Peyronie's disease. Investigation of staging, erectile failure and operative management

Abstract

There are still diverse management options in Peyronie's disease, due to its unknown aetiology, progression or remission. Types, extent and duration of operative management in this disease are subject of controversial discussion. We did complex investigations in 132 patients revealing the following items. Diagnostic tests should include both history and physical examination and comparative X-ray and ultrasound investigations. CT is the best method to differentiate pathological lesions in the tunica albuginea. X-ray (xerography) examination demonstrates calcification of the plaque. Papaverin-hydrochloride injection is a valid method to check the extension of concomitant erectile dysfunction and shows the angulation of the penis. Plaque excision and grafting with various materials were used initially with disappointing results (15 patients, only 20% good results). Modified corporal plication has been used subsequently with good results (54 patients, follow-up 3 years, 90% good results). Implantation of penile prosthesis must be evaluated individually.

A Surgical Algorithm for Men with Combined Peyronie's Disease and Erectile Dysfunction: Functional and Satisfaction Outcomes

“…There is minimal literature pertaining to the options for management of this combined disease as most authorities suggest penile prosthetic surgery [2,[13][14][15].…”

Comparison of the protective effects of papaverine, lidocaine and verapamil on the sperm quality of the testis after induced torsion–detorsion in rats

“…Different vasodilators have been used in urological disorders, including verapamil, papaverine and lidocaine. Verapamil has been used in the treatment of Peyronie's disease and in renal transplantation [19,20]. Papaverine has been used in erectile dysfunction and renal transplantation [21,22].…”

Plaque incision and grafting represents the best surgical approach to the Peyronie’s disease patient: Con

“…Plication procedures have the same drawbacks as Nesbit wedge resection in terms of penile shortening, but the outcome is less reliable [5]. Results of Nesbit [5,8,10,12,[15][16][17] and plication procedures [18][19][20][21][22][23][24][25][26][27] are summarized in Tables 1 and 2, respectively.…”