Management of Peyronie’s Disease During Placement of Penile Prosthesis

Abstract

Up to 20–30% of patients with Peyronie’s disease (PD) suffer from some degree of erectile dysfunction (ED). When medical management fails, the surgical approach towards those with PD and ED relies on the penile prosthesis. Graft material has advanced in recent years, and hemostatic patch material has emerged as a promising, easy to use, and cost-effective approach. Intracorporal techniques that obviate the need for neurovascular bundle mobilization have recently been described, and can be considered a frontier for further investigation. A thorough literature review was performed using the PubMed online database with query: “Penile Prosthesis” and “Peyronie’s disease” with “Plaque excision,” “Plaque incision,” “Tunica albuginea plication,” “Modeling,” and “Excision and grafting.” While the three-piece inflatable penile prosthesis (IPP) is commonly used, malleable implants may also achieve success where three-pieces are unavailable or not appropriate for use. When implant alone does not correct the deformity, manual modeling is a mainstay in treating residual curvature. Tunica plication, incision, and excision/graft techniques are required in patients with more severe/complicated plaques.