Current Sexual Health Reports

, Volume 8, Issue 3, pp 186–192 | Cite as

Advances in the Surgical Treatment of Peyronie’s Disease

  • Georgios HatzichristodoulouEmail author
Male Sexual Dysfunction and Disorders (AW Pastuszak and TS Köhler, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Male Sexual Dysfunction and Disorders


Surgical treatment is the gold standard for correction of penile deviation in patients with Peyronie’s disease. Generally, plication techniques are applied when deviation is less than 60°, the patient has decreased erectile function, and penile length is satisfactory. Grafting techniques are indicated when deviation exceeds 60°, there is a short penis or an hourglass deformity, and the patient has good erectile capacity. In patients with erectile dysfunction refractory to medical treatment, penile prosthesis implantation with simultaneous correction of deviation is the optimal approach. This article summarizes some of the novel advances for each of these procedures, which have been reported in recent years. Surgical technique and outcomes of these techniques are described, and limitations set. Adequate preoperative counseling, including all options available today, is crucial before planning surgical treatment in Peyronie’s disease. Surgeon experience and careful patient selection for each procedure will remain the most determining factors for success.


Grafting techniques Penile prosthesis implantation Peyronie’s disease Plication Surgical therapy 


Compliance with Ethical Standards

Conflict of Interest

The author declares that he has no conflict of interest.

Human and Animal Rights and Informed Consent

All reported studies/experiments with human or animal subjects performed by the author have been previously published and complied with all applicable ethical standards (including the Helsinki declaration and its amendments, institutional/ national research committee standards, and international/national/institutional guidelines).


