The Management of Peyronie’s Disease: Evidence-based 2010 Guidelines

Ralph, David; Gonzalez-Cadavid, Nestor; Mirone, Vincenzo; Perovic, Sava; Sohn, Michael; Usta, Mustafa; Levine, Laurence

doi:10.1111/j.1743-6109.2010.01850.x

Cited by 320 publications

(475 citation statements)

References 194 publications

(234 reference statements)

Supporting

Mentioning

437

Contrasting

Unclassified

Order By: Relevance

“…Penile pain is a relative contraindication except when it may be due to a strong erection imparting torque-like pressure on the penis. 19 Obtaining preoperative consent is a critical aspect of PD management mainly because most patients with PD are distressed and emotionally devastated. It is important to have a frank discussion so that he understands the possible limitations of the operation, and set appropriate expectations regarding outcomes to optimize patient satisfaction.…”

Section: Preoperative Evaluationmentioning

confidence: 99%

“…It is important to have a frank discussion so that he understands the possible limitations of the operation, and set appropriate expectations regarding outcomes to optimize patient satisfaction. 19,20 One must address the possibility of persistent or recurrent curvature, change in penile erect length, diminished rigidity and decreased sexual sensation (Box 1).…”

Section: Preoperative Evaluationmentioning

confidence: 99%

“…19,21 The patient should understand that the goal is to make him 'functionally straight', which expert opinion defines as a residual deformity of 20u or less. Change in penile erect length is more likely in plication vs. grafting though all surgical correction procedures have been associated with some length loss.…”

Section: Preoperative Evaluationmentioning

confidence: 99%

“…This is extremely important for the patient to understand preoperatively as 70%-80% of PD patients initially present with loss of length due to the fibrotic disease process. 19,20 Erectile rigidity will not likely be made better by the procedure, and therefore, consideration for penile prosthesis should be discussed if the patient already has significant erectile dysfunction (ED) preoperatively. 19,21 Decreased sexual sensation has been examined and reported upon infrequently, but it does appear that around 20% of men will describe some reduction in penile sensitivity, rarely interfering with orgasm or ejaculation.…”

Section: Preoperative Evaluationmentioning

confidence: 99%

“…In addition, there can be pain associated with the knots, suture granulomas and, as noted, a potential for tactile and sexual sensitivity changes in 0%-21%. 19,22,37 Surgical straightening with a variety of plication procedures can be expected in 85%-100% of patients with a satisfaction rate of 67%-100%. Recurrence of penile curvature deformity (.30u) has been reported at a rate of 8%-11%, the reported risk of new ED ranges from 0% to 23% and diminished sensation is reported in 4%-21%, with follow-up of up to 89 months.…”

