Surgical Treatment of Peyronie's Disease by the Intracavernosal Plaque Excision Method: A New Surgical Technique

Darewicz, J; Darewicz, Barbara; Gałek, L; Kudelski, Jacek; Badri, B.M.A.

doi:10.1016/j.eururo.2003.05.001

Cited by 10 publications

(3 citation statements)

References 19 publications

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“…While other authors have described this technique for plaques, we describe expansion of this principal to include excision of penile heterotopic ossification [14,15]. In addition, we were able to excise lesions of up to 5 cm as well as those with spikes embedded in the septum.…”

Section: Discussionmentioning

confidence: 92%

Tunica‐sparing ossified Peyronie’s plaque excision

2010

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Study Type – Diagnostic (non‐consecutive series) Level of Evidence 3b What’s known on the subject? and What does the study add? Peyronie’s disease with heterotopic, ossified plaques require surgical removal. While conventional tunical excision techniques risk erectile and sensory compromise, we describe a tunical‐sparing technique which maintains potency with durable results. OBJECTIVE Ossified Peyronie’s plaques may require surgical excision because of the palpable problems and penile curvature that result. As tunical excision can result in impotence and decrease penile sensation, we describe a novel method of tunical preserving excision of such lesions. PATIENTS AND METHODS We evaluated 12 men with dorsal penile curvature between 10° and 90°. Penile plaque size ranged from 1 to 5 cm. 80% had painful erections. An artificial erection was induced with intracavernous injection of papaverine to assess penile deformity. Via a circumcising or ventral incision, plication sutures were placed to correct penile curvature. A lateral longitudinal corporotomy was made and the calcified/ossified portion was dissected free from the tunica albuginea/plaque of the corpora cavernosa. Watertight tunical closure was then performed. RESULTS Postoperatively, 80% of men reported erections always adequate for intercourse and normal sensation with a mean follow‐up of 7 months (range 2.1–14.5 months). All patients required simultaneous penile plication to ensure a straight phallus. Pathologic evaluation of plaque specimens all showed bone fragments. CONCLUSION Tunica‐sparing excision of the ossified/calcified portion of Peyronie’s plaques shows a durable benefit for large, ossified lesions and maintains potency and penile sensation.

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Section: Discussionmentioning

confidence: 92%

Tunica‐sparing ossified Peyronie’s plaque excision

2010

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“…In 2004, Darewicz et al published an alternative approach in which intracavernosal dorsal plaque excision was performed without grafting on 16 men [71]. The operation consisted of incising the corpus cavernosum parallel to the plaque and away from the neurovascular bundles, and through this incision, removing the plaque from the inside without incising or replacing the underlying tunica albuginea, which is then closed.…”

Section: Excisional Proceduresmentioning

confidence: 99%

Peyronie's Disease: Evolving Surgical Management and the Role of Phosphodiesterase 5 Inhibitors

Al-Shaiji

Brock²

2009

The Scientific World JOURNAL

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Peyronie's disease (PD) is a fibrotic disorder of the tunica albuginea of the penis. It is characterized by different degrees of penile curvature and sexual dysfunction. Several medical treatments have been employed to manage the disorder, with variable success rates. Surgical therapy is reserved for patients with severe penile deformity that fails to improve with medical treatment and impedes coital function. The advantages and disadvantages of various surgical approaches have long been debated. Herein, we describe the evolving surgical techniques for PD using knowledge obtained from the contemporary literature. In addition, we discuss the emerging data regarding the role of phosphodiesterase 5 inhibitors in the management of PD.

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“…Despite the open and actual debate about the ideal graft to be used after plaque excision in Peyronie's disease treatment, the Polish colleague Darewicz published his surgical experience of endocavernous plaque excision avoiding any substitutive graft (1). By an incision on the albuginea close to the plaque, the fibrotic tissue can be exposed and after its removal the incision is sutured.…”

Section: Introductionmentioning

confidence: 99%