Surgical Management of Peyronie's Disease

When choosing a management strategy for a patient with Peyronie's disease (PD), it is critical to consider the phase of the disease, penile plaque characteristics, degree of curvature, associated deformities, stretched penile length, and baseline erectile function. Equally important is an understanding of the patient's goals and expectations. Treatment cost and duration may also be vital considerations for the patient. In this case, the degree of curvature and large calcified plaque make treatment with intralesional injection of collagenase Clostridium histolyticum unlikely to result in a functionally straight erection despite 6-7 mo of therapy. Conversely, surgery with either penile plication or plaque incision/partial excision and grafting can provide reliable straightening with 0-1 d of hospitalization and approximately 6 wk of recovery. With careful preoperative counseling and joint decision-making, surgical treatment of PD deformity can provide more complete correction in less time and at lower overall costs.