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Minerva Urologica e Nefrologica 2020 Nov 12

DOI: 10.23736/S0393-2249.20.03890-4


lingua: Inglese

Penile prosthesis implant in the management of Peyronies’ disease: a systematic review of the literature

Paolo VERZE 1 , Ioannis SOKOLAKIS 2, Celeste MANFREDI 3,4, Claudia COLLÀ RUVOLO 3, Georgios HATZICHRISTODOULOU 2, Javier ROMERO-OTERO 4,5

1 Urology Unit, Department of Medicine, Surgery, Dentistry Scuola Medica Salernitana, University of Salerno, Salerno, Italy; 2 Department of Urology, Martha-Maria Hospital Nuremberg, Nuremberg, Germany; 3 Urology Unit, Department of Neurosciences, Reproductive Sciences, Odontostomatology, University of Naples Federico II, Naples, Italy; 4 Department of Urology, Hospital Universitario 12 Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain; 5 Department of Urology, University HM Montepríncipe Hospital, Madrid, Spain


INTRODUCTION: Penile Prosthesis Implantation (PPI), performed with or without adjunct straightening techniques, is one of the available surgical options in cases of Peyronie’s disease (PD) with concomitant erectile dysfunction (ED). The aim of the study was to systematically identify and evaluate evidence regarding IPP in patients with PD and ED.
EVIDENCE ACQUISITION: Using Cochrane’s methodological recommendations on systematic reviews, we conducted a systematic review of the literature on clinical research regarding the use of PPI, alone or in combination with any straightening maneuvers in the treatment of patients with PD and ED. The search was carried until January 2020. We included studies in English language with primary population patients with PD and ED who underwent IPP with the intent to treat the PD. All studies that were not original clinical research articles, reported insufficient data or included fewer than 5 patients were excluded from the final analysis.
EVIDENCE SYNTHESIS: In total 43 clinical articles with more than 2,000 patients (n=2,143) investigating the effects of penile prosthesis implantation (PPI) for the treatment of PD with or without ED were included in the study. Depending on the severity of the penile curvature, additional penile deformities (i.e. hourglass deformity), penile length, prior operations and surgeons experience, 6 main categories of surgical techniques of PPI for penile straightening and treatment of PD were identified: PPI only, PPI with modelling of the penis, PPI with plication of the penis on the convex side of the curvature, PPI with plaque incision(s), PPI with plaque incision/excision plus grafting and PPI with grafting and penile lengthening.
CONCLUSIONS: Overall, patients with PD and ED can expect excellent outcomes with PPI against a minimal risk of side effects. No definite conclusions can be made regarding which technique is superior.

KEY WORDS: Peyronie's disease; Penile induration; Penile prosthesis; Penile implantation

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