Penile straightening surgery is used for stable Peyronie’s disease when curvature or deformity prevents satisfactory sexual activity. If erections are otherwise good, the surgeon usually straightens the penis either by shortening the longer side with plication or by releasing and grafting the scarred shorter side in selected severe or complex cases. If erectile dysfunction is significant and does not respond to medical treatment, a penile implant is usually a better foundation for correction. The aim is a functionally straight, rigid penis—not necessarily a mathematically zero-degree curve.

Who is a candidate for straightening surgery?

• The disease has stopped changing and active pain has settled.
• Curvature, indentation or hinge effect makes penetration difficult or impossible.
• Erection quality is known and adequate for the planned operation.
• The patient understands possible shortening, residual curvature, sensory change and ED risk.
• Non-surgical treatment has been insufficient, unsuitable or is no longer preferred.

Plication: straightening by shortening the long side

Plication places sutures or removes/folds a small amount of tunica on the side opposite the plaque. This brings the two sides closer to equal length. It avoids major dissection of the plaque and neurovascular bundle in many cases, which is why postoperative ED risk is generally lower than with grafting.

Incision and grafting: straightening by lengthening the short side

For severe curvature, marked shortening or complex hourglass/hinge deformity in a man with good erections, the scarred tunica can be incised to release the contracted side. A graft covers the defect. This may better preserve length than plication in selected anatomy, but it is more invasive and the risk of postoperative ED is higher.

What happens during surgery?

How successful is straightening surgery?

Guideline summaries report high rates of functional straightening with appropriately selected plication and grafting procedures, but results vary by technique, curvature complexity and how “straight” is defined. For plication, straightening greater than 85% is commonly reported in published series. The more important outcome is comfortable, stable penetration with acceptable length and erection quality.

Risks and trade-offs

• Penile shortening, particularly with plication.
• Residual or recurrent curvature.
• Palpable suture knots or local discomfort after plication.
• Altered sensation or numbness.
• New erectile dysfunction, especially after lengthening/grafting surgery.
• Haematoma, infection, wound problems and scar formation.
• Need for further treatment if curvature or erectile function remains unsatisfactory.

Recovery in brief

Swelling and bruising are expected for the first days to weeks. Light daily activity gradually resumes as pain settles. Heavy exercise and sexual activity are avoided until the wound and tunica have healed, commonly for several weeks. Some surgeons use postoperative traction or PDE5 inhibitors after grafting or length-restoration procedures; follow the exact protocol given for your operation.

Penile straightening surgery is not one operation

The surgeon is not choosing only how to make the penis straighter; the aim is to preserve a functional erection while correcting enough deformity for comfortable intercourse. Plication shortens the longer side and usually has a lower risk of new ED. Incision with grafting lengthens the short side and may better suit severe or complex deformity, but it exposes the erectile mechanism to greater risk. Pre-operative erection quality therefore matters at least as much as the measured angle.

How plication and grafting differ mechanically

Plication works on the convex, longer side by shortening it until it matches the shorter side. Incision-and-grafting works on the concave side by releasing the tight tunica and covering the resulting defect. That mechanical difference explains most of the counselling: plication is simpler and generally safer for erections but can shorten length, whereas grafting can better address selected severe or complex deformities but carries more risk to erectile function.

When an implant enters the discussion

If baseline erections are poor and do not respond reliably to medication, a straightening-only operation may solve the shape but not the functional problem. In that setting penile prosthesis surgery, with straightening manoeuvres added only as needed, is often the more logical reconstructive strategy. This decision should be made before the operation, not after a technically successful plication or grafting leaves the patient unable to achieve penetration-quality rigidity.

What risks are particularly important with grafting

Grafting creates a larger tunical intervention than plication and can affect the veno-occlusive mechanism that helps maintain an erection. This is why baseline ED, diabetes, vascular disease and weak pharmacological erections matter before choosing it. The graft itself can also contract, stretch or create contour irregularity. No single graft material has proved universally superior, so the operation should be selected for the deformity and the surgeon’s experience rather than on marketing claims about a particular patch.

How much straightening is enough

Published series report high rates of complete or near-complete straightening, but the clinically important endpoint is a stable penis that permits intercourse. Chasing the last few degrees may require additional sutures or dissection and can increase shortening or other risks. A small residual bend that does not interfere with penetration can therefore be an acceptable result, provided this possibility was discussed before surgery.

What determines the straightening technique

• How much usable penile length is present before surgery.
• Whether the deformity is a simple bend or includes hourglass narrowing, indentation or hinge instability.
• Whether erections are fully rigid and durable enough for intercourse before surgery.
• Whether the disease has been stable long enough for an elective correction.
• Which risk you would find harder to accept: some shortening or a higher chance of erectile deterioration.

FAQs

Related reading

• Peyronie’s Disease Surgery: What Are the Options?
• Will Peyronie’s Surgery Shorten the Penis?
• Sex After Peyronie’s Disease Surgery
• Recovery After Peyronie’s Disease Surgery
• Urologist in Latur

References

• European Association of Urology. EAU Guidelines on Sexual and Reproductive Health: Penile Curvature. 2026 https://uroweb.org/guidelines/sexual-and-reproductive-health/chapter/penile-curvature
• Nehra A, Alterowitz R, Culkin DJ, et al. Peyronie’s Disease: AUA Guideline. J Urol. 2015;194(3):745-753. doi:10.1016/j.juro.2015.05.098.
• Chierigo F, Fallara G, Tozzi M, et al. Guideline of guidelines: Peyronie’s disease. BJU Int. 2026;137(5):770-782. doi:10.1111/bju.70201.
• Tozzi M, Gobbo A, Fallara G, et al. Erectile dysfunction in patients with Peyronie’s disease treated with different grafts: a systematic review. Sex Med Rev. 2026;14(1):qeaf053. doi:10.1093/sxmrev/qeaf053.