A Novel Approach for Residual Curvature Correction during Inflatable Penile Prosthesis Implantation in Patients with Peyronie´s disease: The PICS Technique

Title: A Novel Approach for Residual Curvature Correction during Inflatable Penile Prosthesis Implantation in Patients with Peyronie´s disease: The PICS Technique

Author: Georgios Hatzichristodoulou

Key words: collagen fleece, Sealing technique, PICS technique, residual curvature, Peyronie’s disease, penile implant

This video shows the novel PICS technique for residual curvature correction during inflatable penile prosthesis (IPP) implantation in patients with Peyronie’s disease (PD). After the IPP is placed via a peno-scrotal approach, the device is inflated maximally. When residual curvature is >40° the PICS technique (Penile Implant in Combination with the Sealing technique) is performed. The scrotal wound is closed, followed by penile degloving and preparation of the neurovascular bundle. With the implant inflated, a plaque incision is performed at the point of maximum curvature to release the tension. This will lead to penile straightening. The resulting defect of the tunica albuginea is then sealed with the collagen fleece (TachoSil®, Baxter, IL, USA), which represents a self-adhesive fleece that does not require suture fixation. The neurovascular bundle is reapproximated, and Buck’s fascia and the penile skin closed. The PICS technique is a fast approach with low complication rates. It represents a safe and time-saving approach for residual curvature correction during IPP in patients with PD. It moreover prevents device puncture, as the collagen fleece does not require suture fixation into the tunical defect following plaque incision.

Acknowledgements: None

Disclosures: The author has nothing to disclose.

References:

  1. Hatzichristodoulou G. Surgical therapy of Peyronie’s disease by partial plaque excision and Sealing of tunical defect with collagen fleece: The Sealing technique. Video J Prosth Urol 2016;2:076.
  2. Hatzichristodoulou G. Partial Plaque Excision and Grafting With Collagen Fleece in Peyronie Disease. J Sex Med 2016;13:277-281.