Standard operating procedures for Peyronie's disease.

ABSTRACT

INTRODUCTION: Peyronie's disease (PD) refers to a penile deformity that is associated with sexual dysfunction. AIM: To provide recommendations and Standard Operating Procedures (SOPs) based on best evidence for diagnosis and treatment of PD. METHODS: Medical literature was reviewed and combined with expert opinion of the authors. MAIN OUTCOME MEASURES: Recommendations and SOPs based on grading of evidence-based medical literature. RESULTS: PD is a fibrotic wound-healing disorder involving the tunica albuginea of the corpora cavernosa. The resulting scar is responsible for a variety of deformities, including curvature, shortening, narrowing with hinge effect, and is frequently associated in the early phase with pain. Patients frequently experience diminished quality erections. All of these conditions can compromise sexual function for the affected male. The etiopathophysiology of PD has yet to be clarified and as a result, effective, reliable, mechanistic directed non-surgical therapy is lacking. CONCLUSIONS: The management of PD consists of proper diagnosis and treatment, ranging from non-surgical to surgical interventions. The main state of treatment for PD rests at this time on surgical correction that should be based on clear indications, involve surgical consent, and follow a surgical algorithm that includes tunica plication, plaque incision/partial excision and grafting, and penile prosthesis implantation.