Section: Tunical Shortening Proceduresmentioning

confidence: 99%

See 4 more Smart Citations

Surgery for Peyronie's disease

Levine¹,

Larsen²

2012

Asian J Androl

112

View full text Add to dashboard Cite

Peyronie's disease (PD) is most simply referred to as a fibrotic wound-healing disorder of the tunica albuginea. It is both a physically and psychologically devastating disorder that causes penile deformity, curvature, hinging, narrowing and shortening, which may compromise sexual function. Although a variety of non-surgical treatments have been suggested, none to date offer a reliable and effective correction of the penile deformity. As a result, surgery remains the gold standard treatment option, offering the most rapid and reliable treatment which will be the focus of this article. We review the preoperative evaluation, surgical algorithm, graft materials and postoperative management of PD. Outcomes for tunical shortening, tunical lengthening and penile prosthesis placement for penile straightening are reviewed. Tunica albuginea plication is the preferred method of straightening for men with adequate rigidity and less severe disease defined as curvature less than 706 without narrowing/hinging. Men who have more severe, complex deformity, but maintain strong preoperative erectile function should be considered candidates for straightening with plaque incision or partial excision and grafting. Finally, for those men who have inadequate rigidity and PD, penile prosthesis placement with straightening is the best approach to address both problems. Keywords: penile prosthesis; Peyronie's disease, penile reconstruction; plaque excision and grafting; plaque incision; tunica albuginea plication INTRODUCTION Peyronie's disease (PD) is most simply referred to as a fibrotic woundhealing disorder of the tunica albuginea. It is both a physically and psychologically devastating disorder that causes penile deformity, curvature, hinging, narrowing, shortening and painful erections. 1 The perceived loss of length and girth is often more disturbing than the curvature itself, all of which can lead to moderate to severe depressive symptoms, emotional, and relationship problems. 2,3 Despite a myriad of treatment options, PD remains a considerable therapeutic dilemma due to several factors including an incomplete understanding of its etiopathophysiology and the relative paucity of randomized, placebo-controlled trials. A general explanation of this disorder, which has gained acceptance, is that PD is a disorder in which genetically susceptible individuals experience a localized response to endogenous factors such as tumor growth factor-b, which are released in response to microtrauma. This can lead to biological transformation of cells within the tunica albuginea, cell cycle dysregulation, genotypic changes and increased expression of cytokines and free radicals. This inflammatory response leads to unregulated extracellular matrix deposition including fibronectin and collagen, and ultimately plaque scar formation, which does not appear to undergo proper scar remodeling, leaving an inelastic segment in the involved tunica albuginea. [4][5][6][7][8][9] Although a variety of non-surgical treatments have been suggested, none offer a r...

show abstract

Section: Preoperative Evaluationmentioning

confidence: 99%

Section: Preoperative Evaluationmentioning

confidence: 99%

Section: Preoperative Evaluationmentioning

confidence: 99%

Section: Preoperative Evaluationmentioning

confidence: 99%

Section: Tunical Shortening Proceduresmentioning

confidence: 99%

See 3 more Smart Citations

Surgery for Peyronie's disease

Levine¹,

Larsen²

2012

Asian J Androl

112

View full text Add to dashboard Cite

show abstract

Surgical treatment of Peyronie's disease

Kadıoğlu

Salabaş

2016

Male Sexual Dysfunction

View full text Add to dashboard Cite

A universal mathematical model applied to the congenital ventral penile curvature

et al. 2020

View full text Add to dashboard Cite

IntroductionThe macroscopic dynamic of fetal penis development presents a pattern resembling the unfolding of a spiral, so congenital ventral penile curvature could indicate that this natural sequence has been interrupted. Our aim in this article is to offer a mathematical model of congenital ventral curvature of the penis.Materials and MethodsFive individuals who presented with congenital ventral penile curvature and three who presented with acquired penile ventral curvature due to Peyronie's disease were evaluated. The penises were photographed during an induced erection test and the penile curvature patterns were compared with an equiangular spiral. When an association was found, a potential relationship to the golden spiral—a type of equiangular spiral—was also assessed.The mathematical spiral relationships were analyzed using Wolfram CDF Player® (Logarithmic Spiral) and PhiMatrix® software. The Wolfram software generated logarithmic spirals equivalent to the penile curvature with appropriate mathematical values. The PhiMatrix software, which builds any golden spirals from golden rectangles, was used to check whether the spiral was golden as well as equiangular.ResultsAn equiangular spiral that was also golden was found in all cases of congenital ventral penile curvature. In contrast, none of the acquired penile ventral curvature cases showed a specific pattern.ConclusionCongenital ventral penile curvature has the mathematical pattern of a golden spiral. Our results offer a mathematical algorithm for potential use in surgical reconstruction procedures, regenerative medicine, tissue engineering, robotics, and body–machine interfaces.

show abstract

The Management of Peyronie’s Disease: Evidence-based 2010 Guidelines

Cited by 320 publications

References 194 publications

Surgery for Peyronie's disease

Surgery for Peyronie's disease

Surgical treatment of Peyronie's disease

A universal mathematical model applied to the congenital ventral penile curvature

Contact Info

Product

Resources

About