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Soft Prosthesis Implant and Relaxing Albugineal Incision with Saphenous Grafting for Surgical Therapy of Peyronie's Disease: A 5-Year Experience and Long-TermFollow-Up on 145 Operated Patients

Austoni E, Colombo F, Romano AL, Guarneri A, Goumas IK, Cazzaniga A; European Urology 2005 (47) 223-229

KEY WORDS: Peyronie's disease; Prosthesis implant; Venous grafting; Penis elongation; Erectile dysfunction;

Peyronie's disease represents a localized aberration of the wound healing process. Pathogenesis of Peyronie's plaques originates with fibrin deposition and results in scar-like lesions. A number of factors, in particular trauma, may contribute to the initiation of this process.
Most surgical therapies used to date for Peyronie's disease produce good results but cause penis retraction. The authors propose a personal surgical technique that makes use of an intracavernous cylinder, soft but axially rigid in consistency, in association with tunical relaxing incisions and saphenous vein grafting, in this exact sequence.

• A total of 145 patients presenting with Peyronie's disease underwent this 3- phase personal surgical procedure. Complete plaque excision was necessary only for 13 patients (8.9%); in the remaining 132, a single incision was placed in 113 cases (77.9%) and double incisions were used for 19 patients (13.1%). Distance follow-up ranged from a minimum of 6 months to a maximum period of 3 years (mean 13 months).
• Average penile lengthening was approximately 1.5 cm. 80 patients answered the questionnaire (70.75%): 76 expressed complete satisfaction, while 4 patients reported glans paresthesia. No major complications were noted; for 8 patients circumcision was repeated because of preputial edema. In 6 cases there was a local, postoperative infection, that was treated conservatively with a prolonged antibiotic therapy.
• This technique allows to successfully solve penile retraction, caused by traditional surgery for Peyronie's disease. The technique is easy to carry out, has low risks of complications and ensures very high rates of patient satisfaction.