Essed-Schroeder plication for ventral Peyronie’s disease

Kenneth DeLay1, Wayne J.G. Hellstrom1, Paige Kuhlmann2, Faysal A. Yafi1
1: Tulane University, 2: University of Missouri

Introduction: Around 9% of all PD plaques are located on the ventral aspect of the penis.
Due to its infrequent prevalence, there is a paucity of data regarding management.
Case presentation: This is a 66 year old man with Peyronie’s disease for the past 7 months. He has no recall of trauma, preserved erectile function and no pain with erections, but reports minimal penile shortening. Physical exam reveals a circumcised penis with a long ventral calcified plaque with no indentation or instability. Penile duplex Doppler ultrasound reveals an 85 degrees ventral curvature and a non-vascular etiology.
Protocol: The penis is first degloved and a tourniquet is applied. Following creation of an artificial erection, the area of maximal curvature is demarcated. The tunica albuginea is then plicated on the dorsal aspect of the penis using the Essed-Schroeder technique while avoiding the neurovascular bundle. A repeat artificial erection is created to ensure penile straightening. Further plications can then be performed as needed.
Outcome: Four months post-operatively, the patient has a 5 degrees dorsal curvature with 0.5cm loss of stretched penile length. He reports no pain with erections, unchanged erectile function and preserved penile sensation.
Discussion: The Essed-Schroeder plication is an easily reproducible and time-efficient technique for penile straightening for patients with ventral Peyronie’s disease.