CORRECTIVE PROCEDURES FOR PENILE SHORTENING DUE TO PEYRONIES-DISEASE

Peyronie's disease is a poorly understood scarring condition of the tu nica albuginea that often causes pain and deformity of the penis. When Peyronie's disease is present predominantly unilaterally, bending of the penis to 1 side occurs. With bilateral or circumferential disease the tunica albuginea does not expand, and penile shortening and/or nar rowing occurs. We performed unilateral or bilateral penile lengthening procedures on 22 patients with penile shortening due to Peyronie's di sease who refused a procedure, such as tucks or the Nesbit operation, that might result in further penile shortening. Five men underwent inc ision of the plaque and dermal patch without implantation of a penile prosthesis, while 8 underwent penile implantation plus incisions in th e tunica albuginea without patches, and 5 underwent circumferential in cision of the tunica albuginea and its septum with patching and placem ent of a penile implant. (Average length gain with circumferential inc ision was 1.5 inches with this procedure.) There were 18 patients avai lable for followup: 1 had penile skin slough secondary to a compressio n dressing, 2 required removal of the implant and replacement at a lat er date, and 2 had progressive penile shortening after dermal patch re quiring subsequent prosthesis implantation. Penile lengthening procedu res to correct functionally significant penile shortening can be perfo rmed successfully, although significant complications were experienced .