Peyronie Disease with Erectile Dysfunction or Penile Deformity Preventing Coitus Despite Pharmacotherapy or Vacuum Device Therapy

This protocol addresses patients with stable Peyronie's disease — symptoms clinically unchanged for at least three months — in whom erectile dysfunction (ED) and/or penile deformity remains sufficient to prevent coitus even after pharmacotherapy and/or vacuum device therapy.

Clinical scenario: Symptoms have been clinically quiescent or unchanged for at least three months, confirmed by patient report or clinician documentation. Despite pharmacotherapy and/or vacuum device therapy, erectile dysfunction and/or penile deformity persists at a severity sufficient to prevent coitus.

Treatment approach

For this presentation, a surgical approach involving penile prosthesis implantation — with potential for additional intra-operative steps when residual deformity is encountered — represents the recognised management pathway. The full protocol detailing indications, procedure selection, and decision criteria is available via the link below.

Treatment goals: Correction of penile curvature and restoration of satisfactory erectile function sufficient for coitus.

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References

In the patient with stable disease, symptoms have been clinically quiescent or unchanged for at least three months based on either patient report or clinician documentation.

Clinicians may offer penile prosthesis surgery to patients with Peyronie's disease with erectile dysfunction (ED) and/or penile deformity sufficient to prevent coitus despite pharmacotherapy and/or vacuum device therapy.

Clinicians should use inflatable penile prosthesis for patients undergoing penile prosthetic surgery for the treatment of Peyronie's disease.

Clinicians may perform adjunctive intra-operative procedures, such as modeling, plication or incision/grafting, when significant penile deformity persists after insertion of the penile prosthesis.

The Panel interpreted these data to indicate that for the majority of patients penile prosthesis implant results in curvature correction and restoration of satisfactory sexual function in the context of surgical adverse event rates that are relatively low in most studies.

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