Which treatment options are recommended for patients with Peyronie's disease who experience significant penile curvature affecting sexual function?

For patients with Peyronie's disease who experience significant penile curvature affecting sexual function, treatment options primarily focus on surgical correction once the disease is stable (Miner and Seftel, 2014; Pryor et al., 2004).

The main surgical approaches include:

• Plication procedures are considered for patients with adequate penile length and less severe curvature (Zaid et al., 2014). This technique involves shortening the longer side of the penis to straighten it (Zaid et al., 2014).
• Incision or excision with grafting is an option for more severe curvatures or significant penile shortening, aiming to straighten the penis and potentially restore length (Zaid et al., 2014). This involves incising or excising the plaque and covering the defect with a graft (Zaid et al., 2014).
• Penile prosthesis implantation is typically reserved for patients who also have erectile dysfunction in addition to the curvature (Miner and Seftel, 2014; Zaid et al., 2014). The prosthesis can help straighten the penis while also addressing the erectile dysfunction (Zaid et al., 2014).

While non-surgical treatments exist, they are generally less effective for significant curvature that impacts sexual function (Miner and Seftel, 2014).