Surgery for Peyronie’s Disease. A Review of 200 Patients

Abstract

Approximately 10% of patients with Peyronie's disease require surgery for penile angulation or erectile failure severe enough to make coitus difficult or impossible. The results of three different operations performed on 200 patients over the period 1975 to 1984 have been reviewed. The results of plaque excision and dermal grafting in nine patients were disappointing and since 1977, Nesbit's procedure has been performed in 179 patients with excellent results in 53% and moderate results in 19%. Poor results (28%) were usually due to erectile failure and this was usually present pre-operatively. Such patients are better treated by the implantation of penile prostheses and excellent (8) or moderate (2) results were seen in 1 2 patients so treated. The number of patients with poor results after a Nesbit's procedure increased from 14% at 3 months to 28% at 36 months, but then remained fairly constant. Prolonged follow-up is therefore needed t o allow valid conclusions about the ultimate outcome of surgery

Ten years outcome analysis of corporeal plication for Peyronie’s Disease

“…Bailey and associates [1] reported an excellent outcome after Nesbit's procedure in 53% of the 174 patients with Peyronie's Disease over a median follow-up of 33 months. The success rate was higher initially and late failure occurred in some patients after an excellent initial result.…”

“…The available pharmacological treatments of this condition do not provide a reliable cure. In the majority of cases only reassurance is necessary; about 10% of patients require surgical treatment [1]. The aim of such intervention is to straighten the erect penis and enable sexual intercourse.…”

Color Doppler appearance of penile cavernosal–spongiosal communications in patients with severe Peyronie's disease

“…In patients with corporeal veno-occlusive dysfunction plaque excision and grafting surgery is not indicated, because a high rate of postoperative impotence [2,3,16].…”

“…Evaluation of the erectile function in patients with Peyronie's disease is of paramount importance to plan therapy [1,2,3]; however, the etiology of erectile dysfunction remains controversial in these patients [4]. Pain or severe angulation of the penis can make coitus difficult or impossible and penile deformity may result in performance anxiety and reduced libido [5].…”

Penile sonography

“…Colour Doppler sonography provides useful diagnostic information to assess the cause of possible erectile dysfunction. Finally, objective preoperative evaluation of the erectile function is important in patients with Peyronie's disease, because different surgical procedures can result in worsening erectile function [14].…”