Surgery in Peyronie’s Disease: Our Experiences with Tunica Plication, Plaque Incision and Grafting with Gore-Tex, and Satisfaction Degree of the Patients
Archives of Renal Diseases and Management
Research Article
Abstract
Peyronie’s disease is a relatively common condition, with an incidence of 3-9%. It is often associated with diabetes and erectile dysfunction (ED). This condition causes a penile deformity that can affect sexual penetration and lead to psychological disorders because of the difficulty in coping with the situation. Sometime the surgery does not satisfy the patients; we tried to evaluate this aspect of the disease. Materials and methods: We treated 46 patients for recurvatum penis secondary to Peyronie’s disease. The clinical examination involved an accurate medical history, a physical examination to identify the plaque, ultrasonography to detect calcified plaque, and a photograph of the erect penis to document the recurvatum and sandglass deformity. In the case of ED, we administered the IIEF-5 and performed intracavernous injection of PGE1; in patients eligible for grafting, we also carried out a dynamic echo colour Doppler of the cavernous corps. Penis length, altogether, was between 11.5 and 14.5 cm (13.25 ± 1 cm). In 40 patients with moderate curvature (45-60°) we carried out tunica plication and in 6 cases with curvature >60° and with ED we performed plaque incision and partial dissection, with grafting strips of polyester fluoropolymer (Gore-Tex). In all cases, we performed an extended dissection of the dorsal plexus and urethra.
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Research Article
Abstract
Peyronie’s disease is a relatively common condition, with an incidence of 3-9%. It is often associated with diabetes and erectile dysfunction (ED). This condition causes a penile deformity that can affect sexual penetration and lead to psychological disorders because of the difficulty in coping with the situation. Sometime the surgery does not satisfy the patients; we tried to evaluate this aspect of the disease. Materials and methods: We treated 46 patients for recurvatum penis secondary to Peyronie’s disease. The clinical examination involved an accurate medical history, a physical examination to identify the plaque, ultrasonography to detect calcified plaque, and a photograph of the erect penis to document the recurvatum and sandglass deformity. In the case of ED, we administered the IIEF-5 and performed intracavernous injection of PGE1; in patients eligible for grafting, we also carried out a dynamic echo colour Doppler of the cavernous corps. Penis length, altogether, was between 11.5 and 14.5 cm (13.25 ± 1 cm). In 40 patients with moderate curvature (45-60°) we carried out tunica plication and in 6 cases with curvature >60° and with ED we performed plaque incision and partial dissection, with grafting strips of polyester fluoropolymer (Gore-Tex). In all cases, we performed an extended dissection of the dorsal plexus and urethra.
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