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Surgical correction of Peyronie’s disease remains the gold standard of treatment. The goals of surgery should be cosmetic improvement and the preservation or restoration of sexual function. Preoperative workup should include objective assessment of both curvature and erectile function, and shared decision-making with the patient to clearly understand expectations for surgery is critical, as there is a risk of penile shortening and erectile dysfunction with any Peyronie’s surgery. Peyronie’s surgeries fall into three broad categories: plication procedures, plaque incision and grafting, and placement of a penile prosthesis. While direct comparative studies are rare, plication surgeries are the most commonly performed, as they are technically simpler and have excellent satisfaction rates. Grafting techniques are most indicated for more severe cases. Prosthetic placement is appropriate for patients with concurrent erectile dysfunction, and placement alone can correct cases of mild curvature. Additional techniques to straighten the penis can be employed if needed.
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