Surgery for Peyronie's disease. A review of 200 patients.

Approximately 10% of patients with Peyronie's disease require surgery for penile angulation or erectile failure severe enough to make coitus difficult or impossible. The results of three different operations performed on 200 patients over the period 1975 to 1984 have been reviewed. The results of plaque excision and dermal grafting in nine patients were disappointing and since 1977, Nesbit's procedure has been performed in 179 patients with excellent results in 53% and moderate results in 19%. Poor results (28%) were usually due to erectile failure and this was usually present pre-operatively. Such patients are better treated by the implantation of penile prostheses and excellent (8) or moderate (2) results were seen in 12 patients so treated. The number of patients with poor results after a Nesbit's procedure increased from 14% at 3 months to 28% at 36 months, but then remained fairly constant. Prolonged follow-up is therefore needed to allow valid conclusions about the ultimate outcome of surgery.