Editing Peyronie's Disease (section)

====== Penile prosthesis for men with Peyronie Disease ======

* '''<span style="color:#ff0000">Gold standard treatment for PD requiring surgery occurring concurrently with refractory ED</span>'''
* '''<span style="color:#ff0000">Indications (2):</span>'''
*# '''<span style="color:#ff0000">Severe deformity refractory to non-surgical management or failed plication/grafting</span>'''
*# '''<span style="color:#ff0000">Profound penile instability (buckling or hinge).</span>'''
* '''<span style="color:#ff0000">If significant (> 30°) deformity persists after insertion of the penile prosthesis, additional straightening maneuvers may be necessary including (2):'''
*#'''<span style="color:#ff0000">Manual modeling of the phallus over the inflated device'''
*#*'''Critical steps of modeling'''
*#**Marking the point of maximum curvature
*#**Applying force apposite the point of maximum curvature for 90 seconds
*#**Completely inflating the IPP before modeling
*#**Cycling the device and repeating as necessary
*#**Assuring no injury to the urethra or corpora
*#***'''Most common adverse event occurring after manual modeling during placement of a penile prosthesis is urethral injury'''
*#'''<span style="color:#ff0000">Incising the tunica albuginea with or without grafting''' 
* '''Inflatable penile prosthesis is the preferred surgical implant'''.
** See [[Penile Prosthesis|Penile Prosthesis Chapter Notes]]
** '''Most common postoperative complaint with prosthesis is length loss'''
** Complications may include prosthesis infection, persistent penile shortening or curvature, diminished sensitivity, and mechanical device failure or difficulties.