafting is lengthening the shorter side while plication is shortening the longer side.

Grafting is done by either incision or excision of the plaque.

Incision grafting surgery involves making several shallow incisions next to each other and on the Peyronie's scar itself. The incisions relieve and expand under tension, i.e. during erection. Tissue graft is placed over the incisions to aid healing.

Excision grafting surgery involves removing (excising) the scar or plaque tissue. Tissue graft is then used to replace the tissue that was removed.

Incision grafting is the preferred option as removing the plaques increases the risk of erectile dysfunction following the operation. Excision grafting can though be necessary if the plaques are calcified.

Who Is Ideal Candidate For Grafting Surgery?

Peyronie's patients with penis curvature and good erection quality are suitable candidates for either grafting or plication surgery.

To determine which surgery is right for you, your Peyronie's surgeon will evaluate the severity of the penis curvature, the stretched penile length and if penis narrowing is present or not.

Penile grafting is the best surgical option for Peyronie's patients with:

• Severe penis curvature, 60 degrees or more (some surgeons insist on over 90 degrees)
• Associated penis deformity present, like hour-glass effects, hinge or waisting
• Stretched penile length under 10 cm (as there is less risk of penile shortening from grafting operation than plication)

Simply put, grafting surgery is for men with more severe Peyronie's symptoms than those that undergo Plication Surgery. This table helps you to evaluate if grafting or plication is the right surgical option for you.

PD Symptoms	Grafting	Plication
Erection Quality	Good	Good
Curvature	> 60 degrees	< 60 degrees
Stretched Length	< 10 cm	> 10 cm
Narrowing	Yes	No

On the other hand Penile Implants are the only option for Peyronie's patients that suffer from erectile dysfunction (ED).

What Are The Grafting Surgery Benefits?

Grafting includes lower risk of penile shortening than plication, hence more suitable for men with shorter penises.

Grafting is also more effective in correcting severe angulations and improving penis girth, i.e. provides better penile stability to resist buckling.

What Are The Downsides Of Penile Grafting Operation?

Men that have penile surgery cannot resume sexual activity immediately after surgery. Penile surgeries are also the most expensive Peyronie's treatment options available.

The biggest downside of grafting for most men with Peyronie's is though the increased risk of Erectile Dysfunction and/or impotence.

What Are The Grafting Side Effects?

There are various potential side effects. The most serious is the inability to achieve or maintain erection (impotence). The risk of erectile dysfunction is though lower when the plaques are not removed (incision).

Other possible side effects include loss of elasticity, mild reduction in sensitivity and scarring or plaque formation around the graft. Penile shortening is a possibility, but less likely and less severe, than if undergoing plication penile surgery.

Does Penile Grafting Involve Any Health Risk?

Surgery is an invasive procedure and always involves some level of risk and it is important to be aware of them. There can be complications during surgery (anesthesia, bleeding) or after the surgery is over (infections, delayed healing).

There are no major complications associated with the grafting procedure as such but there is a real risk of erectile dysfunction and/or becoming impotent.

The Results Of Using Grafting For Peyronie's Disease

Peyronie's graft surgery has showed to be effective for correcting penis curvature in most patients, though some residual curvature may still be present in some cases.

There are some long-term risks associated with the grafting procedure, e.g. of curvature recurrence and new onset of erectile dysfunction.

Find out what Dr. Levine, one of the best known Peyronie's specialists in the world today, has to say about the benefits, side effects and results from the different Peyronie's surgeries.

Scientific Support
For Penile Grafting As Peyronie's Treatment

There are few factors worth having in mind when evaluating grafting operation studies.

Firstly, the results and not least the side effects from excision grafting surgery are usually worse than from incision surgery. The result can also vary based on the grafting material used but the search for the ideal grafting material is still going on.

Most studies and reviews confirm good results in most patients in correcting the penis curvature. They also confirm the possible side effects and risk previously mentioned.

There are though some concerns about the long-term effects. Like this five-year follow-up study that showed more than 65% of patients to be dissatisfied with the outcomes of their Peyronie's graft surgery:

“The recurrence of penile curvature, penile length loss, and the new-onset of ED are not uncommon sequelae and are associated with a significant patient dissatisfaction rate when a 5-year follow-up is achieved” (J Sex Med. 2011)

Finally, this study compared the results from grafting and plication operations and concluded:

“The results of our study have shown that both procedures are effective surgical options for the correction of Peyronie's disease. Plication is a simple procedure with less morbidity. Shortening is a common complaint, regardless of the type of operation done” (Urology. 2008)

My Personal Experience
And Opinion Of Peyronie's Graft Surgery

I have no personal experience of penile grafting surgery. Luckily, I found non-surgical treatment that worked for my Peyronie's disease.

However, if you need Peyronie's disease surgery, then the condition of your penis will determine which surgical option is the most suitable for you.

Your are good candidate for Peyronie's graft surgery if you have good quality erection but severe penis curvature (more than 60 degrees), stretched penile length under 10 cm and / or some form of penis narrowing.

If your curvature is less, your stretched penile length is over 10 cm and no penis narrowing, then plication surgery might be better option. However, if you suffer from erectile dysfunction not responsive to medical therapy, then penile implants might be your only option.

If you have already had, or are planning to have penis surgery, then you might want to consider using Andropeyronie traction device to prevent post-surgical penile shortening.

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