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Andrology · UK

Operations for Peyronie’s disease, chosen for your curvature, not the surgeon’s habit.

An umbrella page for the surgical treatment of Peyronie’s disease in the UK - Nesbit, Lue plication, plaque grafting, penile prosthesis, and combined procedures. Which one fits depends on curvature, erection and length priorities. We make that decision honest.

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 surgery costs privately in the UK.

NHS-funded surgery is available via urology referral. For technique-level detail on the Nesbit and Lue options, see our dedicated Nesbit and Lue page.

In short

Nesbit or plication from £4,500; grafting from £8,000; prosthesis from £12,000.

Procedure Indicative range
Andrology consultation + Doppler with Kelami test £400–£800
Nesbit procedure (tunical excision + closure) £4,500–£8,000
Lue 16-dot plication (Yachia / Essed-Schroeder) £4,500–£7,500
Plaque incision + grafting (Egydio / Lue graft) £8,000–£13,000
Penile prosthesis (inflatable, with straightening) £12,000–£16,000
Combined plication + grafting (complex curvature) £9,500–£14,000

Prices vary by surgeon, by hospital, by graft material and prosthesis model, and by length of stay.

The problem

Which operation, done by whom, and when.

Peyronie’s disease is fibrous plaque in the tunica albuginea that bends the erect penis, causes pain, and can shorten and soften it. Three to nine per cent of men live with it; most are between 50 and 70. Surgery is a specialist decision - the wrong operation or the right operation too early is a poor result.

  • Two phases, one moment for surgery

    The acute phase (six to eighteen months) is painful and evolving. The stable phase, when the curvature has settled, is the surgical window. Operating before stability risks recurrence.

  • Three questions decide the operation

    How bent is the erection, how firm is it, and how important is length? The answers point to Nesbit, plication, grafting or prosthesis.

  • Conservative first, always

    Tadalafil, traction, verapamil injections, pentoxifylline and shockwave should usually be tried before surgery. Collagenase (Xiaflex) was withdrawn from the UK in 2022.

When it helps

When surgery is the right step for Peyronie’s disease.

The situations we see most, plus the one red flag that means it is too early - not too late - to operate.

  • Stable curvature above 30°

    A bend that has not changed for six to twelve months and prevents or seriously interferes with penetration.

  • Complex or hourglass deformity

    A waist, indentation or hinge effect that buckles the shaft during erection - usually needs grafting.

  • Curvature plus erectile dysfunction

    A bent penis that also will not stay firm. A prosthesis addresses both problems in one operation.

  • Failed conservative treatment

    Pentoxifylline, tadalafil, traction, verapamil or shockwave have been tried and the deformity remains.

  • Painful stable plaque

    Ongoing pain from a mature plaque despite conservative measures - sometimes an indication in its own right.

  • Length loss with functional impact

    Significant shortening that, combined with curvature, makes intercourse impossible or unsatisfying.

  • Recurrence after previous surgery

    A curvature that has come back after a Nesbit, plication or graft - revision surgery is possible and often specialist-led.

  • Red flag: still in the acute phase

    A painful, changing curvature that has not been stable for a year is not yet a surgical case. Operating too early risks recurrence - we will say so.

Procedure options

The full menu of Peyronie’s operations.

A short summary of every surgical option. For Nesbit and Lue plication in technique-level detail, see our dedicated Nesbit and Lue page.

  • Nesbit procedure

    A wedge of tunica is excised on the side opposite the curve, and the defect is closed to straighten the shaft. Reliable straightening, small length loss (1–2 cm), and best for curvature under 60° with good erections.

  • Lue 16-dot plication

    Non-absorbable sutures plicate the tunica on the convex side without cutting into it. Less invasive than Nesbit with comparable outcomes; some length loss. Also called Yachia or Essed-Schroeder in its variants.

  • Plaque incision + grafting

    The plaque itself is incised (or partly excised) and the defect is filled with a graft - dermal, buccal mucosa, saphenous vein, tunica vaginalis or bovine pericardium. Preserves length; higher risk of postoperative erectile dysfunction (10–30%).

  • Penile prosthesis

    An inflatable prosthesis (AMS 700, Coloplast Titan) straightens the shaft mechanically and restores rigidity in one operation. The right choice when curvature is combined with erectile dysfunction that has not responded to medication.

  • Combined plication + grafting

    For complex, biplanar or hourglass deformities where neither technique alone will do. Straightening in more than one plane, at the cost of longer surgery and higher morbidity.

  • Revision surgery

    For recurrent curvature after a previous Nesbit, plication or graft - technically demanding and best reserved for high-volume specialists.

  • Andrology consultation only

    A specialist review with objective curvature measurement and IIEF-5 scoring - often the right first step before committing to any operation.

  • Detailed Nesbit and Lue page

    For the full technique-level detail on Nesbit and Lue plication, see our dedicated page - linked from Related below.

