Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Review Article
  • Published:

Wilson’s Workshop

Is modeling an inflatable penile prosthesis obsolete for patients with Peyronie’s disease?

International Journal of Impotence Research volume 32, pages 267–273 (2020)Cite this article

Subjects

In the mid 1980’s, the Scott prosthesis manufacturer became American Medical Systems (AMS). This company enhanced the cylinder construction to a three-layer sandwich with an outer and inner layer of silicone surrounding a fabric similar to wet suit material. This new construction drastically improved many of the original cylinder’s problems including lack of rigidity to correct crookedness. At approximately the same time in history, a new Mentor IPP appeared in the marketplace whose cylinders were constructed of Bioflex®—a tough polyurethane material displaying exceptional penile rigidity with cylinder inflation.

SKW did his first IPP in 1974. In the 70s and early 80s, I always shied away from attacking the plaques surgically because of fear of the more drastic complications: glans anesthesia, urethral injury and glans necrosis. When newer more rigid cylinders appeared, I wondered why the surgeon could not leave the plaque alone and correct the crookedness by manual modeling over an inflated cylinder much like the Orthopedists did with broken bone deformities using their rod implants. This rationale naturally matured into the technique of penile implant modeling—demonstrating the excellent rigidity of the inflated cylinders. An initial surprising observation was that 30–40% of PD patients did not even need modeling once corporal dilatation and cylinder placement had taken place as the penis was satisfactorily straightened without adjunctive measures. If the penis had ≤ 30° residual curvature, repetitive use of the prosthesis over a few months would completely straighten the phallus and also correct cicatrix and hourglass deformities. Those with more than 30° of curve were modeled and most improved to ≤ 30° curvature [1]. I was delighted with the simplicity the PD correction and presented it to the ISSM symposium in 1991 and the AUA in 1992.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1
Fig. 2
Fig. 3
Fig. 4: Morey Plication: markings made over penis to show location of plication stitiches.
Fig. 5
Fig. 6
Fig. 7: Plaque incision and grafting with Tachosil®.
Fig. 8: Sliding technique with implant (MOST).
Fig. 9: Egydio Multiple Slit Technique over inflated cylinders (MUST).
Fig. 10
Fig. 11: Modeling procedure used more than the classical two times to effect complete straightening at time of surgery.

References

  1. Wilson SK, Delk JR. A new treatment of Peyronie’s disease: modeling the penis over an inflatable penile prosthesis. J Urol. 1994;52:1121–3.

    Article  Google Scholar 

  2. Wilson SK, Cleves MA, Delk JR. Long term follow-up of a treatment of Peyronie’s disease: Modeling the penis over an inflatable penile prosthesis. J Urol. 2001;165:825–9.

    Article  CAS  Google Scholar 

  3. Levine LA, Benson J, Hoover C. Inflatable penile prosthesis placement in men with Peyronie’s disease and drug-resistant erectile function: a single center study. J Sex Med. 2010;7:3775–83.

    Article  Google Scholar 

  4. Morey AF. High patient satisfaction of inflatable penile prosthesis insertion with synchronous penile plication for Peyronie’s disease. J Urol. 2015;193:906–8.

    PubMed  Google Scholar 

  5. Brant WO, Bella AJ, Lue TF. 16-Dot procedure for penile curvature. J Sex Med. 2007;4:777–80.

    Article  Google Scholar 

  6. Perito P, Wilson SK. The Peyronie’s plaque “Scratch”: an adjunct to modeling. J Sex Med. 2013;10:1194–7.

    Article  Google Scholar 

  7. Hatzichristodoulou G, Geschwend JE, Lahme S. Surgical therapy of Peyronie’s disease by partial plaque excision and grafting with collagen fleece: feasibility study of a new technique. Int J Impot Res. 2013;25:183–7.

    Article  CAS  Google Scholar 

  8. Rolle L, Cerutti C, Timpano M, Sedigh O, Destefanis P, Galletto E, et al. A new innovative, lengthening surgical procedure for Peyronie’s disease by penile prosthesis implantation with double dorsal ventral patch graft: the sliding technique. J Sex Med. 2012;9:2389–95.

    Article  Google Scholar 

  9. Egydio PH, Kuehhas FE, Valenzuela RJ. Modified sliding technique for penile lengthening with insertion of inflatable penile prosthesis. J Sex Med. 2015;12:1100–4.

    Article  Google Scholar 

  10. Clavell-Hernandez J, Wang R. Penile size restoration with non-degloving approach for Peyronie’s disease: initial experience. J Sex Med. 2018;10:1506–13.

    Article  Google Scholar 

  11. Wilson SK, Mora-Estaves C, Egydio P, Ralph D, Habous M, Love C, et al. Glans necrosis following penile prosthesis implantation: prevention and treatment suggestions. Urology. 2017;107:144–8.

    Article  Google Scholar 

  12. Egydio PH, Kuehhas FE. The multiple-slit technique (MUST) for penile length and girth enhancement. J Sex Med. 2017;11:223–6.

    Google Scholar 

  13. Kohler TK, Gupta NK, Wilson SK. Wilson’s Pearls Perils and Pitfalls of Penile Prosthesis Surgery. Fort Smith AR: Calvert McBride Publishers; 2018.

    Google Scholar 

  14. Oberlin DT, Matulewicz RS, Bachrach L, Hofer MD, Brannigan RE, Flury SC. National practice patterns of treatment of erectile dysfunction with penile prosthesis implantation. J Urol. 2015;193:2040–4.

    Article  Google Scholar 

  15. Whelan P, Levine LA. Additional procedures performed at time of penile prosthesis implantation: a review of current literature. Int J Impot Res. 2019, https://www.nature.com/articles/s41443-019-0118-y.

Download references

Author information

Authors and Affiliations

  1. Department of Urology, Institute of Urologic Excellence, Indio, CA, USA

    Steven K. Wilson

  2. Departments of Urology, Einstein Healthcare Network and Fox Chase Cancer Center, Philadelphia, PA, USA

    Jay Simhan

Authors
  1. Steven K. Wilson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jay Simhan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jay Simhan.

Ethics declarations

Conflict of interest

SKW is a consultant for AMT, Coloplast, International Medical Devices and is a26 lecturer for Boston Scientific. JS is a consultant for Coloplast

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wilson, S.K., Simhan, J. Is modeling an inflatable penile prosthesis obsolete for patients with Peyronie’s disease?. Int J Impot Res 32, 267–273 (2020). https://doi.org/10.1038/s41443-020-0230-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41443-020-0230-z

This article is cited by

Search

Advanced search

Quick links