Peyronie's disease - Incision and dorsal vein grafting combined with contralateral plication in straightening the penis

Objectives: To evaluate the effectiveness of incisions of Peyronie's plaque and vein grafting combined with contralateral plication to straightening t he penis. Patients and methods: Twenty-four patients with Peyronie's disease were tre ated surgically with a vein patch grafting technique to correct penile curv ature. Median penile deviation was 70 degrees (range 60-90 degrees), in 1 p atient curvature was 30 degrees and all were unable to have normal sexual i ntercourse. The deep dorsal vein was excised and opened longitudinally. Tra nsverse relaxing incisions about 1-2 cm long were made on the plaques at th e point of maximal curvature, then, two other lateral incisions were made o n both ends at 3 and 9 o'clock. The endothelial side of the harvested vein was placed in contact with the cavernous tissue to cover the defect created . Application of the contralateral surface of the tunica albuginea was perf ormed in 21 cases to straighten the penis. Results: After a median follow-up of 24 months, 19 patients were able to pe rform sexual intercourse, 3 patients who required intracavernous injection to maintain erection presented pre-operative adverse factors affecting erec tile function, patient; returned to baseline pre-operative curvature. Twelv e patients reported penile shortening, although only 5 patients were concer ned about it. None of the patients permanently lost sensation in the glans of the penis. Palpable knots on the site of plication were reported in 5 pa tients. Conclusions: Plaque incision and placement of a deep dorsal vein patch graf t, combined with contralateral corporeal plication, is a relatively simple, safe and effective alternative to correct angulations greater than 60 degr ees.