A new, innovative, lengthening surgical procedure for Peyronie's disease by penile prosthesis implantation with double dorsal-ventral patch graft: the "sliding technique".
نویسندگان
چکیده
INTRODUCTION Peyronie's disease is the result of the formation of fibrous plaques in the tunica albuginea of the penis; typical presentations of the disease are represented by pain during erection, erectile dysfunction, and penile deformities, such as curvature, narrowing, and penile shortening. The most complex treatment is related to penile shortening. AIM To find a safe procedure in penile shortening due to Peyronie's disease providing a satisfactory lengthening, allowing an early stabilization of the penis, and preventing axial tension on the neurovascular bundles during dilation. METHODS We describe a new lengthening surgical procedure based on a ventro-dorsal incision of the tunica albuginea, penile prosthesis implantation, and double dorsal-ventral patch grafting with porcine small intestinal submucosa. Three patients, affected by Peyronie's disease with penile shortening and erectile dysfunction, underwent this procedure with approval of our local ethical committee. We evaluated the penis lengthening, intraoperative and postoperative complications, patient's preoperative and postoperative sexual life satisfaction (International Index of Erectile Function [IIEF] questionnaire). RESULTS The average operative time was 2 hours and 50 minutes. No major intraoperative nor postoperative complications occurred. No significant bleedings were recorded. Patients were discharged after 48-72 hours. The average increase in length obtained was 3.2 cm. All patients resumed sexual intercourses with satisfaction; no significant loss of sensitivity or any sign of vascular distress of the glans was recorded. The follow-up is 13 months. The average IIEF score is 60. CONCLUSIONS The lengthening of the penis by a double dorsal-ventral patch graft is an innovative procedure that is based on current techniques of plaque incision and grafting, and that can easily resolve severe shortening of the penis due to Peyronie's disease. In the cases presented, this procedure resulted easily, effectively, and safely. Nevertheless, the technique proposed in this article shall be validated through prospective studies with larger samples.
منابع مشابه
Nondegloving technique for Peyronie's disease with penile prosthesis implantation and double dorsal-ventral patch graft
متن کامل
Commentary on “Nondegloving technique for Peyronie's disease with penile prosthesis implantation and double dorsal-ventral patch graft”
They conclude that, in the penile implant patient with any signs of glans necrosis, the operating surgeon should offer “...immediate implant removal” as it “may prevent subsequent glans necrosis.” In my personal surgical log, I have had only one patient who lost half of his glans after penile prosthesis, and it caused me to lose sleep and necessitated the involvement of hospital risk management...
متن کامل[Current surgical management of severe peyronie's disease. Editorial comment].
OBJECTIVES To report the principles of penile resculpturing of different deformities caused by M. Peyronie: restoration of penile length, girth and shape with or without penile prosthesis implantation. METHODS In the period between February 2007 and March 2009, we performed grafting surgery for M. Peyronie in 98 patients aged between 24 and 72 years (mean 52 years). Penile deformities were di...
متن کاملLengthening strategies for Peyronie’s disease
Loss of penile length is a common complaint of men with Peyronie's disease (PD), both before and after corrective intervention, which has a significant negative effect on patient quality of life. We sought to identify and describe the methods by which penile length can be preserved or increased. We conducted an extensive, systematic literature review, based on a search of the PUBMED database fo...
متن کاملResults of dermal patch graft in the treatment of Peyronie's disease.
PURPOSE To investigate the efficacy of "dermal patch graft" in surgical management of Peyronie's. MATERIALS AND METHODS Eighteen of Peyronie's disease cases, with a mean age of 49 and a history of penile curvature and painful erection were enrolled in this study. Diagnosis was made clinically by plaque palpation. All of them were in the chronic stage of disease with symptom duration of at lea...
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ورودعنوان ژورنال:
- The journal of sexual medicine
دوره 9 9 شماره
صفحات -
تاریخ انتشار 2012