V1588: PENILE PLICATION WITHOUT DEGLOVING FOR REPAIR OF BIPLANAR DEFORMITY DUE TO PEYRONIE'S DISEASE

Video

Introduction and Objectives
Penile plication is a standard treatment for mild to moderate Peyronie’s Disease deformity, while more invasive techniques such as plaque incision and grafting have traditionally been used to treat more severe cases. We present outcomes from our 5-year experience using tunical plication without penile degloving to correct complex Peyronie’s Disease deformities.

Methods
A retrospective study of all men who underwent penile plication for Peyronie’s Disease by the senior author was performed. All patients underwent tunical plication without penile degloving via a 2.5 cm longitudinal penile incision regardless of curvature severity. Complex cases were defined as those involving uniplanar deformity of at least 60° or biplanar deformity. Outcome measures included change in deformity angle, decrease in stretched penile length (SPL), pain at one month follow-up, and need for revision.

Results
In our series of 65 complex cases, mean operative time was 60 minutes (median 54 minutes). Mean pre-op uniplanar deformity angle was 70°, and biplanar deformities had a mean combined angle of 88°. Post-op angle measurements showed a mean improvement of 56° and 70° respectively. A mean of 10 sutures per patient were used (range 4 to 21). Thus, the mean angular improvement per plication suture was 6° (median 5°). There was no measureable decrease in SPL in 91% of patients. Pain at initial follow-up was reported by 4 patients (6%) – 2 resolved, 1 reported only mild pain, and 1 required release of plication sutures. That patient had a past surgical history significant for 2 penile operations and was the only one that required revision of any kind.

Conclusions
These results indicate that the average angle of correction per plication suture stays true even as larger numbers are used for complex deformity. Thus our previously-reported “five degree rule” holds up even under more challenging conditions. Penile plication without degloving is safe and effective for the treatment of complex Peyronie’s Disease deformities.

Funding: none