PURPOSE: When conservative treatment of @entity545 fails, the optimal surgical approach is not well defined. Multiple factors, including @entity2003 , degree of curvature, shaft narrowing with hinge effect and erectile response to vasoactive penile injections, indicate that no single approach is likely to solve the problem in all @entity1 . MATERIALS AND METHODS: A surgical algorithm was developed for the treatment of @entity545 based on our previous surgical experience, which was used prospectively in 103 consecutive @entity1 . Penile straightening without prosthesis was offered to @entity1 with adequate @entity2003 for coitus. Specifically, for mild to moderate curvature less than 60 degrees without hourglass or hinge @entity85 complicated tunica albuginea plication procedure was performed. For those @entity1 with more severe, complex curvature greater than 60 degrees and/or significant hourglass or hinge @entity85 or partial excision with dermal grafting was offered to limit shaft shortening and to reconstruct a shaft with normal caliber to provide optimal axial support during intromission. For @entity1 with poor sexually induced erections and/or inadequate response to intracavernosal pharmacotherapy penile prosthesis placement was recommended to provide adequate straightening and @entity2003 . RESULTS: Of 22 @entity1 who underwent plication procedures 91% remained potent and the penis remained straight postoperatively. Of 52 @entity1 who underwent an incision or partial excision and grafting procedure, 48 had dermal grafts with the penis remaining straight in 94% and 75% remaining potent postoperatively. A total of 29 @entity1 received a prosthesis with the penis remaining straight in 93% who were sexually active postoperatively. During the follow up period (mean 22.3 months) there have been no mechanical device failures. CONCLUSIONS: Surgical outcome was optimized with this algorithm, which correlates surgical complexity to the underlying severity of the @entity546 and erectile capacity.

A surgical algorithm for the treatment of XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'men'] @entity2003 :: ('MESH:D009127', 'Disease') :: ['penile rigidity', 'rigidity'] @entity545 :: ('MESH:D010411', 'Disease') :: ["Peyronie's disease", "Peyronie's Disease"] @entity85 :: ('MESH:D009140', 'Disease') :: ['effect deformity the less', 'effect deformity plaque incision'] @entity546 :: ('MESH:D004414', 'Disease') :: ['penile deformity']
@entity545 :: (MESH:D010411,Disease) :: ['Peyronie's disease']
