AUTHOR=Moisés da Silva Gabriel Veber , Dávila Francisco Javier , Rosito Tiago Elias , Martins Francisco E. 

TITLE=Global Perspective on the Management of Peyronie's Disease

JOURNAL=Frontiers in Reproductive Health

VOLUME=Volume 4 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/reproductive-health/articles/10.3389/frph.2022.863844

DOI=10.3389/frph.2022.863844

ISSN=2673-3153

ABSTRACT=Introduction: Peyronie's disease results in penile curvature, shortening, or significant
discomfort on erection, leading to difficulty in sexual activity and psychological distress.
Despite extensive research, surgery remains the mainstay of treatment.
Objective: We report the most common surgical procedures used in the correction of
Peyronie's disease and suggest a surgical algorithm to guide its management.
Methods: Using PubMed, we reviewed the published literature on the surgical treatment
of Peyronie's disease and its outcomes. We identified original articles, review articles,
and editorials addressing the subject, with a focus on surgical procedures, their
indications, and outcomes.
Results: Peyronie's disease refractory to conservative treatment, can be managed by
corporoplasty and/or penile prosthesis implantation. Corporoplasty includes tunical
shortening (convex side-shortening) plication procedures and tunical lengthening
(concave side lengthening) incision/excision and grafting procedures if the erectile
function is adequate. If refractory erectile dysfunction is present, placement of a penile
prosthesis with or without further adjunctive straightening maneuvers is recommended.
We reviewed the indications, advantages, disadvantages, and outcomes of the available
techniques and proposed a surgical treatment algorithm.
Conclusion: Penile shortening procedures are usually indicated in curvatures <60°, in
penises with adequate length. Partial excision/incision and grafting are indicated for
curvatures >60°, hourglass or hinge deformities, and short penises, if the patient's
erectile function is adequate. The presence of "borderline" erectile function and/or
ventral curvature tilts the choice toward shortening procedures, and refractory erectile
dysfunction is an indication for penile prosthesis placement. An accurate risk/benefit
assessment of the individual patient as well as meticulous patient counseling are
critically important