Modern Strategies for Treatment of Peyronie’s Disease with Penile Prosthesis

  • Matthew J. Ziegelmann
  • David Y. Yang
  • Georgios Hatzichristodoulou
  • Tobias S. KöhlerEmail author


For men with significant erectile dysfunction, treatment of Peyronie’s Disease is combined with the insertion of penile prosthesis. Several techniques exist including no other intervention beside the IPP, penile modeling, penile plication, the use of grafts and other novel techniques. This chapter focuses on patient selection and appropriate application of adjuvant penile straightening techniques with concomitant penile prosthesis insertion.


Peyronie’s Disease Penile Implant Modeling Plication Incision and Grafting Tachosil 


  1. 1.
    Al-Thakafi S, Al-Hathal N. Peyronie’s disease: a literature review on epidemiology, genetics, pathophysiology, diagnosis and work-up. Transl Androl Urol. 2016;5(3):280–9.PubMedPubMedCentralGoogle Scholar
  2. 2.
    Tal R, et al. Peyronie’s disease following radical prostatectomy: incidence and predictors. J Sex Med. 2010;7(3):1254–61.PubMedGoogle Scholar
  3. 3.
    Terrier JE, Nelson CJ. Psychological aspects of Peyronie’s disease. Transl Androl Urol. 2016;5(3):290–5.PubMedPubMedCentralGoogle Scholar
  4. 4.
    Yafi FA, et al. Multi-institutional prospective analysis of intralesional injection of collagenase clostridium histolyticum, tunical plication, and partial plaque excision and grafting for the management of Peyronie’s disease. Urology. 2018;120:138–42.PubMedGoogle Scholar
  5. 5.
    Nehra A, et al. Peyronie’s Disease: AUA Guideline. J Urol. 2015;194(3):745–53.PubMedPubMedCentralGoogle Scholar
  6. 6.
    Burri A, Porst H. The relationship between penile deformity, age, psychological bother, and erectile dysfunction in a sample of men with Peyronie’s Disease (PD). Int J Impot Res. 2018;30(4):171–8.PubMedGoogle Scholar
  7. 7.
    Mulhall JP, Schiff J, Guhring P. An analysis of the natural history of Peyronie’s disease. J Urol. 2006;175(6):2115–8; discussion 2118.PubMedGoogle Scholar
  8. 8.
    El-Sakka AI. Prevalence of Peyronie’s disease among patients with erectile dysfunction. Eur Urol. 2006;49(3):564–9.PubMedGoogle Scholar
  9. 9.
    Chung E, De Young L, Brock GB. Penile duplex ultrasonography in men with Peyronie’s disease: is it veno-occlusive dysfunction or poor cavernosal arterial inflow that contributes to erectile dysfunction? J Sex Med. 2011;8(12):3446–51.PubMedGoogle Scholar
  10. 10.
    Levine LA, Coogan CL. Penile vascular assessment using color duplex sonography in men with Peyronie’s disease. J Urol. 1996;155(4):1270–3.PubMedGoogle Scholar
  11. 11.
    Serefoglu EC, et al. The direction and severity of penile curvature does not have an impact on concomitant vasculogenic erectile dysfunction in patients with Peyronie’s disease. Int J Impot Res. 2015;27(1):6–8.PubMedGoogle Scholar
  12. 12.
    Walsh TJ, 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(3):109–12.PubMedGoogle Scholar
  13. 13.
    Papagiannopoulos D, Yura E, Levine L. Examining postoperative outcomes after employing a surgical algorithm for management of Peyronie’s disease: a single-institution retrospective review. J Sex Med. 2015;12(6):1474–80.PubMedGoogle Scholar
  14. 14.
    Taylor FL, Abern MR, Levine LA. Predicting erectile dysfunction following surgical correction of Peyronie’s disease without inflatable penile prosthesis placement: vascular assessment and preoperative risk factors. J Sex Med. 2012;9(1):296–301.PubMedGoogle Scholar
