Plaque incision and grafting (PIG) is an excellent option for men with significant curvature (greater than 45 degrees), young age and normal erectile function. The success rate defined as having a straight erection after surgery is greater than 85%. However, it is associated with some side effects the most notable one being problems with erection. In our database those patients most likely to develop erectile dysfunction after PIG surgery are men over 55 years of age, men with pre-existing erection difficulties (even mild ED) and curvatures greater than 60 degrees. This is a complicated operation that should only be done by a surgeon with significant expertise ion the procedure.