A Contemporary Evaluation of Peyronie’s Disease During Penile Prosthesis Placement: MOST, MUST, and More
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Purpose of Review
The use of penile implant for the treatment of both erectile dysfunction and Peyronie’s disease has changed little in the last 40 years, primarily limited to modeling and plaque incision. In the current review, I explore the history of Peyronie’s treatment at the time of penile prosthesis placement and explore new surgical options that help resolve several of the issues that were not treated with the traditional approaches.
Advancements have been made in the area of graft material, lengthening procedures, and transcorporal techniques. The goal of these operations is not only to correct curvature, but also to restore length. Not surprisingly, the more complex and aggressive the attempt to correct the curvature, the more complications are possible. While modeling has a low rate of urethral injury, complex lengthening procedure with neurovascular bundle and urethral mobilization may lead to the dreaded complication of glans necrosis. Meanwhile, transcorporal techniques seem to offer a more modest improvement for length and curvature restoration with fewer risks than those seen in more aggressive lengthening procedures.
The main limitation to the historical treatment of Peyronie’s disease during penile prosthesis, modeling, and plaque incision is there is often no resolution to the penile length—as the maneuvers are made after the implant is already in place. Newer lengthening procedures are promising, however carry increased risks and complexity.
KeywordsPeyronie’s disease Penile prosthesis placement Urologic surgery Penile implant
Compliance with Ethical Standards
Conflict of Interest
Jonathan Nicholas Warner is a consultant for Coloplast and Olympus.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
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