Conservative therapy of Peyronie's disease has not given very encouraging results. This means operative treatment strategies are the only effective therapy form that appears to be successful. Another treatment form, which often leads to a non-acceptable shorting of the penis, is the technique used in the Schröder-Essed and Nesbit procedures. Removal of the plaque, followed by a tissue transplant to cover the excision area, enables a correction of the deviation and maintenance of the original length of the penis. Because of the periodically described, possibly fatal results of postoperative perception disorders of the glans penis, preparation of the dorsal neurovascular bundle is performed under microsurgical conditions. Because of the certainty with which optical identification of nerves and vessels is achieved, it is possible to keep the nerves protected and to have atraumatic isolation of the plaque. After the first encouraging surgical results, we present the operative procedure under microsurgical conditions.