Plication Surgery in Bargarh: Procedure, Benefits & More

You may have heard of Peyronie’s disease. It is a disorder in which scar tissue forms under the skin of the penis, causing it to curve or bend. This penile curvature can make erections painful and cause problems during sexual intercourse. There are many treatment methods to correct Peyronie’s disease, both non-surgical and surgical. One of the most preferred surgical methods of treatment is called penile plication. It is a minimally invasive surgical method of straightening the penis.  Let’s find out more about the procedure, recovery, and complications associated with penile plication.

Penile plication is a surgical procedure for straightening a penis that has become curved due to Peyronie’s disease. During the surgery, the side of the penis opposite the curve is tightened with the help of a small incision and stitches. The procedure includes creating an artificial erection with a saltwater injection or the use of medications. Next, the outer skin of the penis is pulled back, the penis is straightened, and the excess tissue on the outer side of the curve is tightened by placing a series of stitches.

Also Read: Sling Procedure

Penile plication is recommended as treatment when a patient is diagnosed with Peyronie’s Disease. Peyronie’s disease is a penile curvature condition resulting from a fibrous scar tissue called plaque that develops on the penis. 

The plaque builds up inside a thick elastic membrane called the tunica albuginea in the penis, whose major role is to keep the penis stiff during an erection. As the plaque develops, it pulls on the surrounding tissues and causes the penis to curve, usually during an erection. The plaque may also cause a shortening of the penis length. 

The condition can result in curved and painful erections, difficulty in maintaining an erection (a condition called erectile dysfunction), and unsatisfactory sexual life. Due to all of these issues, it can cause stress and anxiety in men. 

There are several treatment options available for Peyronie's disease, including surgery. The doctor may recommend penile plication if the penis has a mild to moderate curvature (less than 60°) or if the condition prevents sexual intercourse. 

Penile plication is recommended if a patient has had the condition for 9 to 12 months and the curvature of the penis has stabilized for at least 3 to 6 months.

• Before the surgery is scheduled, you should have a detailed discussion with the surgeon about the procedure, its benefits, and risks. You should also discuss your expectations, the results, and any doubts you may have. 
• The surgeon will also want to know about your medical and surgical history and any medication you are currently on. You may be asked to temporarily stop blood-thinning medications as these may increase the risk of bleeding during surgery. 
• As part of the preparation for the surgery, the doctor will need to perform a physical examination of the penis in a flaccid state to identify plaque, indentation, and other abnormalities. Examination of the penis will also be carried out in an erect state to measure curvature degree and direction.
• You will be asked not to eat or drink anything after midnight on the day of surgery.
• You will also have to arrange for someone to drive you home after the surgery.
• On the day of the surgery, you should wash the surgical area with an antibacterial soap.

Penile plication surgery is performed under general anesthesia or local anesthesia with sedation. 

• The surgery begins with a transurethral catheter being placed in your bladder. An artificial erection is induced by placing a tourniquet around the base of the penis and injecting the corpus cavernosum (the erectile tissue of the penis) with a saline solution using a needle. This enables a detailed examination of the penis when fully erect. The degree of curvature of the penis is measured and the tourniquet is removed.
• Next, the surgical team marks incisions on the penis and goes ahead with making incisions for circumcision and penile degloving (separating the skin and other soft tissues of the penis from the underlying structures). 
• The surgeon then dissects Buck’s fascia (a layer of connective tissue with interspersed blood vessels and nerves that surrounds the collagen layer making up the tunica albuginea) and this incision exposes the tunica albuginea. 
• Using a surgical pen, the surgeon marks 16 plication dots on the tunica albuginea. 
• The surgeon straightens up the penile curvature with sutures on these 16 plication points. Shods are placed on the sutures to prevent damage to them. 
• The tourniquet is placed on the penis base, an artificial erection is stimulated with an injection of saline solution into the corpus cavernosum, and the curvature of the penis is measured again. 
• The incision on the tunica albuginea is closed with sutures, and so is the circumcision incision.
• A gauze dressing is placed over the wound to limit swelling. This dressing should be removed after 24 hours. 
• The catheter is removed on the first postoperative day. 

• You will be monitored for a few hours and sent home upon clearance from the surgical team. 
• The doctor may prescribe pain medications, give post-surgery care instructions, and fix a follow-up appointment schedule before you go home. 
• At home, rest adequately and avoid unnecessary activity. 
• Expect some tenderness, bruising, and swelling at the surgical site that should resolve over the next 1 to 2 weeks. 
• Apply a cold pack on the site intermittently (20 minutes at a time) for 48 hours after the surgery as per the doctor’s instructions. 
• You will have your first follow-up appointment within 24 hours of the surgery for a wound check and dressing change.
• At home, you can change the dressing once a day for five days as per the doctor’s instructions.
• You can clean yourself with a washcloth but avoid showering for 5 days after the procedure. 
• You should be able to return to work within a day or two of the surgery.
• Avoid driving until your doctor deems you fit to do so. 

Just like any other surgery, penile plication is also associated with chances of certain risks or complications. These include:

• Under-correction of penile curvature
• Persistent pain after surgery
• Shortening of penile length
• Changes to erectile function or penile sensation
• Bumps or lumps in the penis
• Remaining indentations in the penis
• Recurrence of curvature and a need for revision surgery

Also Read: Laparoscopic Hydrocelectomy

Surgery can be a daunting aspect, and feeling anxious is absolutely normal. The massive amount of information you can get from the internet may confuse you even more. This is where Medfin can help. Leave us the hefty task of finding the best hospital, the finest doctor in Bargarh, and the latest procedure at the lowest cost. Let us take charge while you sit back and focus on your health and recovery. Think surgery! Think Medfin!