Peyronie's disease. Investigation of staging, erectile failure and operative management

There are still diverse management options in Peyronie's disease, due to its unknown aetiology, progression or remission. Types, extent and duration of operative management in this disease are subject of controversial discussion. We did complex investigations in 132 patients revealing the following items. Diagnostic tests should include both history and physical examination and comparative X-ray and ultrasound investigations. CT is the best method to differentiate pathological lesions in the tunica albuginea. X-ray (xerography) examination demonstrates calcification of the plaque. Papaverin-hydrochloride injection is a valid method to check the extension of concomitant erectile dysfunction and shows the angulation of the penis. Plaque excision and grafting with various materials were used initially with disappointing results (15 patients, only 20% good results). Modified corporal plication has been used subsequently with good results (54 patients, follow-up 3 years, 90% good results). Implantation of penile prosthesis must be evaluated individually.