Peyronie's disease: treatment and NEF technique without loss of size.

Peyronie's disease causes the appearance of fibrous plaques in the tunica albuginea, which reduces elasticity and causes curvaturepossible pain, shortening and sometimes erectile dysfunction. Classical techniques (plication/grafting) straighten but frequently shorten the penis. At Clínica Nef website we use a proprietary minimally invasive technique which releases fibrosis with Toledo Cannula e autologous stem cell implantation to remodel the tissue without loss of length. In our clinical experience, the 84% of patients improves curvature and function; if not enough, we offer free repetition per year.

What is Peyronie's disease?

The Peyronie's disease (also called "curved penis"or fibrosis of the tunica albuginea) consists of the formation of scar tissue plaques in the tunica albuginea that surrounds the corpora cavernosa. This tissue loses elasticity and acts as a "fixed point" during erection: it pulls to one side, bends the penis towards the plate and prevents uniform filling of blood, with curvature, apparent shortening and, sometimes, erectile pain or difficulty.

Note on common language: many patients search for information such as "surgery curved penis", "deviated penis" or write "peronie/peyroni". We mean the same thing: Peyronie's disease.

Symptoms and phases

• Inflammatory (active) phase: pain on erection, hardened area to the touch and progressive curvature.
• Stable (chronic) phase: pain usually subsides, the plaque stabilizes and the curvature stops increasing, but shortening and/or erectile dysfunction may persist.

Causes and mechanism

Different triggers lead to the same mechanism: replacement of elastic tissue with stiff fibrous tissue.

• Repeated microtrauma: sexual intercourse, contact sports, or beatings.
• Autoimmune processes: abnormal inflammatory response of the immune system.
• Scar sequelae after previous inflammations.

Diagnosis

• Clinical history and examination: plaque palpation, location and size.
• Evaluation of erection/curvature: photographs and measurement in degrees.
• Penile ultrasound when appropriate, to characterize the plaque and rule out calcifications.

When is it convenient to treat?

• Curvature that hinders penetration or generates discomfort/pain.
• Erectile dysfunction associated with or impact on self-esteem.
• Evidence of progression in the active phase.

The therapeutic objective is improve straightness, keep the length y optimize erectile functionminimizing risks and sequelae.

Existing treatments (overview)

1) Conservative measures

• Observation and control in very mild and stable cases.
• Oral drugs/supplements: limited evidence to "dissolve" plaque; they may be adjuvants at the physician's discretion.
• Traction and vacuum devices: useful in selected profiles and always under medical supervision.
• Intralesional infiltrations (e.g. collagenase) in indicated cases.

2) Conventional surgery

• Plicatura: shorten the opposite side of the plate to straighten; usually reduces length.
• Grafts/meshes: replace scar tissue; greater complexity, with risk of sensory alteration and shortening.

Key limitation: although they align, the classical techniques frequently "sacrifice centimeters"generating dissatisfaction.

Stem cell NEF technique: straightening without loss of size

At Clínica Nef websitedirected by Dr. César Noval (Carlos V Award for Medical Innovation 2024), we have developed a procedure own y minimally invasive that combines surgical precision y regenerative medicine to restore form and function without sacrificing length.

• Release of fibrous fasciae responsible for the curvature by Toledo Cannulaacting precisely on the affected area.
• Autologous stem cell implantation (from adipose tissue) between the fasciae released for remodeling fibrosis and to promote the regeneration of a more elastic fabric.

This principle is comparable to that observed in improvements in skin elasticity after fat grafting in breast radiotherapy patients.

Clinical results and NEF warranty

• Success of the 84% in curvature correction and erection improvement (data from our practice).
• Length maintenance original penis.
• Improvement of the sexual pleasure and overall functionality.

In the few cases where correction is not sufficient, we repeat the treatment free of charge per year. It is a rare involvement in this type of surgery.

Safety and possible complications

• Procedure minimally invasive with high safety profile.
• Possible adverse effects: transient hematomas and, infrequently, relapse.

Who is a good candidate? Preparation and recovery

• Men with limiting curvaturepain, pain, shortening and/or associated erectile dysfunction.
• Patients who wish to correct without loss of length as an alternative to plication/grafting.

Before: assessments with the team, resolution of doubts and preoperative tests.
During: mild sedation; fibrosis release with Toledo Cannula and stem cell implantation; duration ~1 hour; usually no income.
Afterwards: daily life and driving in few dayssexual activity at 4-6 weeks; programmed revisions.

Why NEF Clinic?

• Hyperspecialization in male intimate surgery (lengthening, thickening, sex change and Peyronie's disease treatment).
• NEF Technique recognized and awarded.
• Documented results: thousands of cases, photographs and testimonials (dossier available upon request).
• Team led by Dr. César Noval and experienced urologists/surgeons.
• NEF Warranty: possibility of repeating the procedure free of charge if the result is not sufficient.