Bokarica P et al. (2005) Surgical treatment of Peyronie's disease based on penile length and degree of curvature. Int J Impot Res 17: 170–174

Peyronie's disease is a disorder of unknown etiology that is characterized by an accumulation of excess fibrous tissue in the TUNICA ALBUGINEA, resulting in curvature of the penis. In severe cases, where penile distortion prevents coitus, surgical correction is the treatment of choice. Several approaches are available to the surgeon, but no gold-standard procedure has been defined. Bokarica and co-workers have recently proposed novel selection criteria for surgical treatment of this condition, based on the literature and personal experience.

Between January 1990 and January 2000, 55 patients underwent surgery for Peyronie's disease. NESBIT'S OPERATION, which unavoidably results in shortening of the penis, was performed in men with erect penile length of >13 cm and penile curvature of <60°. The remaining patients, with erect penile length of ≤13 cm and penile curvature of ≥60°, were treated with PLAQUE EXCISION and polytetrafluoroethylene-patch grafts. Postoperatively, penile straightening was observed in 87.5% of patients who underwent Nesbit's operation and in 80% of those who received plaque excision with polytetrafluoroethylene-patch grafts. Erectile dysfunction was reported by 5% and 6% of patients in the two treatment groups, respectively. Penile shortening is a necessary consequence of Nesbit's operation but was subjectively reported by only 6 patients (15%) in this group. No patients in the plaque excision group reported subjective penile shortening. The authors conclude that selection of surgical procedure for Peyronie's disease should be based on both the length of the erect penis and the degree of penile curvature, and that Nesbit's operation should not be performed in patients with an erect penile length of <13 cm.