Several strategies to optimize penile length in the presence of Peyronie's Disease (PD) have been described so far. In case of severe curvature and preserved erectile function, plaque incision/excision (PIG/PEG) are advisable in order to maximize penile length, despite the risk of postoperative erectile dysfunction (ED), recurrent curvature, or penile shortening. For men with PD deformities associated to a certain degree of ED several lengthening techniques associated to penile prosthesis (PPI) implantation can be considered. Because of the potential postoperative complications, the indication must be balanced between patient's risk factors and surgeon's experience. Furthermore, adjuvant surgeries, such as prepubic V-Y plasty, suspensory ligament release, suprapubic lipectomy, and ventral phalloplasty, can be performed simultaneously or in a staged fashion to maximize the outcomes. Restoration a decent penile length in the case of a severe PD represents a real challenge for reconstructive surgeons. We present a systematic review of the literature on the current practices for penile lengthening in severe PD, providing the reader with a practical overview on the existing surgical strategies and their surgical and functional outcomes.

中文翻译：

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重度佩罗尼氏病患者阴茎延长的策略和当前实践：系统评价。

到目前为止，已经描述了几种在存在佩罗尼氏病（PD）的情况下优化阴茎长度的策略。如果出现严重的曲率并保留勃起功能，尽管有术后勃起功能障碍（ED），反复曲度或阴茎缩短的风险，建议采用斑块切开/切除术（PIG / PEG）以使阴茎长度最大化。对于患有与一定程度的ED相关的PD畸形的男性，可以考虑几种与阴茎假体（PPI）植入相关的延长技术。由于潜在的术后并发症，必须在患者的危险因素和外科医生的经验之间取得平衡。此外，还有一些辅助手术，例如耻骨前VY成形术，悬韧带释放，耻骨上脂肪切除术和腹部阴茎成形术，可以同时执行，也可以分阶段执行，以最大程度地提高结果。对于严重的PD，要恢复适当的阴茎长度对重建外科医师而言是真正的挑战。我们提供了有关重度PD阴茎延长术当前实践的文献的系统综述，为读者提供了有关现有手术策略及其手术和功能结局的实用概述。