Surgical Treatment of Peyronie's Disease by Incision and Grafting

Hellstrom, W., Johnsen, N., Ma, L., Richardson, B.

Peyronie´s Disease, incision and grafting

This video covers the surgical technique of a plaque incision and grafting for Peyronie´s Disease. The authors describe in detail the diagnostic aspects and preoperative management of the patients with severe deformity of the penis. The principal aspects of implantation are demonstrated: careful preparation of the dorsal neurovascular bundle especially in the area of the plaque as an essential step of the surgery, a modified T- shape incision of the tunica albuginea across the midline laterally to the point of normal albuginea, a choice of the graft 10% greater than the size of the defect of the tunica albuginea. Bovine pericardial graft (Tutoplast® [Coloplast, Minneapolis] was used as graft material. The graft is then sutured to the tunica with 00000 PDS in a non-locking running fashion; lateral aspects of the defect are secured first, followed by transverse aspects. For the postoperative period the author recommends: 1. Low dose PDE5i, 2. Application of cocoa butter to penis, 3. Daily use of penile stretching device (2 hours).    

Consultant for AMS and Coloplast

1. Gokce A, Wang JC, Powers MK, Hellstrom WJ. Current and emerging treatment options for Peyronie's disease. Res Rep Urol 2013 14; 17-27
2. Gur S, Limin M, Hellstrom WJ. Current status and new developments in Peyronie's disease: medical, minimally invasive and surgical treatment options. Expert Opin Pharmacother 2011 12; 931-944