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Specialist andrology · London

Nesbit and Lue 16-dot plication for Peyronie’s disease, by a specialist andrologist.

Definitive surgical correction of penile curvature - Nesbit, 16-dot plication, plaque incision with grafting, or a penile prosthesis. The right operation is chosen by curvature, erectile function and your priorities, not by convenience.

See indicative pricing
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What Peyronie’s disease surgery costs privately in London.

Indicative ranges across our partner andrology units.

In short

£4,500–£8,000, home the same day.

Procedure Indicative range
Nesbit procedure (private) £4,500–£8,000
16-dot plication (Lue / Essed–Schroeder) £4,500–£8,000
Plaque incision + grafting (Egydio / Lue) £6,500–£12,000
Penile prosthesis (inflatable, with straightening) £10,000–£16,000
Andrology assessment + Doppler with PGE1 £450–£750
Consultation only £250–£450

Prices vary by andrologist, by technique, by graft or prosthesis choice, and by whether a one-night stay is planned.

The problem

The right technique, chosen by curvature and erections - not by the surgeon’s habit.

Peyronie’s surgery is one of the most technique-sensitive operations in urology. The wrong technique costs you length, erections, or both.

  • Still in the acute phase?

    Painful, evolving curvature is not a surgical problem yet - you wait for stability. We say so, we do not operate early.

  • Worried about length loss?

    Nesbit shortens 1–2 cm, plication less, grafting largely preserves it. You hear the trade-off before you sign, not after.

  • Curvature plus ED?

    When erections have failed too, a prosthesis with straightening is often the right single operation - not two attempts.

When it helps

When Peyronie’s surgery is the right step.

The situations that map to surgery - plus the one that means waiting, not operating.

  • Stable dorsal or lateral curvature

    A curvature greater than 30° that has been stable for at least 12 months and is stopping you having intercourse.

  • Palpable plaque + pain resolved

    A firm plaque in the tunica albuginea, but the acute painful phase has settled - the fibrosis is mature.

  • Hourglass or indentation deformity

    A narrowing or waist along the shaft with instability during erection - often needs plaque incision and grafting.

  • Curvature with preserved erections

    You still get reliable, rigid erections but the curve makes penetrative sex impossible or painful - Nesbit or plication territory.

  • Curvature with erectile dysfunction

    A significant curvature plus ED that has not responded to PDE5 inhibitors or injections - a penile prosthesis may straighten and restore rigidity in one operation.

  • Failed conservative treatment

    Traction, verapamil injection, extracorporeal shockwave or PDE5 inhibitors have not worked, and Xiaflex (collagenase) was withdrawn in the UK in 2022.

  • Associated Dupuytren’s disease

    A family or personal history of Dupuytren’s contracture - often a marker of the same fibrotic tendency and worth flagging.

  • Red flag: still in the acute phase

    Painful erections, curvature that is still changing month to month - surgery is not the right answer yet. Wait for stability, usually 12–18 months.

Procedure options

Four families of operation. One will fit.

Plication (Nesbit, 16-dot, Yachia), plaque incision with grafting, plaque excision, or penile prosthesis - chosen by curvature severity, ED status and your priorities.

  • Nesbit procedure

    Excises one or two elliptical wedges of tunica albuginea on the convex side and closes primarily to straighten the shaft. Time-tested; expect 1–2 cm length loss.

  • 16-dot plication (Lue)

    Plicates the tunica with 16 non-absorbable double-armed sutures. Less invasive than a Nesbit, comparable straightening, usually less length loss.

  • Yachia / Essed–Schroeder variants

    Plication variants used for the same indication - the surgeon chooses the one that matches the curvature and their experience.

  • Plaque incision + grafting

    For curvature >60° or hourglass deformity: incise the plaque and inlay a graft (buccal mucosa, saphenous vein, tunica vaginalis, dermal or pericardial - PegaSanct) on the concave side to preserve length.

  • Plaque excision + grafting

    Full plaque excision then grafting - used less often now because of a higher ED rate; incision is usually preferred where the plaque anatomy allows.

  • Inflatable penile prosthesis

    For combined severe curvature and medication-refractory ED: AMS 700 or Coloplast Titan implant, with intra-operative straightening. Restores rigidity and correction in one operation.

  • Assessment first

    Doppler ultrasound with intracavernosal PGE1 (Kelami test), goniometry, IIEF-5, plaque imaging by US or MRI - the honest inputs the surgeon needs to choose.

  • Consultation only

    An honest discussion of whether you are in the stable phase yet, and which technique fits your curvature, erectile function and priorities.

Safety and recovery

What to expect afterwards - honestly.

Straightening success is 85–95% for Nesbit and plication and 75–90% for grafting. The things worth planning are the length trade-off, the ED risk profile, and a firm four-to-six-week no-sex window.

  • Length loss is real and discussed up front

    Nesbit typically shortens by 1–2 cm. Plication is a little less. Grafting largely preserves length. You will hear this from the andrologist before you consent, not after.

