EGYDIO Technique 

for the surgical correction of Peyronie's Disease

The EGYDIO technique developed by Dr Paolo Egydio is now considered as the gold-standard for the surgical treatment of  Peyronie's disease, adopted by leading surgeons throughout the world . It is not a single surgical technique but rather a category of surgical techniques to correct penis curvature due to Peyronie's disease, which are based on geometrical principles. The ACPCT medical team has not only developed the surgical techniques but have consistently performed the highest number of surgeries and reported the best post-operative results.

What is Peyronie's Disease?

Peyronie's disease (PD) is characterized by scarring of the tunica albuginea, the tissue which covers the penis erection mechanism. The exact reasons why the scar develops in the first place are still not definitely determined but it is hypothesized that this happens because of micro-injuries of the penis tissue during sexual intercourse. However, it should be noted that not all penis micro-injuries (which are quite common) will lead to Peyronie’s disease. Because of this scar (plaque), the tunica albuginea loses elasticity, which in turn results in penile deformity during erection. This deformity is usually severe curvature of the penis, making sexual intercourse very difficult or even impossible. The condition is also invariably associated with penis length reduction and around 1 in 3 patients will also present erectile dysfunction because of Peyronie’s. As a result, patients usually report that the disease has significant impacts on their quality of life and 1 in 2 patients report severe psychological distress and even depression.

 

The most common symptoms that patients usually first notice are the following:

  • Penile pain

  • Palpable lumps on the penis shaft

  • Initial curvature of the penis

  • Shortening and narrowing of the penis

  • Erectile dysfunction

 

Is there a treatment for Peyronie's Disease?

It should be pointed out that ALL cases of Peyronie's disease are treatable and that patients should be able to have a normal sexual life following treatment. Beyond that, peyronie’s disease is characterised by two phases:

 

  • The Peyronie’s disease acute phase ( to 12 months from the onset of the disease)

 

During the acute phase of the disease, the plaque is still active in the sense that it continues to change. This phase is usually characterized by pain and changes in the penis curvature. A number of conservative treatments have been proposed to treat Peyronie’s during the acute phase, but the efficacy of those is limited and their main aim  is to reduce pain rather than the curvature. Unfortunately, during the acute phase, for most men penis curvature becomes worse but the pain gradually reduces. Worsening of the curvature also usually implies shortening of the penis.

 

  • The Peyronie’s disease stable phase (from 12 months onwards or eariler if the curvature has been stable for at least 6 months)

 

After the plaque and the resultant curvature has been stabilised then surgical treatment of Peyronie’s disease can be considered. The surgical technique employed will depend on a number of variables such as the type of curvature, whether Peyronie’s has resulted to erectile dysfunction as well as the wishes of the patient.

 

Surgical Treatment of Peyronie's Disease

The ​objective of a Peyronie's operation is 4-fold:

 

  • Restore a straight penis and minimize any residual curvature

  • Retain, restore or increase penis length and girth

  • Retain a good erectile function

  • Minimize the potential for any minor complication such hematoma, reduction in penis sensibility etc.

 

The first step to succesful treatment, is to choose the operating technique that is best for the individual patient. At ACPCT we offer all the surgical options and we will guide our patients to the one that will ensure the best possible result. However, according to our experience and as reported by other independent leading surgeons, for most cases, the best surgical option is the Egydio technique based on geometric principles. 

 

 

The Egydio Technique for the Treatment of Peyronie's Disease

To-date the most common technique for surgical treatment of congenital penile curvature remains the Nesbit corporoplasty. Under this technique, after the penis has been degloved, the longer side of the penis is plicated (pulled together) so as to  straighten the penis. Subsequently permanent stitches are applied so as to prevent curvature from reoccurring.

 

Whereas a number of modifications of the original Nesbit technique have been proposed, all of them suffer from a number of disadvantages:

 

  • High percentage of penile curvature recurrence (around 25%)

  • Significant penile shortening

  • Formation of lumps on the penis from the permanent stitches which can be felt or are visible

  • Deep incisions (cuts) on the penis body, increasing the probability of complications such as erectile dysfunction

  • Applicable mainly on single axis penile curvatures and not appropriate for bi-planar curvatures (more complicated) due to limited precision of the technique

 

It is generally true that if a Nesbit operation is performed by very experienced surgeons then the above issues can in general be prevented or at least minimized. Nonetheless, penile shortening (around 1cm for every 20 degrees of curvature) is inevitable with this type of operation.

 

Another category of surgical techniques are the so called excision and grafting. These techniques, involve elongating the short side of the penis by completely removing the Peyronie's plaque and using a graft to cover the defect. Whereas this technique can restore penile length, it can result to high incidence of post-operative erectile dysfunction and in cases with multiple plaques or non-visible plaque formation, it becomes very difficult to apply.

 

For these reasons Dr Egydio, developed in the early 2000s, the so called Egydio technique for surgical treatment of Peyronie's disease.

 

Technical Description of the Egydio Technique

 

As opposed to Nesbit type of operations where the long side of the penis is shortened so as to correct the curvature, the Egydio technique involves elongating the short side of the penis (which has been shortened due to Peyronie's ) by making relaxing incisions on the plaque based on geometric principles. These principles, guide the surgeon so as to perform the correct incisions on the plaque as well as precisely prepare the grafts that cover these incisions.  The advantages of the Egydio technique are very significant:

 

  • No penile shortening - significant penis length and girth restoration can be achieved (average of 3cm)

  • Any type of curvature can be corrected using this technique

  • Due to the precise nature of the surgical technique, the risk for curvature reccurence is extremely low - over 90% success rate from the first surgery

  • Grafting and cover of the tunical defect is done in a very precise manner, minimizing the probability of post-operative erectile dysfunction

  • Careful and standardised mobilization of the neuro-vascular bundle ensures that surgical complications are minimized

 

There have been numerous academic publications on the efficacy of the Egydio technique and its superiority to the Nesbit type and excision and grafting operations is now widely accepted in the medical community and most importantly patient satisfication rates are very high.   

 

Video - Egydio geometric principles

Advanced Center for Penile Curvature Treatment

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