  15. 15.
    Flores S, et al. Erectile dysfunction after plaque incision and grafting: short-term assessment of incidence and predictors. J Sex Med. 2011;8(7):2031–7.PubMedGoogle Scholar
  16. 16.
    Hellstrom WJ, et al. Bother and distress associated with Peyronie’s disease: validation of the Peyronie’s disease questionnaire. J Urol. 2013;190(2):627–34.PubMedGoogle Scholar
  17. 17.
    Cwikla DJ, Yafi FA. Intralesional collagenase Clostridium histolyticum in the management of Peyronie’s disease: current best practice. Ther Adv Urol. 2018;10(4):139–53.PubMedPubMedCentralGoogle Scholar
  18. 18.
    Mulhall J, Anderson M, Parker M. A surgical algorithm for men with combined Peyronie’s disease and erectile dysfunction: functional and satisfaction outcomes. J Sex Med. 2005;2(1):132–8.PubMedGoogle Scholar
  19. 19.
    Tausch TJ, et al. Intraoperative decision-making for precise penile straightening during inflatable penile prosthesis surgery. Urology. 2015;86(5):1048–52.PubMedGoogle Scholar
  20. 20.
    Chung E, et al. Comparison between AMS 700 CX and Coloplast Titan inflatable penile prosthesis for Peyronie’s disease treatment and remodeling: clinical outcomes and patient satisfaction. J Sex Med. 2013;10(11):2855–60.PubMedGoogle Scholar
  21. 21.
    Montague DK, et al. AMS 3-piece inflatable penile prosthesis implantation in men with Peyronie’s disease: comparison of CX and Ultrex cylinders. J Urol. 1996;156(5):1633–5.PubMedGoogle Scholar
  22. 22.
    Habous M, et al. Malleable penile implant is an effective therapeutic option in men with Peyronie’s disease and erectile dysfunction. Sex Med. 2018;6(1):24–9.PubMedPubMedCentralGoogle Scholar
  23. 23.
    Levine LA, Benson J, Hoover C. Inflatable penile prosthesis placement in men with Peyronie’s disease and drug-resistant erectile dysfunction: a single-center study. J Sex Med. 2010;7(11):3775–83.PubMedGoogle Scholar
  24. 24.
    Garaffa G, et al. The management of residual curvature after penile prosthesis implantation in men with Peyronie’s disease. BJU Int. 2011;108(7):1152–6.PubMedGoogle Scholar
  25. 25.
    Chaudhary M, et al. Peyronie’s disease with erectile dysfunction: penile modeling over inflatable penile prostheses. Urology. 2005;65(4):760–4.PubMedGoogle Scholar
  26. 26.
    Mulhall J, Ahmed A, Anderson M. Penile prosthetic surgery for Peyronie’s disease: defining the need for intraoperative adjuvant maneuvers. J Sex Med. 2004;1(3):318–21.PubMedGoogle Scholar
  27. 27.
    Wilson SK, Delk JR 2nd. A new treatment for Peyronie’s disease: modeling the penis over an inflatable penile prosthesis. J Urol. 1994;152(4):1121–3.PubMedGoogle Scholar
  28. 28.
    Perito P, Wilson S. The Peyronie’s plaque “scratch”: an adjunct to modeling. J Sex Med. 2013;10(5):1194–7.PubMedGoogle Scholar
  29. 29.
    Levine LA, Larsen SM. Surgery for Peyronie’s disease. Asian J Androl. 2013;15(1):27–34.PubMedGoogle Scholar
  30. 30.
    Henry GD, Laborde E. A review of surgical techniques for impending distal erosion and intraoperative penile implant complications: part 2 of a three-part review series on penile prosthetic surgery. J Sex Med. 2012;9(3):927–36.PubMedGoogle Scholar
  31. 31.
    Wilson S. The top 5 surgical things that i wish i had known earlier in my career: lessons learned from a career of prosthetic urology. J Sex Med. 2018;15(6):809–12.PubMedGoogle Scholar
