In patients with stable Peyronie's disease who retain normal erectile function, severe penile curvature, inadequate penile length, or a complex structural deformity — such as an hourglass or hinge configuration — can make penetrative intercourse impossible or severely compromised. When the disease has stabilised and function is impaired by the deformity, a surgical approach is indicated.
Stable Peyronie's disease with normal erectile function and one or more of the following: inadequate penile length, penile curvature exceeding 60 degrees, hourglass penile deformity, or hinge penile deformity — with sexual intercourse compromised by the deformity. Surgery is considered only once the disease has reached a stable phase.
Functional penile straightening sufficient to restore the ability for penetrative intercourse.
Use tunical lengthening procedures for patients with PD and normal EF, without adequate penile length, severe curvature or presence of complex deformities.
Tunical lengthening surgery is preferable in patients with significant penile shortening, severe curvature and/or complex deformities (hourglass or hinge) but without underlying ED.
Perform surgery only when Peyronie's disease (PD) is stable and sexual intercourse is compromised due to the deformity.
On the concave side of the penis, at the point of maximum curvature, which usually coincides with the location of the plaque, an incision is made, creating a defect in the albuginea that is covered with a graft.
The type of graft used is dependent on the surgeon and patient preference, as no graft has proven superior to its counterparts.
The aim of surgery is to correct curvature and allow penetrative intercourse.
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.