Tunica-sparing ossified Peyronie's plaque excision.

Abstract

OBJECTIVE:

Ossified Peyronie's plaques may require surgical excision because of the palpable problems and penile curvature that result. As tunical excision can result in impotence and decrease penile sensation, we describe a novel method of tunical preserving excision of such lesions.

PATIENTS AND METHODS:

We evaluated 12 men with dorsal penile curvature between 10° and 90°. Penile plaque size ranged from 1 to 5 cm. 80% had painful erections. An artificial erection was induced with intracavernous injection of papaverine to assess penile deformity. Via a circumcising or ventral incision, plication sutures were placed to correct penile curvature. A lateral longitudinal corporotomy was made and the calcified/ossified portion was dissected free from the tunica albuginea/plaque of the corpora cavernosa. Watertight tunical closure was then performed.

RESULTS:

Postoperatively, 80% of men reported erections always adequate for intercourse and normal sensation with a mean follow-up of 7 months (range 2.1-14.5 months). All patients required simultaneous penile plication to ensure a straight phallus. Pathologic evaluation of plaque specimens all showed bone fragments.

CONCLUSION:

Tunica-sparing excision of the ossified/calcified portion of Peyronie's plaques shows a durable benefit for large, ossified lesions and maintains potency and penile sensation.

• Authors: Michael L Eisenberg, James F Smith, Alan W Shindel, Tom F Lue
• Journal: BJU international (BJU Int) Vol. 107 Issue 4 Pg. 622-5 (Feb 2011) ISSN: 1464-410X [Electronic] England
• PMID: 20804484 (Publication Type: Journal Article)
• Copyright: © 2010 THE AUTHORS. JOURNAL COMPILATION © 2010 BJU INTERNATIONAL.

Topics

• Adult
• Erectile Dysfunction (etiology, surgery)
• Humans
• Male
• Middle Aged
• Penile Induration (diagnostic imaging, pathology, surgery)
• Treatment Outcome
• Ultrasonography
• Urologic Surgical Procedures, Male (methods)