Introduction

The most successful treatment option of Peyronie's disease remains surgical, despite also being the most invasive. There are described several techniques for the correction of penile curvature, being technically demanding those in which grafts are used. We present our initial experience and preliminary results of partial plaque incision and grafting with self-adhesive film containing collagen combined with PPI (inflatable or malleable) in the treatment of Peyronie's disease.

Methods

Between January 2015 and August 2016 we operated 14 patients using this technique, six by implantation of a malleable prosthesis and the other eight with inflatable. Five of them kept proper erectile function and three had significant shortening of the penis without curvature. Four of them had been previously operated: one inflatable prosthesis + modeling; and other with sequelae after simple plication. The mean presurgical PDQ PD bother score was 9.7(8-12). Surgery was performed in the case of malleable through a single incision (with penile degloving) while IPP was performed either by 2 incisions (scrotal + penile degloving) or through a single incision (Kulkarni approach). Curvature correction was made by partial plaque incision with an H modified technique in the area of maximum curvature (or corporeal relaxing incisions) and placing a patch without suturing, covering prosthethic material.

Results

The mean operative time was 69 (55-85) min. The mean postsurgical penile lengthening was 4.5 (3-6) cm. There was an improvement in PDQ PD bother score of 4.5(2-5) points. No patients had hematoma, glans isquemia or any infectious complications. All patients showed good capability of penetration and correction of the penile curvature (<10 grades of residual curvature in the seven patients) 3 months after surgery. Six patients had glans hypoestesia at this time, while after the first three months, only 3 of them remains symptomatic. The overall satisfaction rate was of 90%.

Conclusions

In our experience, plaque incision and collagen fleece grafting during penile prosthesis implantation seems to be a safe and reproducible technique that yelds higher satisfaction rates and greater penile lengthening than prosthesis implantation alone. Also this technique could be consider in the management of sequalae after PD surgery.

Funding

None