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Hatzichristodoulou G, Lahme S. Peyronie’s disease. In: Merseburger AS, Kuczyk MM, Moul JW, editors. Urology at a Glance. Berlin-Heidelberg: Springer Publishing; 2014. p. 225–36.Google Scholar
  2. 2.
    Kadioglu A, Kücükdurmaz F, Sanli O. Current status of the surgical management of Peyronie’s disease. Nat Rev Urol. 2011;8:95–106.CrossRefPubMedGoogle Scholar
  3. 3.
    Larsen S, Levine LA. Review of non-surgical treatment options for Peyronie’s disease. Int J Impot Res. 2012;24:1–10.CrossRefPubMedGoogle Scholar
  4. 4.
    Ralph D, Gonzalez-Cadavid N, Mirone V, et al. The management of Peyronie’s disease: evidence-based 2010 guidelines. J Sex Med. 2010;7:2359–74.CrossRefPubMedGoogle Scholar
  5. 5.
    Smith J, Walsh TJ, Lue TF. Peyronie’s disease: a critical appraisal of current diagnosis and treatment. Int J Impot Res. 2008;20:445–59.CrossRefPubMedGoogle Scholar
  6. 6.
    Nelson C, Mulhall JP. Psychological impact of Peyronie’s disease: a review. J Sex Med. 2013;10:653–60.CrossRefPubMedGoogle Scholar
  7. 7.
    Levine L, Burnett AL. Standard operating procedures for Peyronie’s disease. J Sex Med. 2013;10:230–44.CrossRefPubMedGoogle Scholar
  8. 8.
    Mulhall J, Schiff J, Guhring P. An analysis of the natural history of Peyronie’s disease. J Urol. 2006;175:2115–8.CrossRefPubMedGoogle Scholar
  9. 9.
    Hatzichristodoulou G. Conservative therapy of Peyronie’ s disease: update 2015. Urologe A. 2015;54:641–7.CrossRefPubMedGoogle Scholar
  10. 10.
    Nehra A, Alterowitz R, Culkin DJ, et al. Peyronie’s disease: AUA Guideline. J Urol. 2015;194:745–53.CrossRefPubMedGoogle Scholar
  11. 11.•
    Hatzichristodoulou G, Gschwend JE, Lahme S. Surgical therapy of Peyronie’s disease by partial plaque excision and grafting with collagen fleece: feasibility study of a new technique. Int J Impot Res. 2013;25:183–7. This study reports initial results of a novel technique by partial plaque excision and grafting of the tunical defect with a self-adhesive collagen fleece.CrossRefPubMedGoogle Scholar
  12. 12.••
    Walsh T, Hotaling JM, Lue TF, et al. How curved is too curved? The severity of penile deformity may predict sexual disability among men with Peyronie’s disease. Int J Impot Res. 2013;25:109–12. This study emphasizes that penile curvature > 60° is the main determing factor for performing sexual intercourse, rather than the type of deformity.CrossRefPubMedGoogle Scholar
  13. 13.
    Staerman F, Pierrevelcin J, Ripert T, et al. Medium-term follow-up of plaque incision and porcine small intestinal submucosal grafting for Peyronie’s disease. Int J Impot Res. 2010;22:343–8.CrossRefPubMedGoogle Scholar
  14. 14.
    Kueronya V, Miernik A, Stupar S, et al. International multicentre psychometric evaluation of patient-reported outcome data for the treatment of Peyronie’s disease. BJU Int. 2015;115:822–8.CrossRefPubMedGoogle Scholar
  15. 15.
    Sansalone S, Garaffa G, Djinovic R, et al. Long-term results of the surgical treatment of Peyronie’s disease with Egydio’s technique: a European multicentre study. Asian J Androl. 2011;13:842–5.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Taylor F, Levine LA. Surgical correction of Peyronie’s disease via tunica albuginea plication or partial plaque excision with pericardial graft: long-term follow up. J Sex Med. 2008;5:2221–8.CrossRefPubMedGoogle Scholar
  17. 17.
    Chung E, Clendinning E, Lessard L, et al. Five-year follow-up of Peyronie’s graft surgery: outcomes and patient satisfaction. J Sex Med. 2011;8:594–600.CrossRefPubMedGoogle Scholar
  18. 18.
    Nesbit R. Congenital curvature of the phallus: report of three cases with description of corrective operation. J Urol. 1965;93:230–2.PubMedGoogle Scholar
  19. 19.
    Gur S, Limin M, Hellstrom WJG. Current status and new developments in Peyronie’s disease: medical, minimally invasive and surgical treatment options. Expert Opin Pharmacother. 2011;12:931–44.CrossRefPubMedGoogle Scholar
  20. 20.•
    Chung P, Tausch TJ, Simhan J, et al. Dorsal plication without degloving is safe and effective for correcting ventral penile deformities. Urology. 2014;84:1228–33. This study shows that dorsal plication without degloving is safe and leads to satifying results in patients with ventral deviation.CrossRefPubMedGoogle Scholar
  21. 21.•
    Cantoro U, Polito M, Catanzariti F, et al. Penile plication for Peyronie’s disease: our results with mean follow-up of 103 months on 89 patients. Int J Impot Res. 2014;26:156–9. This study shows that plication techniques lead to reliable results for correction of deviation, even in the long-term.CrossRefPubMedGoogle Scholar
  22. 22.
    Yafi F, Hatzichristodoulou G, Knoedler CJ, et al. Comparative analysis of tunical plication vs. intralesional injection therapy for ventral Peyronie’s disease. J Sex Med. 2015;12:2492–8.CrossRefPubMedGoogle Scholar
  23. 23.
    Cormio L, Zucchi A, Lorusso F, et al. Surgical treatment of Peyronie’s disease by plaque incision and grafting with buccal mucosa. Eur Urol. 2009;55:1469–76.CrossRefPubMedGoogle Scholar
  24. 24.
    Hsu GL, Chen HS, Hsieh CH, et al. Long-term results of autologous venous grafts for penile morphological reconstruction. J Androl. 2007;28:186–93.CrossRefPubMedGoogle Scholar
  25. 25.
    Imbeault A, Bernard G, Ouellet G, et al. Surgical option for the correction of Peyronie’s disease: an autologous tissue-engineered endothelialized graft. J Sex Med. 2011;8:3227–35.CrossRefPubMedGoogle Scholar
  26. 26.
    Kalsi J, Christopher N, Ralph DJ, et al. Plaque incision and fascia lata grafting in the surgical management of Peyronie’s disease. BJU Int. 2006;98:110–5.CrossRefPubMedGoogle Scholar
  27. 27.
    Kim D, Lesser TF, Aboseif SR. Subjective patient-reported experiences after surgery for Peyronie’s disease: corporal plication versus plaque incision with vein graft. Urology. 2008;71:698–702.CrossRefPubMedGoogle Scholar
  28. 28.
