Giulio Garaffa, Widi Atmoko, Jody Felizio, Ponco Birowo, Nur Rasyid, Akmal Taher

Penile Impant, Peyronie Disease, Plaque Excision, Tunica Vaginalist Graft, Erectile Dysfunction

In this video, we demonstrate the use of plaque excision with penile implant and tunica vaginalis graft in the management of Peyronie disease and erectile dysfunction. Due to availability and cost effectivity reasons, Shah Implant Semi Rigid without Hinge and Vancomycin 500 mg plus Gentamycin 2 x 80 mg antibiotic washout for prevention of bacterial contamination were used. The excision of plaque and the combination with penile implant and tunica vaginalis graft was known to be effective in preventing further decrease in penile length and successfully restoring initial penis length and sexual function. This video also demonstrated how the use of autologous tunica vaginalis is not only convenient to harvest but also provide good histocompatibility without compromising on pliability and elasticity during penile erection. Since this is the first experience of penile implant surgery in Indonesia, this video aims to describe how this seemingly complex procedure can still be achieved successfully in the setting of developing country and still resulted in excellent outcome with proper perioperative and intraoperative procedure. 

• Liu B, Li Q, Cheng G, Song N, Gu M, Wang Z. Surgical treatment of Peyronie’s disease with autologous tunica vaginalis of testis. BMC Urology 2016; 16:1.
• Djordjevic ML, Kojovic V. Penile prosthesis implantation and tunica albuginea incision without grafting in the treatment of Peyronie’s disease with erectile dysfunction. Asian J Androl. 2013; 15(3):391-394.