Selection algorithm

How specialists choose between the operations

  • Good erections + curvature under 60°: Nesbit or plication. Small length loss accepted for reliable straightening.
  • Good erections + curvature over 60° or hourglass: plaque incision with grafting. Length preserved, higher ED risk.
  • Poor erections at any curvature: penile prosthesis. Rigidity and straightening in one operation.
  • Complex biplanar or waist deformity: combined plication + grafting, in a high-volume unit.

Safety and recovery

What to expect afterwards - honestly.

Peyronie’s surgery is safe and effective in the right hands, but every technique carries trade-offs. The ones worth planning around are length, ED risk, recurrence and the six-to-eight-week rest.

  • Length loss is expected with Nesbit and plication

    One to two centimetres of stretched length is usual. If preserving length is the priority, grafting or prosthesis are discussed instead.

  • New or worsening ED after grafting

    Ten to thirty per cent of grafting patients report new erectile dysfunction. Worth weighing honestly, especially if erections were borderline beforehand.

  • Recurrent curvature 5–15%

    A small proportion of curvatures come back or a new bend develops elsewhere. Higher after grafting than after Nesbit or plication.

  • Change in penile sensation

    Numbness in the glans is not uncommon in the first months and usually settles. Persistent altered sensation is a small but real risk.

  • Six to eight weeks with no sex

    Sutures, grafts and neurovascular bundles need time. Early intercourse is the commonest cause of technical failure.

  • Rehabilitation matters

    Traction and low-dose daily tadalafil after surgery help preserve length and erectile function - done routinely by good units.

  • Prosthesis-specific risks

    Infection (1–3%), mechanical failure over years, erosion and the need for revision. Antibiotic-coated devices in specialist units keep the numbers low.

  • Realistic straightening, not perfect straightening

    Residual curvature of 10–20° is considered a successful result. Perfectly straight is not the aim; functional intercourse is.

  • Red flags after surgery

    Spreading redness, fever, heavy bleeding, or (with a prosthesis) fluid discharge from the wound - call the operating team 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

    Which operation was done and why

    Nesbit, plication, grafting, prosthesis or combined - and the curvature and erectile function that led to the choice.

  2. 02 Technique

    Approach, closure and any graft used

    The incision, the technique, the graft material if one was used, the prosthesis model if one was placed, and the intraoperative curvature check.

  3. 03 Findings

    Plaque location, residual curvature

    Where the plaque sat, whether the curvature was uniplanar or complex, and the residual curvature measured at the end of the case.

  4. 04 Impression

    Recovery, rehab, no-sex window

    Read this first: catheter removal, traction and PDE5 rehab plan, when it is safe to return to sex and exercise, and the review schedule.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Cover for Peyronie’s surgery varies by insurer and by indication - usually funded when curvature prevents intercourse, self-pay for cosmetic-only cases.

Frequently asked

Everything we get asked about Peyronie’s surgery.

Quick answers on which operation, how much length you might lose, cost, ED risk and recovery.

  • When is surgery the right step for Peyronie’s disease?

    When the disease is in the stable phase - no change for six to twelve months - the curvature is more than 30° and it prevents satisfying intercourse. Conservative options (tadalafil, traction, pentoxifylline, verapamil or shockwave) should usually have been tried first.

  • Which operation will I need?

    That depends on three things: how bent the erection is, how firm it is, and whether preserving length matters most. Nesbit or plication suits curvature under 60° with good erections. Grafting suits curvature over 60° or hourglass deformity where length must be preserved. A penile prosthesis addresses curvature and erectile dysfunction in one operation.

  • How much length will I lose?

    With Nesbit or plication, expect one to two centimetres of stretched length loss. Grafting is designed to preserve length. Prosthesis surgery may add back length that Peyronie’s took away. The specialist measures your stretched length before surgery so the conversation is honest.

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

    Roughly £4,500–£8,000 for a Nesbit or plication, £8,000–£13,000 for plaque grafting, and £12,000–£16,000 for a penile prosthesis. NHS-funded surgery is available via urology referral.

  • What is the risk of erectile dysfunction after the operation?

    Low after Nesbit or plication (under 5% new ED). Higher after grafting (10–30%) because the neurovascular bundles are dissected. A prosthesis guarantees rigidity, which is the whole point of choosing it.

  • When can I have sex again?

    Six weeks at the earliest, eight is safer for grafting and prosthesis cases. Traction and low-dose daily tadalafil are often started at four to six weeks as rehabilitation.

  • What is the difference between Nesbit and Lue plication?

    A Nesbit removes a wedge of tunica opposite the curve and closes the defect; a Lue plication folds the tunica with sutures without cutting it. Comparable straightening; plication is technically less invasive. See our detailed page for the full comparison.

  • Can I have surgery if I am still in the painful, changing phase?

    Not usually. Operating on active disease has a high recurrence rate. Most specialists want six to twelve months of stability first, with pain settled and curvature unchanged.

Related pages

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