Surgical Treatment of Peyronie's Disease by Incision and Grafting

VJPU 2014; 1: 019

Wayne J.G: Hellstrom, Johnsen, N., Ma, L., Richardson, B.

Keywords: Peyronie´s Disease, incision and grafting

This video covers the surgical technique of a plaque incision and grafting for Peyronie´s Disease. The authors describe in detail the diagnostic aspects and preoperative management of the patients with severe deformity of the penis. The principal aspects of implantation are demonstrated: careful preparation of the dorsal neurovascular bundle especially in the area of the plaque as an essential step of the surgery, a modified T- shape incision of the tunica albuginea across the midline laterally to the point of normal albuginea, a choice of the graft 10% greater than the size of the defect of the tunica albuginea. Bovine pericardial graft (Tutoplast® [Coloplast, Minneapolis] was used as graft material. The graft is then sutured to the tunica with 00000 PDS in a non-locking running fashion; lateral aspects of the defect are secured first, followed by transverse aspects. For the postoperative period the author recommends: 1. Low dose PDE5i, 2. Application of cocoa butter to penis, 3. Daily use of penile stretching device (2 hours).   

Acknowledgements: none

Disclosures: Consultant for AMS and Coloplast

References:

  1. Gokce A, Wang JC, Powers MK, Hellstrom WJ. Current and emerging treatment options for Peyronie's disease. Res Rep Urol 2013 14; 17-27
  2. Gur S, Limin M, Hellstrom WJ. Current status and new developments in Peyronie's disease: medical, minimally invasive and surgical treatment options. Expert Opin Pharmacother 2011 12; 931-944