Surgical Management of Peyronie’s Disease With Co-Existent Erectile Dysfunction

Krishnappa, Pramod; Fernández-Pascual, Esaú; Carballido, Joaquı́n; Moncada, Ignacio; Lledó-García, E.; Martínez-Salamanca, Juan Ignacio

doi:10.1016/j.esxm.2019.08.009

Cited by 19 publications

(10 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In experienced medical centers, plaque incision and grafting surgery can also be performed, involving the mobilization of the urethra and neurovascular bundle [ 12 ]. In patients with ventral curvature, for mobilizing the neurovascular bundle, lateral dissection of the neurovascular bundle may be preferred [ 13 ].…”

Section: Complex Deformitiesmentioning

confidence: 99%

“…Patients with penile curvature exceeding 60° in one or biplanar direction are also considered as having complex deformity. In those with good erectile capacity, tunical lengthening surgeries are performed, while in those with ED, treatment involves penile prosthesis implantation with additional shortening and lengthening procedures [ 2 , 13 , 14 ] (Fig. 2 ).…”

Section: Complex Deformitiesmentioning

confidence: 99%

See 1 more Smart Citation

Surgical management of complex curvature in Peyronie’s disease

Kadıoğlu,

Gürcan,

Rakhmonovich

et al. 2024

World J Urol

View full text Add to dashboard Cite

Purpose About 10% of Peyronie's patients are complex cases with severe curvature (>60 degrees), ventral plaque, multiplanar curvature, hour-glass/hinge deformity, notching deformity, and ossified plaque. In patients with complex Peyronie’s disease (PD), different techniques (shortening procedures, lengthening procedures, and penile prosthesis implantation (IPP)) may be necessary to achieve successful result. This review aims to analyze the various surgical techniques employed in the management of Peyronie's disease, with a specific focus on patients with complex deformity. Methods Articles focusing on the surgical management of complex curvature in Peyronie’s disease were searched in MEDLINE and PubMed published between 1990 and 2023. Results Shortening procedures are linked to penile shortening and are not recommended for complex cases such as notching, hour-glass deformity, or ossified plaque. Lengthening procedures are suitable for addressing complex curvatures without erectile dysfunction (ED) and are a more appropriate method for multiplanar curvatures. Penile prosthesis implantation (IPP), with or without additional procedures, is the gold standard for patients with ED and Peyronie's disease. IPP should also be the preferred option for cases of penile instability (hinge deformity) and has shown high satisfaction rates in all complex cases. Conclusion While surgical interventions for complex curvature in Peyronie's disease carry inherent risks, careful patient selection, meticulous surgical techniques, and post-operative care can help minimize complications and maximize positive outcome.

show abstract

Section: Complex Deformitiesmentioning

confidence: 99%

Section: Complex Deformitiesmentioning

confidence: 99%

Surgical management of complex curvature in Peyronie’s disease

Kadıoğlu,

Gürcan,

Rakhmonovich

et al. 2024

World J Urol

View full text Add to dashboard Cite

show abstract

“…Following the insertion of an IPP with or without modeling, residual curvature may still be present. Curvature of less than 30 degrees is not an indication for further procedures as the curvature is likely to resolve with device cycling on its own over the following year ( 23 , 24 ).…”

Section: Modelingmentioning

confidence: 99%

“…Penile plication as an adjunctive treatment to penile prosthetic insertion was first introduced by Rahman et al in 2004 ( 32 ). Coming nearly 40 years after plication had begun being used for PD ( 24 ). In this study, 5 patients who had undergone previous failed treatments for PD with concurrent ED were treated with IPP and additional intraoperative plication ( 32 ).…”

Section: Penile Plicationmentioning

confidence: 99%

Inflatable penile prosthesis placement in Peyronie’s disease: a review of surgical considerations, approaches, and maneuvers

Good,

Crist,

Henderson

et al. 2024

Transl Androl Urol

View full text Add to dashboard Cite

Peyronie’s disease (PD) is a fibrotic disorder of the tunica albuginea that results in penile deformity and/or curvature. Patients usually present complaining of penile pain, shortening and deformity resulting in dissatisfaction with intercourse. Many patients with PD will present with concomitant erectile dysfunction (ED). This disease is a significant concern for patients as it impacts both sexual function and overall quality of life. While there are several interventions available for PD treatment, inflatable penile prosthesis (IPP) implantation is considered the gold standard approach for those with moderate to severe concomitant ED, refractory to medical therapy. The goal of treatment is to give a man a functionally straight erection. Placement of an IPP alone may achieve this. However, when curvature still exists, several adjunct procedures may be performed to include manual modeling, plication, plaque incision or excision and grafting. Additionally, advanced lengthening procedures may also be used. In this paper we will present a comprehensive review of the adjuvant straightening techniques that can be used during IPP placement in men with PD and refractory ED when curvature still exists. Patient selection is a key predictor of implant success, as is preoperative and postoperative management to optimize overall patient care and satisfaction. These topics along with the different surgical approaches to IPP insertion for PD will also be discussed, including the benefits and shortcomings of each. A flowchart to aid surgeons in their intraoperative decision making based on curvature characteristics and specific patient concerns is presented.

show abstract

“…Surgical treatment of PD is broadly grouped into three main categories: penile shortening procedure (tunical plication), penile lengthening procedure (grafting) and penile prosthesis (PP) with / without additional maneuvers such as manual modeling [9]. The EAU guidelines panel committee [10] has a strong recommendation that PP in PD should be considered only when pharmacotherapy has failed in ED management.…”

Section: Introductionmentioning

confidence: 99%

Penile Prosthesis Implantation as First-Line Surgery in Peyronie’s Disease with or without ED

Krishnappa,

Moncada,

Zaccaro

et al. 2023

Preprint

Self Cite

View full text Add to dashboard Cite

Penile prosthesis (PP) in Peyronie’s disease (PD) is considered only when pharmacotherapy has failed in management of erectile dysfunction (ED). Patients with PD who underwent PP (malleable or inflatable) with or without additional maneuvers like manual modeling and grafting from 2012 to 2022 were included in the study. Patient and partner satisfaction were assessed using a 5-point Likert scale. ED was assessed using a validated questionnaire. A total of 168/636 patients underwent PP as first-line surgical management for PD and were included in the study. The mean age was 56.3 years +/- 12.4 and a median BMI of 27.2. Mean follow-up was 56 months (95% CI: 11-21). All 168 patients had undergone additional maneuvers such as manual modeling in 85.7% and grafting in 14.3%. Majority of the patients underwent a 3-piece inflatable PP (86.9%). Thirty-three (19.7%) PD patients without ED had undergone PP. The satisfaction of PD patients with ED and without ED was not statistically different (88.9% vs 87.9%). If surgery is offered in PD, PP may be considered as a first-line surgical treatment regardless of the ED in view of the acceptable complications and high satisfaction rates.

show abstract

Surgical Management of Peyronie’s Disease With Co-Existent Erectile Dysfunction

Cited by 19 publications

References 45 publications

Surgical management of complex curvature in Peyronie’s disease

Surgical management of complex curvature in Peyronie’s disease

Inflatable penile prosthesis placement in Peyronie’s disease: a review of surgical considerations, approaches, and maneuvers

Penile Prosthesis Implantation as First-Line Surgery in Peyronie’s Disease with or without ED

Contact Info

Product

Resources

About