  • Erectile dysfunction risk

    Nesbit and plication carry a 5–10% ED risk. Grafting is 10–30%. A prosthesis is the answer when ED already coexists with severe curvature.

  • No sex for four to six weeks

    Tissue healing is the reason. Sex or masturbation too early is the commonest cause of recurrence and suture failure.

  • PDE5 inhibitors to soften early erections

    Some units prescribe low-dose tadalafil for two weeks to reduce painful nocturnal erections and protect the repair.

  • Altered sensation is common early

    Numbness around the incision or glans is common in the first weeks and usually recovers. Persistent sensory change is rare.

  • Recurrent curvature

    Around 5–15% of men develop some recurrent curvature over five years. It is usually milder than the original deformity.

  • Suture palpability

    After plication the knots can occasionally be felt under the skin. Bothersome sutures can be removed once healed.

  • Prosthesis-specific risks

    For implant cases: mechanical failure over a decade, infection (roughly 1–3%), and rare erosion. Modern hydrophilic-coated devices have reduced infection significantly.

  • Red flags

    Fever, spreading redness, an expanding haematoma or a cold, dusky glans after surgery are not normal - call the clinic or A&E the same day.

Reading your operation note

Your operation note in four parts. Read the last one first.

Whichever technique was used, the note the andrologist sends you keeps to the same shape.

A UK consultant andrologist reviewing a patient’s operation notes

A quiet reminder

Surgical language is precise and can read coldly - we translate it for you.

If you would like us to talk you through the note before your review, just ask.

  1. 01 Header

    Indication and technique chosen

    Why the operation was done - curvature angle, ED status, plaque location - and which technique was agreed with you.

  2. 02 Technique

    Approach and correction detail

    Degloving approach (subcoronal, penoscrotal or ventral), artificial erection findings, and the exact correction - number of wedges, number of plication bites, graft type, or prosthesis make.

  3. 03 Findings

    Residual curvature and length

    Post-correction residual curvature under artificial erection, stretched penile length before and after, and any incidental findings.

  4. 04 Impression

    Recovery, no-sex window, review timing

    Read this first: the four-to-six-week no-sex window, PDE5 inhibitor plan if any, traction protocol, and when you will be seen again.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Cover for Peyronie’s surgery varies by insurer and technique - plication and grafting are usually funded when medically indicated; a prosthesis often requires pre-authorisation.

Frequently asked

Everything we get asked about Peyronie’s surgery.

Quick answers on technique choice, length loss, ED risk, and cost.

  • What is Peyronie’s disease?

    An acquired penile deformity where a fibrous plaque forms in the tunica albuginea and causes curvature, pain, indentation or erectile dysfunction. It affects 3–9% of men, peaks between 50 and 70, and is associated with Dupuytren’s contracture. Microtrauma, genetic and autoimmune factors all contribute.

  • When is surgery the right answer?

    Once the disease has been stable for at least 12 months, the curvature is greater than about 30° and it stops you having intercourse, causes pain or troubles you aesthetically. Surgery in the acute painful phase is not appropriate - you wait for the plaque to mature.

  • Nesbit or Lue 16-dot plication - which is better?

    For a curvature under 60° with preserved erectile function, both give 85–95% straightening. Nesbit removes small wedges of tunica; plication uses 16 non-absorbable sutures. Plication is usually a little less shortening; Nesbit is the more time-tested. The surgeon will recommend based on your anatomy and their experience.

  • When is plaque incision and grafting used instead?

    For curvature greater than 60°, hourglass deformity or shaft indentation. The plaque is incised and a graft (buccal mucosa, saphenous vein, tunica vaginalis, dermal or pericardial) is inlaid on the concave side to lengthen it. It preserves length but carries a higher ED rate - 10–30% versus 5–10% for plication.

  • Will I lose length?

    Some, in most techniques. Nesbit typically shortens by 1–2 cm. Plication is a little less. Grafting largely preserves length, which is the trade-off you accept for the higher ED risk. This is disclosed before consent - it is a BAUS standard.

  • What if I already have erectile dysfunction?

    If your ED has not responded to PDE5 inhibitors or injections and your curvature is severe, a penile prosthesis with intra-operative straightening is usually the right operation - one procedure that restores rigidity and correction at the same time. AMS 700 and Coloplast Titan are the two inflatable devices used in the UK.

  • How much does Peyronie’s surgery cost privately in London?

    Roughly £4,500–£8,000 for a Nesbit or 16-dot plication, £6,500–£12,000 for plaque incision and grafting, and £10,000–£16,000 for an inflatable prosthesis with straightening. Available on the NHS through urology as well - we can help you decide which route fits.

  • What does the pre-op assessment involve?

    A Doppler ultrasound with intracavernosal PGE1 (the Kelami test) to induce an artificial erection and measure the curvature with a goniometer, an IIEF-5 questionnaire for erectile function, and plaque imaging by ultrasound or MRI. Without this, the surgeon cannot choose the right technique.

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