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2016 ; 5
(3
): 342-50
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
A review of surgical strategies for penile prosthesis implantation in patients
with Peyronie s disease
#MMPMID27298781
Anaissie J
; Yafi FA
Transl Androl Urol
2016[Jun]; 5
(3
): 342-50
PMID27298781
show ga
The introduction of the inflatable penile prosthesis (IPP) has revolutionized the
treatment of patients with both Peyronie's disease (PD) and erectile dysfunction
(ED). A thorough literature review was performed in order to review the surgical
strategies used to treat PD, using the PubMed online database with the keywords
"penile prosthesis", "surgical management" and "Peyronie's disease". Patient
satisfaction rates of 72-100% and partner satisfaction rates of 89% have been
reported in the literature, although strong preoperative education may be needed
to prepare patients for risks such as penile shortening, seen in up to 54% of
patients. Three-piece IPPs are most commonly used, and when comparing the two
most popular models (AMS 700 CX vs. Coloplast Titan), no significant differences
were seen in functional outcomes or patient satisfaction. Simple insertion of an
IPP has been shown to resolve curvature in 33-90% of patients, but surgeons may
often need to also utilize ancillary straightening procedures for residual
curvatures. Manual modeling can correct residual curvature with an 86-100%
success rate, but with a 4% risk of urethral injury. When the post-modeling
residual curvature exceeds 30 degrees, a plaque-releasing incision or plication
is recommended to further reduce curvature. Grafting is recommended if the
resulting incisional defect is larger than two centimeters. Alternative
straightening techniques such as plication prior to IPP insertion, endoscopic
plaque resection, the "scratch technique" and bone saw plaque incision have also
been described.