Plaque incision and grafting represents the best surgical approach to the Peyronie’s disease patient: Con

Abstract

Surgical treatment options for Peyronie’s disease include tunica shortening (Nesbit and plication) and grafting procedures. Tunica shortening procedures are associated with penile shortening. However, the amount of penile shortening is rarely significant for the patient. Although grafting procedures aim to prevent penile shortening, this may still be an issue due to the pathologic extent of Peyronie’s disease. Long-term postoperative erectile dysfunction is the major drawback. Many types of grafting material have been used, but only saphenous vein has gained certain acceptance. Grafting procedures must be restricted to patients with normal preoperative erectile status and excessive curvature. Nesbit or plication procedures may be associated with significant penile shortening. Grafting procedures are also indicated in cases of hourglass deformities, because they cannot be corrected by the Nesbit procedure. Nesbit wedge resection is still the gold standard for treating Peyronie’s disease.