Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Research
  • Published:

Surgical treatment of Peyronie's disease based on penile length and degree of curvature

Abstract

The aim of the study was to present the selection criteria for surgical techniques for the treatment of patients with Peyronie's disease. A total of 55 men with Peyronie's disease were surgically treated. We created specific criteria for selection of the appropriate surgical technique. All patients had a stable disease for 6 months and impossible vaginal intromission. All patients had subjective (as reported by the patient) and/or objective normal penile rigidity (as observed after intracavernous administration of alprostadil). Also, they all underwent drug therapy, which was unsuccessful. Among them, 40 patients with penile curvature of <60° and erect penile length of >13 cm underwent Nesbit's operation, whereas plaque excision and grafting with polytetrafluoroethylene patch was performed in 15 patients with penile curvature of ≥60° and/or erect penile length of ≤13 cm. At a mean (±s.d.) follow-up of 81.1±33.8 and 78.7±32.8 months, respectively, straightening of the penis was achieved in 35 out of 40 (87.5%) and 12 out of 15 (80%) patients, respectively, whereas erectile dysfunction developed in two out of 40 (5%) and one out of 15 (6%), respectively. Shortening of the penis occurred in all 40 patients undergoing Nesbit's operation, and in none of the patients undergoing plaque excision. Six out of 40 (15%) patients undergoing Nesbit's operation reported subjective perception of penis shortening, whereas none of the patients undergoing plaque excision complained of this discomfort. In conclusion, we recommend the selection of surgical technique based on penile length and degree of curvature. Nesbit's operation is an appropriate surgical technique for the treatment of patients with erect penile length of >13 and deviation of <60°, whereas the plaque excision and grafting with polytetraflouroethylene patch is a technique of choice in the treatment of patients with erect penile length of ≤13 and/or deviation of ≥60°.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Pryor JP, Fitzpatrick JM . A new approach to the correction of the penile deformity in Peyronie's disease. J Urol 1979; 122: 622–623.

    Article  CAS  Google Scholar 

  2. Benson Jr RC, Patterson DE . The Nesbit procedure for Peyronie's disease. J Urol 1983; 130: 692–694.

    Article  Google Scholar 

  3. Bailey MJ, Yande S, Walmsley B, Pryor JP . Surgery for Peyronie's disease. Br J Urol 1985; 57: 746–749.

    Article  CAS  Google Scholar 

  4. Licht MR, Lewis RW . Modified Nesbit procedure for the treatment of Peyronie's disease: a comparative outcome analysis. J Urol 1997; 158: 460–463.

    Article  CAS  Google Scholar 

  5. Devine CJ, Horton CE . Surgical treatment of Peyronie's disease with a dermal graft. J Urol 1974; 111: 44–49.

    Article  Google Scholar 

  6. Lue TF, El-Sakka AI . Venous patch graft for Peyronie's disease. Part I: technique. J Urol 1998; 160: 2047–2049.

    Article  CAS  Google Scholar 

  7. Gholami SS et al. Peyronie's disease: a review. J Urol 2003; 169: 1234–1241.

    Article  Google Scholar 

  8. Schonfeld WA, Beebe GW . Normal growth and variation in the male genitalia from birth to maturity. J Urol 1942; 48: 759–777.

    Article  Google Scholar 

  9. Lee PA et al. Micropenis. I. Criteria, etiologies and classification. John Hopkins Med J 1980; 146: 156–163.

    CAS  Google Scholar 

  10. Wessells H, Lue TF, McAninch JW . Penile length in the flaccid and erect states: guidelines for penile augmentation. J Urol 1996; 156: 995–997.

    Article  CAS  Google Scholar 

  11. Kelami A . Classification of congenital and acquired penile deviation. Urol Int 1983; 38: 229–233.

    Article  CAS  Google Scholar 

  12. Ralph DJ, Al-Akraa M, Pryor JP . The Nesbit operation for Peyronie's disease: 16-year experience. J Urol 1995; 154: 1362–1363.

    Article  CAS  Google Scholar 

  13. Andrews HO, Al-Akraa M, Pryor JP, Ralph DJ . The Nesbit operation for Peyronie's disease: an analysis of the failures. BJU Int 2001; 87: 658–660.

    Article  CAS  Google Scholar 

  14. Ganabathi K, Dmochowski R, Zimmern PE, Leach GE . Peyronie's disease: surgical treatment based on penile rigidity. J Urol 1995; 153: 662–666.

    Article  CAS  Google Scholar 

  15. Montorsi F et al. Evidence based assessment of long-term results of plaque incision and vein grafting for Peyronie's disease. J Urol 2000; 163: 1704–1708.

    Article  CAS  Google Scholar 

  16. Usta MF et al. Patient and partner satisfaction and long-term results after surgical treatment for Peyronie's disease. Urology 2003; 62: 105–109.

    Article  Google Scholar 

  17. Hellstrom WJG, Usta MF . Surgical approaches for advanced Peyronie's disease patients. Int J Impot Res 2003; 15(Suppl 5): S121–S124.

    Article  Google Scholar 

  18. Levine LA, Lenting LE . A surgical algorithm for the treatment of Peyronie's disease. J Urol 1997; 158: 2149–2152.

    Article  CAS  Google Scholar 

  19. Dalkin BL, Carter MF . Venogenic impotence following dermal graft repair for Peyronie's disease. J Urol 1991; 146: 849–851.

    Article  CAS  Google Scholar 

  20. Sampaio JS et al. Surgical correction of severe Peyronie's disease without plaque excision. Eur Urol 1992; 22: 130–133.

    Article  CAS  Google Scholar 

  21. Yurkanin JP, Dean R, Wessells H . Effect of incision and saphenous vein grafting for Peyronie's disease on penile length and sexual satisfaction. J Urol 2001; 166: 1769–1773.

    Article  CAS  Google Scholar 

  22. Levine LA, Estrada CR . Human cadaveric pericardial graft for the surgical correction of Peyronie's disease. J Urol 2003; 170: 2359–2362.

    Article  Google Scholar 

  23. Montorsi F et al. Five year follow-up of plaque incision and vein grafting for Peyronie's disease. Eur Urol 2004; 3(Suppl 2): 33, abstract123.

  24. Backhaus BO, Müller SC, Albers P . Corporoplasty for advanced Peyronie's disease using venous and/or dermis patch grafting: new surgical technique and long-term patient satisfaction. J Urol 2003; 169: 981–984.

    Article  Google Scholar 

  25. Leungwattanakij S, Bivalacqua TJ, Reddy S, Hellstrom WJ . Long-term follow-up on use of pericardial graft in the surgical management of Peyronie's disease. Int J Impot Res 2001; 13: 183–186.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to P Bokarica.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bokarica, P., Parazajder, J., Mazuran, B. et al. Surgical treatment of Peyronie's disease based on penile length and degree of curvature. Int J Impot Res 17, 170–174 (2005). https://doi.org/10.1038/sj.ijir.3901255

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijir.3901255

Keywords

This article is cited by

Search

Quick links