Abstract
With the advent of new surgical techniques to treat Peyronie’s disease with concomitant erectile dysfunction, there remains a question of whether manual modeling (MM), an older technique, still has a place in the treatment algorithm within penile prosthesis (PP) surgery. While the implantation of a PP often corrects moderate to severe curvature, penile curvature can remain greater than 30°, even when concurrent MM is performed during prothesis implantation. There are new variations of the MM technique that have been recently utilized in the intraoperative and postoperative setting to achieve penile curvature less than 30° when the implant is fully inflated. The inflatable PP, regardless of the specific model of choice, is preferred over the noninflatable PP when utilizing the MM technique. MM should be the first line of treatment for persisting intraoperative penile curvature after the placement of a PP due to its long-term efficacy, noninvasive approach, and significantly low risk of adverse effects.
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All data analyzed during this study are included in this published article. The data in this paper can be found by searching the listed references on PubMed.
References
Sandean DP, Lotfollahzadeh S. Peyronie Disease. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2022.
El-Khatib FM, Huynh LM, Yafi FA. Intraoperative methods for residual curvature correction during penile prosthesis implantation in patients with Peyronie’s disease and refractory erectile dysfunction. Int J Impot Res. 2020;32:43–51.
XIAFLEX® (collagenase clostridium histolyticum). Accessed October 1, 2022. https://www.xiaflex.com
Carson CC, Levine LA. Outcomes of surgical treatment of Peyronie’s disease. BJU Int. 2014;113:704–13.
Levine LA, Dimitriou RJ. A surgical algorithm for penile prosthesis placement in men with erectile failure and Peyronie’s disease. Int J Impot Res. 2000;12:147–51.
Lucas JW, Gross MS, Barlotta RM, Sudhakar A, Hoover CRV, Wilson SK, et al. Optimal Modeling: an Updated Method for Safely and Effectively Eliminating Curvature During Penile Prosthesis Implantation. Urology. 2020;146:133–9.
Garaffa G, Minervini A, Christopher NA, Minhas S, Ralph DJ. The management of residual curvature after penile prosthesis implantation in men with Peyronie’s disease. BJU Int. 2011;108:1152–6.
Knoll LD. Use of porcine small intestinal submucosal graft in the surgical management of tunical deficiencies with penile prosthetic surgery. Urology. 2002;59:758–61.
Eigner EB, Kabalin JN, Kessler R. Penile implants in the treatment of Peyronie’s disease. J Urol. 1991;145:69–71; discussion -2.
Mobley DF. Early history of inflatable penile prosthesis surgery: a view from someone who was there. Asian J Androl. 2015;17:225–9.
Wilson SK, Delk JR 2nd. A new treatment for Peyronie’s disease: modeling the penis over an inflatable penile prosthesis. J Urol. 1994;152:1121–3.
Wilson SK, Delk JR 2nd. Historical advances in penile prostheses. Int J Impot Res. 2000;12 Suppl 4:S101–7.
Wilson SK. Surgical techniques: modeling technique for penile curvature. J Sex Med. 2007;4:231–4.
Levine LA, Benson J, Hoover C. Inflatable penile prosthesis placement in men with Peyronie’s disease and drug-resistant erectile dysfunction: A single-center study. J Sex Med. 2010;7:3775–83.
Wilson SK, Cleves MA, Delk JR 2nd. Long-term followup of treatment for Peyronie’s disease: modeling the penis over an inflatable penile prosthesis. J Urol. 2001;165:825–9.
Mulhall J, Ahmed A, Anderson M. Penile prosthetic surgery for Peyronie’s disease: defining the need for intraoperative adjuvant maneuvers. J Sex Med. 2004;1:318–21.
Kadioglu A, Sanli O, Akman T, Cakan M, Erol B, Mamadov F. Surgical treatment of Peyronie’s disease: a single center experience with 145 patients. Eur Urol. 2008;53:432–9.
Tausch TJ, Chung PH, Siegel JA, Gliga L, Klein AK, Morey AF. Intraoperative Decision-making for Precise Penile Straightening During Inflatable Penile Prosthesis Surgery. Urology. 2015;86:1048–52.
Chung PH, Scott JF, Morey AF. High patient satisfaction of inflatable penile prosthesis insertion with synchronous penile plication for erectile dysfunction and Peyronie’s disease. J Sex Med. 2014;11:1593–8.
Perito P, Wilson S. The Peyronie’s plaque “scratch”: an adjunct to modeling. J Sex Med. 2013;10:1194–7.
Ghanem HM, Fahmy I, el-Meliegy A. Malleable penile implants without plaque surgery in the treatment of Peyronie’s disease. Int J Impot Res. 1998;10:171–3.
Chung E, Solomon M, DeYoung L, Brock GB. Comparison between AMS 700™ CX and Coloplast™ Titan inflatable penile prosthesis for Peyronie’s disease treatment and remodeling: clinical outcomes and patient satisfaction. J Sex Med. 2013;10:2855–60.
Levine LA, Estrada CR, Morgentaler A. Mechanical reliability and safety of, and patient satisfaction with the Ambicor inflatable penile prosthesis: results of a 2 center study. J Urol. 2001;166:932–7.
Moncada I, Krishnappa P, Ascencios J, Lopez I, Martinez-Salamanca JI. Home modeling after penile prosthesis implantation in the management of residual curvature in Peyronie’s disease. Int J Impot Res. 2021;33:616–9.
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The authors wish to thank Scott Bailey, PhD, for his efforts in editing this manuscript.
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Conceived and/or designed the work that led to the submission, acquired data, and/or played an important role in interpreting the results: WJC, BJH, WJGH. Drafted or revised the manuscript: WJC, BJH. Approved the final version: WJGH. Agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved: WJGH.
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Conlon, W.J., Herzog, B.J. & Hellstrom, W.J.G. Residual penile curvature correction by modeling during penile prosthesis implantation in Peyronie’s disease patients. Int J Impot Res 35, 639–642 (2023). https://doi.org/10.1038/s41443-023-00694-5
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DOI: https://doi.org/10.1038/s41443-023-00694-5