The penile disassembly technique in the surgical treatment of Peyronie's disease

Objective To present an approach for treating Peyronie's disease. using the penile disassembly technique for reconstructive surgery. Patients and methods From November 1996 to September 2000. 74 patients with Peyronie's disease were treated surgically. The penile disassembly techniq ue was used in 46 of the patients mean age 51 years, range 21-63). The indi cations were severe penile deviation under the glans cap, plaque in the dis tal third of the corpora cavernosa with the 'hour-glass' phenomenon, and mo re than one plaque at different sites. The corporal bodies are separated fr om the glans, neurovascular bundle and urethra. The technique enables the c omplete preservation of all structures of the neurovascular bundle, especia lly if it is incorporated into the plaque. The method provides an excellent approach to the repair of all deformities on the completely free corpora c avernosa and that are affected by the plaque. In the plaque region, incisio nal grafts are placed using full-thickness penile skin or saphenous vein. T he technique also enables reduction corporoplasty, i.e. amputation of the t ips of the corpora cavernosa that include plaque, in those with sufficient penile length. Penile re-assembly involves joining the glans, neurovascular bundle, urethra and repaired corpora cavernosa into their normal anatomica l relationships. Results The mean (range) follow-up was 27 (6-53) months. The penis was comp letely straightened in 40 patients (87%) but the deviation recurred in six. In four patients the deformity was <10<degrees> and in two was <20<degrees >. Penile shortening occurred in 9% of the patients. There was no evidence of inflammation or infection after surgery. There were no injuries of eithe r the neurovascular bundle or urethra. Conclusion The penile disassembly technique could be a good alternative to other surgical techniques in treating selected patients with Peyronie's dis ease; it allows an excellent approach to penile deformities which can then be easily and safely corrected.