Recent surgical advances in Peyronie’s Disease

Introduction: Peyronie’s disease, a fibrotic disorder of the tunica albuginea of the penis, has been associated with penile shortening and some degree of erectile dysfunction. It affects patient’s quality of life, leading to severe psychological, mental, and physical stress. Penile deformation hampers sexual life leading to depression, lack of sexual confidence, loss of sexual function and performance anxiety. Peyronie’s disease etiology is yet to be known. Material and Methods: Literature search was conducted in Medline, Embase, and Cochrane databases in January 2015 in order to identify papers related to Peyronie’s disease, concerning evolving surgical management, technique, outcomes as well as ancillary treatments. Publications not concerning humans were not considered. We identified original articles, review articles, and editorials addressing the subject. All articles published in the English language were selected for screening. The eligibility criteria for inclusion were based on relevance concerning the subject. Results: The variety of penile deformities associated with Peyronie’s disease still doesn’t have an effective and reliable non-surgical therapy. We summarize the updated surgical techniques and management algorithm described for Peyronie’s disease. Discussion: Surgical management shares similar goals: correcting the curvature, preserving erectile function and penile length, and minimizing morbidity. Conclusion: To date there is no high level of evidence-based data to determine the best surgical treatment of Peyronie’s disease. After proper diagnosis, surgical reconstruction should be based on giving a functional penis, that is, rectifying the penis with rigidity enough to enable sexual intercourse.

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Initial experience in the treatment of Peyronie’s disease using testicular vaginal tunica graft

Journal of Clinical Urology ◽

10.1177/20514158211016646 ◽

2021 ◽

pp. 205141582110166

Author(s):

Rico Luis ◽

Villasante Nicolás ◽

Blas Leandro ◽

Bonnano Nicolás ◽

Ameri Carlos

Keyword(s):

Sexual Function ◽

Tunica Albuginea ◽

Peyronie’S Disease ◽

Sexual Life ◽

Rank Test ◽

Penile Curvature ◽

Initial Experience ◽

Level Of Evidence ◽

Paired Samples ◽

Peyronie's Disease

Background: Peyronie’s disease (PD) is a progressive disorder of the connective tissue of the tunica albuginea of the penis that produces an abnormal curvature, painful erections and different degrees of erectile dysfunction (ED). The aim of this study is to evaluate our initial experience in the surgical treatment of PD using an autologous graft of testicular vaginal tunica. Materials and methods: A retrospective study of 23 patients was carried out between 2015 and 2019. The successful surgical stretching rate was defined as a functional 20 degrees of curvature or less. Postoperative sexual function and complications rate were evaluated as secondary objectives. We used the abbreviated IIEF-5 questionnaire and evaluated the sexual function before and after the surgical procedure. Wilcoxon signed-rank test for paired samples (U test) was used, considering a value of p<0.05 to be statistically significant. Results: Only one patient presented a recurrence of the penile curvature, resulting in a 95.6% success rate of functional stretching. We observed a 1.6 and 0.9 difference between pre- and postoperative total score and satisfaction ( p = 0.002 and p = 0.003 respectively) Conclusion: In this series, the use of testicular vaginal tunic was found to be safe and effective with a significant change in the quality of sexual life, especially reflected in the overall satisfaction after the procedure and a low rate of complications. Level of evidence: Not applicable for this multicentre audit.

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Use of inflatable penile prostheses AMS CX with momentary squeeze in a patient with Peyronie’s disease after removal of two previously implanted penile prostheses

Archivio Italiano di Urologia e Andrologia ◽

10.4081/aiua.2014.1.46 ◽

2014 ◽

Vol 86 (1) ◽

pp. 46

Author(s):

Patrizio Vicini ◽

Ferdinando De Marco ◽

Gabriele Antonini ◽

Ettore De Berardinis ◽

Riccardo Giovannone ◽

...

Keyword(s):

Erectile Dysfunction ◽

Tunica Albuginea ◽

Penile Prosthesis ◽

Longitudinal Axis ◽

Peyronie’S Disease ◽

Neurovascular Bundle ◽

Complex Case ◽

Sexual Life ◽

Penile Prostheses ◽

Peyronie's Disease

Objective: Peyronie's disease (PD) is a fibrotic wound-healing condition of the tunica albuginea that results in penile deformity, curvature, hinging, narrowing and shortening, penile pain, and in some cases, erectile dysfunction (ED). Surgery remains the gold standard treatment option, ensuring the faster and trustworthy treatment. For those patients who have erectile dysfunction and PD, penile prosthesis placement with straightening procedure is the best method to solve both diseases. The aim of this article is to present the use of hydraulic penile prostheses AMS CX with Momentary Squeeze associated with a complete isolation of the neurovascular bundle in a complex case after removal of two previously implanted prostheses in a man suffering from Peyronie’s disease and erectile dysfunction. Material and method: A 50 year-old patient underwent two previous prosthetic implants in another hospital. The first implantation was performed using an infrapubic approach followed by placement of a three-component hydraulic penile prosthesis. After six months the prosthesis was removed using an infra-pubic approach and two soft prosthesis Virilis II were implanted during the same surgery. One year after the second operation we implanted a hydraulic penile prosthesis AMS CX with Mo - mentary Squeeze after complete isolation of the neurovascular bundle, fixing the two crural tips at the same level of albuginea of the two corpora cavernosa. Result: Twelve months after surgery the penis was completely straight without penile shortening and the patient was fully satisfied with his sexual life. Conclusion: The procedure enabled a perfect alignment of the cylinders along the longitudinal axis and penile prosthetic symmetry to obtain a good penile rigidity and a perfect penile straightening.

