V1584: TRANS-SCROTAL PLICATION FOR PEYRONIE'S DISEASE WITH SYNCHRONOUS PENILE IMPLANT
VideoIntroduction and Objectives
Current standard management of Peyronie’s disease with erectile dysfunction involves penile prosthesis placement with manual modeling. We report an alternative technique utilizing synchronous penile plication and inflatable penile prosthesis (IPP) placement.
An artificial erection is induced with injectable saline and a penile tourniquet to identify the nature of the penile curvature. A 2 cm penoscrotal incision is made and mobilized over the convex aspect of the penile curvature. The dissection is carried down through dartos and Buck’s fascia. The incision is then mobilized distally along the shaft to allow placement of multiple parallel plicating sutures (braided, nonabsorbable polyester) in the tunica albuginea until the curvature is completely corrected. IPP placement is then immediately performed through the same incision in a standard fashion. Patients were administered a postoperative survey to identify functional outcomes and patient satisfaction.
Sixteen patients have undergone synchronous penile plication with IPP placement. Preoperative penile curvature was a mean of 43 degrees compared with 4 degrees post-procedure. We achieved approximately 8 degrees of correction with each plication suture. Of the 10 patients who completed the survey, 90% described their penile curvature as much better and 10% as slightly better. No patients have had infection or have required reoperation.
Penile plication with concomitant IPP placement is an effective, safe, and controlled method for treatment of Peyronie’s disease with erectile dysfunction.