EVALUATION OF CORPORA ALTERATIONS AND ERECTILE DYSFUNCTION FOLLOWING RADICAL SURGERY FOR PEYRONIES-DISEASE AND LONG-TERM FOLLOW-UP ON 152 OPERATED PATIENTS

The radical surgical option we propose for Peyronie's disease consists in removing the sclerohyalinotic focus of disease and replacing it by an autologous dermal graft taken from the upper outer thigh area. Bet ween 1981 and 1991, we operated on 335 patients with Peyronie's diseas e, 152 of whom underwent plaque excision and dermal graft. All could b e assessed with a 2-year followup. Two main complications were observe d: mild penile flexure due to scar retraction of the graft (35% of cas es), and partial erectile deficit with decreased corporal rigidity (17 % of cases). The degree of graft retraction is linked to the individua l's histologic response. A mild deviation of the penis can occur some months after surgery and is not a relapse flexure due to disease progr ession, but is mere scar retraction and will spontaneously regress. Be cause the patient will date the onset of a postoperative erectile defi cit from the time of the operation, it is advisable to assess preopera tively the erectile ability of all patients. Furthermore, an impaired erectile response could result from hypoaesthesia of the glans, postsu rgical stress, and fibrosis of the erectile tissue. A retrospective as sessment of radical surgery cases involving plaque excision and dermal graft led us to propose this option where precise indications apply, providing that other alterations of the erectile function are preopera tively assessed.