Surgical decisions in Peyronie's disease

In this review, we examine recent advances assisting surgical decision in Peyronie's disease. Surgical treatment is indicated in penile deformities that have persisted for at least 6 months and functionally impair or preclude intercourse. Procedures shortening the longer side of the penis are invariably associated with length reduction, which may displease patients, despite penile straightening. Procedures lengthening the shorter side by means of grafting provide the best possible gain from a reconstruction procedure, although they may not restore the penis to its original length. Penile rectification and rigidity are required to achieve complete functional restoration of the penis. Most patients experience associated erectile dysfunction, and penile straightening alone may not be enough to restore complete function. Therefore, in some cases, phosphodiesterase inhibitors, self-injection, or a penile prosthesis may need to be added. Issues concerning surgical indication, patient selection, surgical techniques, and grafting are discussed. Copyright © 2006 by Current Science Inc.