Peyronie disease
ICD-10 N48.6 · ICD-11 GB06.2

Peyronie Disease with Penile Curvature Up to 60 Degrees: Surgical Management in Stable Disease

This protocol covers the management of stable Peyronie's disease in men who have adequate penile length and rigidity, penile curvature up to 60 degrees, no complex deformity, and sexual intercourse compromised by the deformity.

Clinical Scenario
Management Approach

Surgery is performed once disease is confirmed stable and intercourse is compromised. The surgical approach in this setting involves a tunical shortening procedure — a class of techniques applied to the tunica albuginea. Technique selection and procedural details are defined in the complete protocol.

Treatment goals: Functional penile straightening and restoration of the ability for penetrative intercourse.

Instant Access to Structured Evidence-Based Regimens

References

  1. Perform surgery only when Peyronie's disease (PD) is stable and sexual intercourse is compromised due to the deformity.
  2. Use tunical shortening procedures as the first treatment option for PD patients with adequate penile length and rigidity, less-severe curvatures, and absence of complex deformities (hourglass or hinge).
  3. For men with good EF, adequate penile length, without complex deformities, such as an hourglass or hinge type narrowing abnormalities, and non-severe curvature, a tunical shortening procedure can be considered an appropriate surgical approach.
  4. The type of procedure used is dependent on surgeon and patient preference, as no procedure has proven superior to its counterparts.
  5. Numerous techniques have been described, although they can be classified as excisional, incisional and plication techniques.
  6. The Nesbit procedure operation is based on an elliptical excision of tunica albuginea opposite to the point of maximum curvature.
  7. The aim of surgery is to correct curvature and allow penetrative intercourse.
  8. The main objective of surgery is to achieve a 'functionally straight' penis, and this must be fully understood by the patient to achieve the best possible satisfaction outcomes after surgery.
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