Novel Peyronie's algorithm at the time of penile implant

Peyronie's disease (PD) is a fibrous transformation of the tunica albuginea within the corpora cavernosa causing curvature of the penis while erect. This cannot only be painful but can also cause narrowing, shortening, an hourglass deformity and problems with penetrative intercourse. There are many means of management of Peyronie's disease at the time of penile implant. Modeling is a commonly used approach but leaves the penis without increased length. Multi-incisional techniques enhance length restoration, but risk significant vascular and neurologic compromise. Herein, we present our experience with a novel algorithm to approach Peyronie's disease with an effort to enhance and restore length without elevation of the neurovascular bundle.

A retrospective review was performed of an institutional review board approved database. Patients treated for Peyronie's disease and erectile dysfunction with penile implant from 8/16/18 to 8/20/2020 were evaluated.

In our cohort of 33 patients there is an average of 1.9 cm average stretch difference in stretch penile length before and after management. There was a 2.15 cm difference in the cohort subset that utilized the Brock technique. We had no loss of sensation or glans ischemia. There was one patient with autoinflation. All patients had less than 10 degrees of residual curvature.

With the proposed algorithm, we are able to safely maximize length restoration without elevation of the neurovascular bundle. More patients with longer follow up is needed to ensure the safety and validity of this algorithm.