Surgical treatment of Peyronie's disease based on penile length and degree of curvature

Abstract

The aim of the study was to present the selection criteria for surgical techniques for the treatment of patients with Peyronie's disease. A total of 55 men with Peyronie's disease were surgically treated. We created specific criteria for selection of the appropriate surgical technique. All patients had a stable disease for 6 months and impossible vaginal intromission. All patients had subjective (as reported by the patient) and/or objective normal penile rigidity (as observed after intracavernous administration of alprostadil). Also, they all underwent drug therapy, which was unsuccessful. Among them, 40 patients with penile curvature of o601 and erect penile length of 413 cm underwent Nesbit's operation, whereas plaque excision and grafting with polytetrafluoroethylene patch was performed in 15 patients with penile curvature of Z601 and/or erect penile length of r13 cm. At a mean (7s.d.) follow-up of 81.1733.8 and 78.7732.8 months, respectively, straightening of the penis was achieved in 35 out of 40 (87.5%) and 12 out of 15 (80%) patients, respectively, whereas erectile dysfunction developed in two out of 40 (5%) and one out of 15 (6%), respectively. Shortening of the penis occurred in all 40 patients undergoing Nesbit's operation, and in none of the patients undergoing plaque excision. Six out of 40 (15%) patients undergoing Nesbit's operation reported subjective perception of penis shortening, whereas none of the patients undergoing plaque excision complained of this discomfort. In conclusion, we recommend the selection of surgical technique based on penile length and degree of curvature. Nesbit's operation is an appropriate surgical technique for the treatment of patients with erect penile length of 413 and deviation of o601, whereas the plaque excision and grafting with polytetraflouroethylene patch is a technique of choice in the treatment of patients with erect penile length of r13 and/or deviation of Z601.

Peyronie`s disease surgery: Surgical outcomes of 268 cases

“…Curvature recurrence rates were conveyed between 4-27% in the same studies. [2,9,10,[13][14][15][16] The recurrent cases who underwent SP were predominated by bi-planar curvatures (50%) and recurring side was lateral in general in our series. Therefore instead of suture/ tissue problems, cavernosal anatomy which is weaker at the lateral sides may be blamed for the recurrences.…”

A novel modification of tunical plication by plaque thinning: long-term results in treating penile curvature of Peyronie’s disease

“…Briefly, instead of ellipse, a large longitudinal incision or multiple smaller longitudinal incisions were made, and the tunica albuginea was closed horizontally. Although satisfactory results were achieved in several long-term studies with penile straightening rates from 86.3 to 90.5% [4,13,23], however, it also involved some surgical complications and function failures, such as hematoma, infection as well as ED for opening the corpora cavernosa, decreased penile sensitivity or urethral injury due to the mobilization, and penile shortening and recurrent curvature [24].…”

Peyronie’s surgery: Graft choices and outcomes

“…Bokarica et al [47] and Ganabathi et al [48] have each published a small, retrospective case series evaluating the effi cacy of plaque excision/incision and grafting with Gore-Tex. Bokarica et al [47] achieved good results, with complete straightening in 12 of 15 patients and ED in only 1 of 15.…”