PEG Procedure

PEG Procedure
VJPU 2015; 2: 053
Laurence A. Levine

Keywords: Peyronie´s Disease, partial plaque excision and grafting (PEG), pericardium graft

This extensive video covers step by step surgical technique of the use a pericardium graft also known as the partial plaque excision and grafting (PEG) for Peyronie´s Disease. The indication for PEG procedure is a severe penile deviation with or without “hourglass” deformity. These are the important points of the procedure: a. preoperative and postoperative measurement of the penis from the pubis to the corona dorsally, b. the involved tunica albuginea must be carefully separated from the cavernous tissue, c. tunica defect must be measured with the penis on stretch. The goal is to equalize both lateral sides of the defect. d. an initial four-point fixation of the Tutoplast® patch is essential to cover the defect of the tunica albuginea completely. e. the graft is sutured to the tunica with 0000 PDS in a non-locking running fashion, f. lateral aspects of the defect are secured first, followed by transverse aspects. For the postoperative period the author recommends: 1. Low dose PDE5i one week after surgery for 30 days, 2. Massage and stretch of the penis for at least 5 min/4 weeks, 3. Optionally, a traction therapy 3-4 weeks after surgery 3 hours per day/ 3 months.

Acknowledgements: educational grant from Coloplast

Disclosures: Consultant for AMS, Coloplast

References:

  1. Taylor FL, Levine LA. Surgical correction of Peyronie's disease via tunica albuginea plication or partial plaque excision with pericardial graft: long-term follow up. J Sex Med 2008 5; 2221-2228
  2. Levine LA. Partial plaque excision and grafting (PEG) for Peyronie's disease. J Sex Med 2011 8; 1842-1845