Trans-scrotal plication for Peyronie┬┤s Disease with synchronous penile implant

VJPU 2013; 1: 013

Belsante, M., Flemons, J., Morey, A., Scott, J., Zhao, L.

Keywords: Peyronie´s Disease, plication of the tunica albuginea, trans-scrotal plication

This video covers the surgical technique of a plication of the tunica albuginea through the transscrotal access with synchronous penile implant insertion. The case presented a 65 years old patient with refractory ED and 60 degree dorsal penile curvature. This is an ideal candidate for ventral plication through the trans-scrotal access. For this reason, a high longitudinal skin incision was done. A Senn retractor was used to transfer the longitudinal incision to the distal penile shaft for ventral plication. Plication was performed as described by Tom Lue, using 00 Ethibond suture. An artificial erection showed a significant improvement of penile curvature. The surgeon continued with a penile prosthesis implantation in the described fashion. The advantages of plication with synchronous penile implant are: 1. Most deformities are dorsal or lateral (roughly 90%), 2. Controlled, precise, and safe procedure with predictable results. Minimal risk of urethral injury, 3. Plication can be done with a 5-10 degree correction per stitch, 4. Once the technique is learned, it adds roughly 10 min to the procedure.  The authors recommend this method of adjunctive straightening over modeling because it achieves better immediate straightening. 

Acknowledgements: educational grant from Coloplast

Disclosures: Allen F. Morey is a lecturer for Coloplast and Boston Scientific,  James R. Flemons is an employee of Coloplast

References:

  1. 1. Gholami SS, Lue TF. Correction of penile curvature using the 16-dot plication technique: a review of 132 patients. J Urol 2002 167;2066-2069
  2. Hudak SJ, Morey AF, Adibi M, Bagrodia A. Favorable patient reported outcomes after penile plication for wide array of peyronie disease abnormalities. J Urol 2013 189;1019-1024