I t is a condition that has series of symptoms that includes penile pain, penile length loss, curvature, fibrous plaque and eventually sexual dysfunction. The various treatment options depend on the duration of symptoms, extent of penile curvature, hour-glass deformity, size of penile plaque and erectile dysfunction. Penile curvature may reoccur again owing to abnormalities in the underlying penile tissue. However, it can be corrected with the help of surgery.
Generally, patients do not respond to drug therapy though various drugs have been such as vitamin E, Colchicine and Verapamil have been tried with limited benefit.
Shock wave therapy has been tried with limited success in reduction of plaque.
Surgical treatment is indicated in for patients with severe curvature, patients in whom penile and with hour glass deformity.e length has shortened . The type of surgery depends upon penile length , penile deformity and erectile function status
Preoperative counselling is essential
There are 3 main types of surgical procedures for Peyronie’s disease.
Penile plication surgery
Penile Plication Surgery normally involves performing a tuck procedure on the region opposite to the plaque. This helps to shorten the long side of the penis. Some of the main benefits of this procedure include its simplicity, preservation of preoperative erection ability, and a high degree of patient satisfaction. The disadvantages basically include loss of penile length. Patients who are regarded as ideal candidates for this procedure include those who have sufficient penile length and a simple curvature without any related abnormalities.
Plaque incision/excision and grafting
Plaque incision/excision and grafting is a series of procedures that primarily involves incision of the plaque and opening up the space leads to correction of curvature. The space is filled with materials such as dermis, saphenous vein and intestinal submucosa.
- Suitable candidates for this approach are men who have shorter penile length and have normal erectile function irrespective of the degree or severity of curvature and men who have hour-glass deformity or waisting. Some of the main disadvantages include the development of postoperative erectile dysfunction in men who have weak erectile function and loss of penile sensation.
Penile implant or Penile prosthesis enables urgent correction of the penile curvature as well as fully rigid erections. A prominent benefit of penile implants is the high degree of postoperative patient satisfaction and low incidence of risks and complications. Penile prosthesis is generally recommended for men who have erectile dysfunction as well as penile curvature.