Ez. Moriel et al., VEIN GRAFTING OF TUNICAL INCISIONS COMBINED WITH CONTRALATERAL PLICATION IN THE TREATMENT OF PENILE CURVATURE, Urology, 43(5), 1994, pp. 697-701
Objective. To evaluate whether multiple incisions of Peyronie's plaque
with placement of vein grafts to cover the tunical defects coupled wi
th contralateral tunical plication is effective in straightening the p
enis while allowing preservation of normal erectile function. Methods.
Nine patients with Peyronie's disease and 2 patients with congenital
curvature of the penis were surgically treated with a vein patch graft
technique to correct their penile curvature. All patients underwent r
elaxing transverse incisions of their plaque with placement of a vein
graft from the deep dorsal vein of the penis and/or the saphenous vein
. Transverse relaxing incisions about 1 to 2 cm long were made on the
tunica albuginea where a curvature was identified by an artificial ere
ction. A corresponding size of the harvested vein was sewn into the de
fect created by the relaxing incisions. If there was evidence of a res
idual curvature after the vein grafts were sewn in, a plication of the
contralateral surface of the tunica albuginea was performed. Results.
Of 10 patients who were potent preoperatively, 9 retained their poten
cy postoperatively. Complete straightening of the erect penis occurred
in 9 of 11 patients. Penile shortening occurred in three men. None of
the patients permanently lost sensation in the shaft or glans of the
penis. Two patients have anesthesia on part of the skin of the penile
shaft. In all patients, the grafts were unable to straighten the penis
100 percent, thereby requiring at least one plication suture in the c
ontralateral corpus. Conclusions. The use of vein grafts to cover mult
iple incisions of the tunica albuginea combined with contralateral cor
poreal plication is an easy alternative and an effective way to treat
penile curvature while attempting to preserve erectile function.