VENOUS PATCH GRAFT FOR PEYRONIES-DISEASE - PART II - OUTCOME ANALYSIS

Purpose: We evaluate the results of tunical incision and venous patch grafting for correcting penile deformity in Peyronie's disease. Materi als and Methods: In 112 patients with symptoms of Peyronie's disease f or more than a year indications for surgery included penile shortening , persistent pain, severe curvature, penile narrowing or indentation a nd/or failure of previous surgery. Preoperative evaluation included de termination of patient and partner expectation, potency status, circum cision status, measurement of penile length (short and long side) and saphenous vein, and color duplex ultrasonography to evaluate possible accessory vascular communication. Patients underwent plaque incision a nd venous patch grafting. The configuration, size and number of tunica l incisions depended on the size and shape of the lesion. Lower and up per saphenous, and deep dorsal veins served as the graft materials. Po stoperative followup was as long as 18 months. Results: In 96% of pati ents the penis became straight, while residual curvature was 30 degree s in 3% and 15 degrees in 1%, In 94% of patients narrowing and indenta tion were absent and in 83% penile length was the same or longer posto peratively. Of the patients who were potent preoperatively 88% experie nced the same or better erectile quality after surgery. In 10% of case s a change in sensation occurred lasting longer than 6 months. Overall satisfaction was expressed by 92% of men who believed that surgery im proved the psychological state as well as the relationship with the pa rtner. Conclusions: The. results are satisfactory and this procedure o ffers a reasonable solution for correction of Peyronie's disease.