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Peyronie's Disease: Evolving Surgical Management and the Role of Phosphodiesterase 5 Inhibitors

The Scientific World JOURNAL ◽

10.1100/tsw.2009.101 ◽

2009 ◽

Vol 9 ◽

pp. 822-845 ◽

Cited By ~ 3

Author(s):

Tariq F. Al-Shaiji ◽

Gerald B. Brock

Keyword(s):

Tunica Albuginea ◽

Surgical Techniques ◽

Peyronie’S Disease ◽

Surgical Approaches ◽

Penile Curvature ◽

Advantages And Disadvantages ◽

Phosphodiesterase 5 Inhibitors ◽

Peyronie's Disease ◽

Phosphodiesterase 5

Peyronie's disease (PD) is a fibrotic disorder of the tunica albuginea of the penis. It is characterized by different degrees of penile curvature and sexual dysfunction. Several medical treatments have been employed to manage the disorder, with variable success rates. Surgical therapy is reserved for patients with severe penile deformity that fails to improve with medical treatment and impedes coital function. The advantages and disadvantages of various surgical approaches have long been debated. Herein, we describe the evolving surgical techniques for PD using knowledge obtained from the contemporary literature. In addition, we discuss the emerging data regarding the role of phosphodiesterase 5 inhibitors in the management of PD.

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Review of the Surgical Approaches for Peyronie's Disease: Corporeal Plication and Plaque Incision with Grafting

Advances in Urology ◽

10.1155/2008/263450 ◽

2008 ◽

Vol 2008 ◽

pp. 1-4 ◽

Cited By ~ 5

Author(s):

Viet Q. Tran ◽

Dennis H. Kim ◽

Timothy F. Lesser ◽

Sherif R. Aboseif

Keyword(s):

Patient Satisfaction ◽

Surgical Management ◽

Vein Graft ◽

Surgical Techniques ◽

Peyronie’S Disease ◽

Surgical Approaches ◽

Clinical Aspects ◽

Advantages And Disadvantages ◽

Exact Etiology ◽

Peyronie's Disease

The understanding and management of Peyronie's disease (PD) has improved but elucidating the exact etiology of the disease has yet to be achieved. In this paper, we review the historical and clinical aspects of PD. We focus on the evolution of surgical management for PD and review recent published articles that compare popular surgical techniques such as plication and plaque incision with vein graft. These two techniques have been reported to be equivalent with respect to patient satisfaction; however, each technique has its own advantages and disadvantages.

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The evolution in the surgical management of Peyronie’s disease

Urologia Journal ◽

10.1177/03915603211005326 ◽

2021 ◽

pp. 039156032110053

Author(s):

Fulvio Colombo ◽

Alessandro Franceschelli ◽

Giorgio Gentile ◽

Matteo Droghetti ◽

Alessandro Fiorillo ◽

...

Keyword(s):

Surgical Treatment ◽

Personal Experience ◽

Tunica Albuginea ◽

Peyronie’S Disease ◽

Surgical Experience ◽

Disease Etiology ◽

Patient’S Satisfaction ◽

Penile Pain ◽

Healthy Side ◽

Peyronie's Disease

Peyronie’s disease (PD) is due to a fibrotic alteration of the tunica albuginea of the penis. It is responsible of penile pain, angulation, and possible erectile dysfunction (ED). Despite almost three centuries have passed since the first description of the disease, etiology still remains uncertain. This fact has led to the lack of a truly effective medical therapy and to date the surgical treatment, although not yet standardized, is the only one that offers acceptable outcomes in terms of function and overall patient’s satisfaction. Since the beginning of the surgical experience in this field, two different currents of thought have developed: the first, involved the proposal of a number of different plication techniques, applied on the healthy side of the penis, opposite to the sick side, with the sole purpose of correcting the curvature; on the other side, efforts have focused on treating the “focus” of the disease, thus developing the so called “plaque surgery.” If with the passing of the decades neither of the two “philosophical” currents has prevailed, this probably depends on the fact that is still not clear which is the lesser of evils: the frequent onset of ED which may follows the plaque surgery or rather the penis shortening that inevitably occurs if any technique of plication has been applied. Our contribution aims to offer an historical retrospective of the surgical treatment of this disease as well as to discuss the latest international guidelines on this topic. The reader will also find some notes about our personal experience in this field.

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Peyronie’s Disease: Still a Surgical Disease

Advances in Urology ◽

10.1155/2012/206284 ◽

2012 ◽

Vol 2012 ◽

pp. 1-5 ◽

Cited By ~ 10

Author(s):

Daniel Martinez ◽

Cesar E. Ercole ◽

Tariq S. Hakky ◽

Andrew Kramer ◽

Rafael Carrion

Keyword(s):

Tunica Albuginea ◽

Surgical Techniques ◽

Clinical Manifestations ◽

Peyronie’S Disease ◽

Morbid Condition ◽

Surgical Disease ◽

Peyronie's Disease ◽

The Common ◽

Clinically Significant ◽

Morphologic Changes

Peyronie’s Disease (PD) remains a challenging and clinically significant morbid condition. Since its first description by François Gigot de la Peyronie, much of the treatment for PD remains nonstandardized. PD is characterized by the formation of fibrous plaques at the level of the tunica albuginea. Clinical manifestations include morphologic changes, such as curvatures and hourglass deformities. Here, we review the common surgical techniques for the management of patients with PD.

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