Editing Peyronie's Disease (2015) (section)

==== Surgical reconstruction ====
* '''Patients who are considering surgical reconstruction should have chronic, stable disease, i.e. the presence of Peyronie’s disease symptoms ≥12 months and stable curvature for 3-6 months'''
** The surgical literature focuses almost entirely on patients with stable disease; outcomes for patients with active disease are not known.
* '''Options:'''
** '''Treatment is based on baseline erectile function'''; because tunical plication or plaque incision/excision with or without grafting are not treatments for ED and because the consequences of these procedures with regard to erectile function remain unclear, the most appropriate candidates for surgery are patients with intact erectile function or with ED responsive to oral medications or vacuum pump therapy
** '''For patients with capable erectile function''' '''(with or without adjunct therapy''' (oral medications, vacuum pump therapy, or intracavernosal injections)) '''and lack of deformity adequate for intercourse, options include (2):'''
**# '''Tunical plication surgery to improve penile curvature'''
**# '''Plaque incision or excision and/or grafting to improve penile curvature'''
** '''For patients with erectile dysfunction (ED) and/or penile deformity sufficient to impair coitus despite adjunct therapy'''
*** '''Inflatable penile prosthesis'''
**** Can perform adjunctive intra-operative procedures, such as modeling, plication or incision/grafting, when significant penile deformity persists after insertion of the penile prosthesis