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Strategies for Penile Prosthesis Placement in Peyronie’s Disease and Corporal Fibrosis

  • Men’s Health (R Carrion and C Yang, Section Editors)
  • Published:
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Abstract

Peyronie’s disease (PD) is a wound healing disorder of the tunica albuginea of the penis. PD is generally categorized into two phases: the early acute inflammatory and late chronic fibrotic. Surgical reconstruction is only recommended during the latter established phase. There are a variety of options when erections are functional. However, when erectile dysfunction is present, the gold standard treatment is the placement of an inflatable penile prosthesis with or without additional straightening procedures. General recommendations include that after implanting and inflating the cylinders, if a clinically significant curvature is present, manual modeling is performed. If a residual curve >30° remains after modeling, then various techniques, including plaque releasing incision, is the next step. Grafting can be considered if tunical defects are >2.0 cm. Causes of corporal fibrosis include complications from an infected implant such as explantation, priapism, penile trauma, and prolonged use of an intracavernosal injection agent. Implant placement in the setting of corporal fibrosis can be technically challenging. Available strategies include incision or excision of the scar, corporotomies with or without grafting, the use of cavernotomes, or other specialized dilators, implant downsizing, and transcorporeal resection.

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Conflict of Interest

Dr. Faysal A Yafi, Dr. Premsant Sangkum, and Dr. Ian Ross McCaslin each declare no potential conflicts of interest.

Dr. Wayne J. G. Hellstrom reports personal fees from Coloplast; personal fees from American Medical Systems; personal fees from Antares; grants from Auxilium; personal fees from Endo; personal fees from Lilly, USA; personal fees from New England Research Institutes, Inc; personal fees from Promescent, other from NIH, and other from Theralogix.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA

    Faysal A. Yafi, Premsant Sangkum, Ian Ross McCaslin & Wayne J. G. Hellstrom

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  1. Faysal A. Yafi
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  2. Premsant Sangkum
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  3. Ian Ross McCaslin
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  4. Wayne J. G. Hellstrom
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Correspondence to Wayne J. G. Hellstrom.

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Yafi, F.A., Sangkum, P., McCaslin, I.R. et al. Strategies for Penile Prosthesis Placement in Peyronie’s Disease and Corporal Fibrosis. Curr Urol Rep 16, 21 (2015). https://doi.org/10.1007/s11934-015-0491-0

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