    Knoll L. Use of porcine small intestinal submucosa graft in the surgical management of Peyronie’s disease. Urology. 2001;57:753–7.CrossRefPubMedGoogle Scholar
  29. 29.
    Knoll L. Use of small intestinal submucosa graft for the surgical management of Peyronie’s disease. J Urol. 2007;178:2474–8.CrossRefPubMedGoogle Scholar
  30. 30.
    Levine L, Estrada CR, Storm DW, et al. Peyronie disease in younger men: characteristics and treatment results. J Androl. 2003;24:27–32.PubMedGoogle Scholar
  31. 31.
    Otero J, Gómez BG, Polo JM, et al. Use of a lyophilized bovine pericardium graft to repair tunical defect in patients with Peyronie’s disease: experience in a clinical setting. Asian J Androl. 2016. doi: 10.4103/1008-682X.171572.Google Scholar
  32. 32.
    Salehipour M, Izadpanah K, Safaei A, et al. Application of human amniotic membrane in canine penile tunica albuginea defect: first step toward an innovating new method for treatment of Peyronie’s disease. Int Braz J Urol. 2014;40:400–7.CrossRefPubMedGoogle Scholar
  33. 33.
    Salem E, Elkady EH, Sakr A, et al. Lingual mucosal graft in treatment of Peyronie disease. Urology. 2014;84:1374–7.CrossRefPubMedGoogle Scholar
  34. 34.
    Segal R, Burnett AL. Surgical management for Peyronie’s disease. World J Mens Health. 2013;31:1–11.CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.•
    Wimpissinger F, Parnham A, Gutjahr G, et al. 10 years’ plaque incision and vein grafting for Peyronie’s disease: does time matter? J Sex Med. 2016;13:120–8. This study shows that reliable and durable long-term results can be achieved with grafting techniques.CrossRefPubMedGoogle Scholar
  36. 36.
    Zucchi A, Silvani M, Pastore AL, et al. Corporoplasty using buccal mucosa graft in Peyronie disease: is it a first choice? Urology. 2015;85:679–83.CrossRefPubMedGoogle Scholar
  37. 37.••
    Hatzichristodoulou G. Partial plaque excision and grafting with collagen fleece in Peyronie disease. J Sex Med. 2016;13:277–81. This article gives a detailed description of the grafting technique with the self-adhesive collagen fleece.CrossRefPubMedGoogle Scholar
  38. 38.
    Fabiani A, Fioretti F, Filosa A, et al. Patch bulging after plaque incision and grafting procedure for Peyronie’s disease. Surgical repair with a collagen fleece. Arch Ital Urol Androl. 2015;87:173–4.CrossRefPubMedGoogle Scholar
  39. 39.
    Kozacioglu Z, Degirmenci T, Gunlusoy B, et al. Effect of tunical defect size after Peyronie’s plaque excision on postoperative erectile function: do centimeters matter? Urology. 2012;80:1051–5.CrossRefPubMedGoogle Scholar
  40. 40.
    Simonato A, Gregori A, Varca V, et al. Penile dermal flap in patients with Peyronie’s disease: long-term results. J Urol. 2010;183:1065–8.CrossRefPubMedGoogle Scholar
  41. 41.
    Wilson S, Delk II JR. A new treatment for Peyronie’s disease: modeling the penis over an inflatable penile prosthesis. J Urol. 1994;152:1121–3.PubMedGoogle Scholar
  42. 42.
    Wilson S, Cleves MA, Delk II JR. Long-term follow-up of treatment for Peyronie’s disease: modeling the penis over an inflatable penile prosthesis. J Urol. 2001;165:825–9.CrossRefPubMedGoogle Scholar
  43. 43.
    Berookhim B, Karpman E, Carrion R. Adjuvant maneuvers for residual curvature correction during penile prosthesis implantation in men with Peyronie’s disease. J Sex Med. 2015;12 Suppl 7:449–54.CrossRefPubMedGoogle Scholar
  44. 44.
    Segal R, Cabrini MR, Bivalacqua TJ, et al. Penile straightening maneuvers employed during penile prosthesis surgery: technical options and outcomes. Int J Impot Res. 2014;26:182–5.CrossRefPubMedGoogle Scholar
  45. 45.
    Chung P, Scott JF, Morey AF. High patient satisfaction of inflatable penile prosthesis insertion with synchronous penile plication for erectile dysfunction and Peyronie’s disease. J Sex Med. 2014;11:1593–8.CrossRefPubMedGoogle Scholar
  46. 46.•
    Djordjevic M, Kojovic V. Penile prosthesis implantation and tunica albuginea incision without grafting in the treatment of Peyronie’s disease with erectile dysfunction. Asian J Androl. 2013;15:391–4. This study reports results after plaque incision without grafting, to correct penile deviation during penile prosthesis implantation.CrossRefPubMedPubMedCentralGoogle Scholar
  47. 47.
    Egydio P, Kuehhas FE, Valenzuela RJ. Modified sliding technique (MoST) for penile lengthening with insertion of inflatable penile prosthesis. J Sex Med. 2015;12:1100–4.CrossRefPubMedGoogle Scholar
  48. 48.
    Perito P, Wilson SK. The Peyronie’s plaque “scratch”: an adjunct to modeling. J Sex Med. 2013;10:1194–7.CrossRefPubMedGoogle Scholar
  49. 49.•
    Rolle L, Falcone M, Ceruti C, et al. A prospective multicentric international study on the surgical outcomes and patients’ satisfaction rates of the ‘sliding’ technique for end-stage Peyronie’s disease with severe shortening of the penis and erectile dysfunction. BJU Int. 2015. doi: 10.1111/bju.13371. This study reports results of the sliding technique to correct penile deviation and increase penile length, during penile prosthesis implantation.PubMedGoogle Scholar
  50. 50.
    Weinberg A, Pagano MJ, Diebert CM, et al. Sub-coronal inflatable penile prosthesis placement with modified no-touch technique: a step-by-step approach with outcomes. J Sex Med. 2016;13:270–6.CrossRefPubMedGoogle Scholar
  51. 51.
    Zucchi A, Silvani M, Pecoraro S. Corporoplasty with small soft axial prostheses (VIRILIS I®) and bovine pericardial graft (HYDRIX®) in Peyronie’s disease. Asian J Androl. 2013;15:275–9.CrossRefPubMedPubMedCentralGoogle Scholar
  52. 52.
    Egydio P, Kuehhas FE. Penile lengthening and widening without grafting according to a modified ‘sliding’ technique. BJU Int. 2015;116:965–72.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2016

Authors and Affiliations

  1. 1.Department of UrologyTechnical University of Munich, University Hospital Klinikum rechts der IsarMunichGermany

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