Introduction: Surgery is gold-standard for correction of Peyronie's curvature. Recently, there have been reports on partial plaque excision and grafting with collagen fleece technique regarding long term efficacy. However, there is still concern regarding post-operative bleeding complications and worsening of erectile function. Here, we introduce a less invasive technique by multiple grid plaque incisions instead of plaque excisions to minimize complications.
Methods: From May 2018 and March 2019, 13 patients with stable Peyronie’s disease (PD) were included. Surgical technique was composed 3 major steps; 1) releasing and elevation of the neurovascular bundle or urethra, 2) multiple deep grid plaque incisions and 3) sealing with collagen fleece (TachoSil®) without suturing. We assessed the stretched penile length (SPL), totally straightness and International Index of Erectile Function (IIEF-5) preoperatively and 12weeks postoperatively.
Results: Mean patient age was 62.3 ± 4.9 years (range: 52–72). The mean curvature was 50.5 (40-80) degree, 8 with dorsal curvature, 3 with pure lateral curvature and 2 with ventral curvature. Mean operative time was 95.0 ± 24.6 minutes (60–140). Mean follow-up was 5.5 ± 3.9 months (3– 10). All patients achieved totally straightness. Mean penile length of preoperative and postoperative 12 weeks were 10.6 ± 1.0cm (range: 9-12) and 11.7 ± 0.8cm (range: 10-12), respectively. None of patients had hematoma postoperatively and erectile function was preserved postoperatively 12 weeks.
Conclusions: Our initial experience with this technical modification of various plaque incisions shows that one can achieve a sufficient surgical effect without making defect of carvernosum. However, long-term clinical outcomes are necessary to confirm these encouraging findings. Source of
