Surgical Treatment of Peyronie's Disease (Induratio Penis Plastica)

Symptoms of Peyronie's Disease – What Patients Experience

The symptoms of Peyronie's disease can vary widely in severity. Typical symptoms include:

• Curvature of the penis during erection
• Palpable hardening or nodules in the penile shaft
• Pain during or after erection
• Shortening of the penis
• Indentations or so-called hourglass deformities
• Erectile dysfunction

Not every patient develops all symptoms. The extent and combination of symptoms vary from person to person – and are decisive for choosing the right treatment.

Course of the Disease

Active Phase

In the active phase, the changes develop. Pain may occur, the curvature can increase, and new hardened areas can form. This phase typically lasts several months to about a year.

Stable Phase

As the condition progresses, it often moves into a more stable phase. The curvature then usually changes only slightly – however, the existing changes remain and generally do not resolve on their own.

Spontaneous healing is very rare. In many cases, waiting worsens the symptoms and makes later treatment more difficult. Early medical assessment is therefore advisable.

Causes of Peyronie's Disease and Risk Factors

The exact causes of Peyronie's disease are still not fully understood. According to current understanding, it is a disorder of wound healing and connective tissue metabolism – resulting in excessive scar formation within the lining of the erectile tissue.

Various factors appear to increase the risk:

• Genetic predisposition
• Connective tissue disorders (e.g. Dupuytren's contracture of the hand)
• Repeated microtrauma to the penis
• Certain surgical procedures in the pelvic area
• Metabolic diseases such as diabetes

Important: Patients with Dupuytren's contracture should also be examined for IPP – and vice versa. Early treatment of both conditions improves outcomes.

Psychological Burden – An Underestimated Aspect

The physical changes associated with Peyronie's disease are often only part of the problem. Many affected men report that the psychological burden weighs at least as heavily as the physical symptoms themselves. This is partly because IPP affects a very personal and intimate area of life – and that leaves a clear mark on many patients.

In conversations with our patients, similar themes come up again and again. Affected men frequently report a fear of rejection in intimate situations, which over time can lead to feelings of shame and outright withdrawal from relationships. This is often accompanied by a loss of self-confidence and self-esteem, along with fundamental concerns about one's own masculinity. These burdens rarely remain limited to the person affected – they frequently also affect the partnership and can, in some cases, extend to depressive moods.

For this reason, we always take a holistic approach to treating Peyronie's disease at UGRS. During the consultation, we deliberately don't just talk about the physical situation, but also take time for the psychological dimension – because only by keeping both sides in view can we truly help those affected.

Diagnosis of Peyronie's Disease – The First Step Is Not a Procedure

Many men come to us with one question: Do I need surgery? The honest answer is: not necessarily. Diagnosis begins with a detailed conversation and a physical examination. Depending on the situation, this is supplemented by ultrasound, blood-flow diagnostics, or MRI.

Overview of Treatment Options for Peyronie's Disease

Conservative Treatments

Many men come to us with one question: Do I need surgery? The honest answer is: not necessarily. Diagnosis begins with a detailed conversation and a physical examination. Depending on the situation, this is supplemented by ultrasound, blood-flow diagnostics, or MRI.

Surgical Treatments

Several methods are available for surgical treatment – ranging from shortening procedures (Nesbit, Essed-Schröder) to grafting techniques and microsurgical plaque removal with biological reconstruction, as performed at UGRS.

Our Surgical Method

At UGRS Center Darmstadt, we follow a reconstructive approach: microsurgical removal of the affected tissue (plaque) followed by biological reconstruction – primarily using the patient's own oral mucosa, and in selected cases, a biodegradable collagen fleece. No permanent artificial material is used.

The goal is not straightening alone – but the most comprehensive treatment possible: correcting the curvature, preserving penile length, restoring elasticity, and preserving erectile function.

This procedure is designated in the EAU guidelines as the preferred approach for pronounced curvatures. It requires specialized experience – and is led by Prof. Agustín Fraile Poblador.

Costs and Reimbursement

Surgical treatment of Peyronie's disease at UGRS costs approximately €14,500, including all services. As a private medical service, it is not covered by German statutory health insurance (GKV). However, there is a little-known reimbursement option under European law – in certain cases, up to 90% may be possible.

For full details on costs, insurance coverage, and reimbursement options, please contact us directly.

Risks and Healing Process

As with any operation, surgical treatment of IPP carries risks. General risks include secondary bleeding, wound-healing disorders, and infections. Specific risks associated with reconstructive procedures include residual curvature and changes in erectile function.

The healing process varies from patient to patient. The final result can only be assessed after several months. Structured aftercare is a fixed part of our treatment concept.

When Is a Second Opinion Advisable?

Peyronie's disease is one of the more complex conditions in reconstructive urology. Particularly in cases of pronounced curvature, conflicting treatment recommendations, or planned surgery, an independent second opinion can be very valuable. Many of our patients come to us in exactly this situation – and that too is welcome.

Our Experience, Your Advantage

30 Years – And a Track Record That Proves It

The choice of surgeon is one of the most important decisions patients make.

UGRS Center Darmstadt has more than 30 years of experience in reconstructive surgery of the male genital area. Treatment of Peyronie's disease is led by Prof. Agustín Fraile Poblador.

• Over 30 years of experience in reconstructive genital surgery
• Specialization in microsurgical reconstruction techniques
• Biological reconstruction approach – no artificial materials
• Holistic treatment concept: function, form, and psychological well-being
• Discreet consultation, confidential atmosphere