  32. 32.
    Shindel AW, Bullock TL, Brandes S. Urologist practice patterns in the management of Peyronie’s disease: a nationwide survey. J Sex Med. 2008;5(4):954–64.PubMedGoogle Scholar
  33. 33.
    Mulcahy JJ, Wilson SK. Management of Peyronie’s disease with penile prostheses. Int J Impot Res. 2002;14(5):384–8.PubMedGoogle Scholar
  34. 34.
    Wilson SK, Cleves MA, Delk JR 2nd. Long-term followup of treatment for Peyronie’s disease: modeling the penis over an inflatable penile prosthesis. J Urol. 2001;165(3):825–9.PubMedGoogle Scholar
  35. 35.
    Chung E, et al. A worldwide survey on Peyronie’s disease surgical practice patterns among surgeons. J Sex Med. 2018;15(4):568–75.PubMedGoogle Scholar
  36. 36.
    Rahman NU, et al. Combined penile plication surgery and insertion of penile prosthesis for severe penile curvature and erectile dysfunction. J Urol. 2004;171(6 Pt 1):2346–9.PubMedGoogle Scholar
  37. 37.
    Chung PH, 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(6):1593–8.PubMedGoogle Scholar
  38. 38.
    Gholami SS, Lue TF. Correction of penile curvature using the 16-dot plication technique: a review of 132 patients. J Urol. 2002;167(5):2066–9.PubMedGoogle Scholar
  39. 39.
    Kim DH, Lesser TF, Aboseif SR. Subjective patient-reported experiences after surgery for Peyronie’s disease: corporeal plication versus plaque incision with vein graft. Urology. 2008;71(4):698–702.PubMedGoogle Scholar
  40. 40.
    Anaissie J, Yafi FA. A review of surgical strategies for penile prosthesis implantation in patients with Peyronie’s disease. Transl Androl Urol. 2016;5(3):342–50.PubMedPubMedCentralGoogle Scholar
  41. 41.
    Garcia-Gomez B, et al. Grafts for Peyronie’s disease: a comprehensive review. Andrology. 2018;6(1):117–26.PubMedGoogle Scholar
  42. 42.
    Kadioglu A, et al. Graft materials in Peyronie’s disease surgery: a comprehensive review. J Sex Med. 2007;4(3):581–95.PubMedGoogle Scholar
  43. 43.
    Hatzichristodoulou G. The PICS technique: a novel approach for residual curvature correction during penile prosthesis implantation in patients with severe Peyronie’s disease using the collagen fleece TachoSil. J Sex Med. 2018;15(3):416–21.PubMedGoogle Scholar
  44. 44.
    Hatzichristodoulou G, et al. Peyronie’s graft surgery-tips and tricks from the masters in andrologic surgery. Transl Androl Urol. 2017;6(4):645–56.PubMedPubMedCentralGoogle Scholar
  45. 45.
    Antonini G, et al. Inflatable penile prosthesis placement, scratch technique and postoperative vacuum therapy as a combined approach to definitive treatment of Peyronie’s disease. J Urol. 2018;200(3):642–7.PubMedGoogle Scholar
  46. 46.
    Antonini G, et al. Distal corporal anchoring stitch: a technique to address distal corporal crossovers and impending lateral extrusions of a penile prosthesis. J Sex Med. 2017;14(6):767–73.PubMedGoogle Scholar
  47. 47.
    Montorsi F, et al. Reconfiguration of the severely fibrotic penis with a penile implant. J Urol. 2001;166(5):1782–6.PubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Matthew J. Ziegelmann
    • 1
  • David Y. Yang
    • 1
  • Georgios Hatzichristodoulou
    • 2
  • Tobias S. Köhler
    • 1
    Email author
  1. 1.Mayo Clinic Department of UrologyRochesterUSA
  2. 2.Department of Urology and Pediatric UrologyJulius-Maximilians-University of WürzburgWürzburgGermany

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