Surgical treatments for Peyronie's disease and erectile dysfunction are generally straightforward and associated with excellent outcomes. However, severe (>60°) and multidirectional curvature, hourglass deformity, severe penile shortening, and ossified plaque may complicate surgery in patients with Peyronie's disease. Similarly, a history of priapism, prior implant infection, and penile injury can pose challenges to successful implant surgery secondary to severe corporal fibrosis. Thus, when these pathophysiological processes cause severe fibrosis and loss of function of the tunica albuginea and deep cavernosal spaces, adjunctive reconstructive techniques are necessary. Herein, we integrate the literature regarding surgical management of complex Peyronie's disease and erectile dysfunction with emphasis on plication, grafting, and implants to achieve satisfactory outcomes across the full range of etiology and degree of surgical complexity.
The Urologic clinics of North America. 2022 Jun 30 [Epub]
Ziho Lee, Jolie Shen, Hunter Wessells
Department of Urology, Northwestern University, Northwestern University Feinberg School of Medicine, 675 North Saint Clair Street, Galter Pavilion, Suite 20-150, Chicago, IL 60611, USA. Electronic address: ., Department of Urology, University of Washington School of Medicine, 1959 Northeast Pacific Street, Seattle, WA 98195, USA.