Treatment of Peyronie's disease in 2009

Clinical examination suffices to establish a diagnosis. Additional assessment is not necessary, face and profile photography being sufficient to decide on the best treatment strategy. Medical treatments are available but show little efficacy, except for pain. Surgical treatment for penile curvature and erectile dysfunction are proposed if curvature has been stable for at least 6 month. Erection quality, size of the penis, severity of the curvature and capacity for sexual intercourse are important parameters to decide on the best treatment strategy. Corrective techniques include the Nesbit and Yachia as the gold standard. When an important curvature is found, plaque incision with graft is proposed and upon erectile dysfunction unresponsive to medical treatment, penile prosthesis with modeling or incision with graft is proposed. We also describe Leriche's technique and extra-corporeal shockwaye as promising techniques.