1078 THE COMBINATION OF VEIN GRAFTING AND TWO DIFFERENT TYPES OF CORPOREAL PLICATION IN COMPLEX CURVATURE DUE TO PEYRONIE'S DISEASE

Abstract

You have accessJournal of UrologySexual Function/Dysfunction/Andrology: Peyronie's Disease/Surgical Therapy I1 Apr 20101078 THE COMBINATION OF VEIN GRAFTING AND TWO DIFFERENT TYPES OF CORPOREAL PLICATION IN COMPLEX CURVATURE DUE TO PEYRONIE'S DISEASE Onder Kayigil, Mustafa Aldemir, and Emrah Okulu Onder KayigilOnder Kayigil More articles by this author , Mustafa AldemirMustafa Aldemir More articles by this author , and Emrah OkuluEmrah Okulu More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.2237AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES This study aimed to investigate the surgical results of incision and vein grafting combined with two types of plication sutures including Essed-Schroder and longitudinal imbrication to correct the cavernous sacculation in complex curvature due to Peyronie's disease. METHODS Sixty one patients with Peyronie's disease were surgically treated between 2004-2008 to correct penile curvature.Twenty of the patients had complex curvature of more than 1 direction causing penile torsion.The degree of penile angulation was >50° in all the patients.Eight of the 20 patients had cavernous sacculation which was defined as a new concept including albugineal elonguation except the normally morphological cavernosal stricture diagnosed intraoperatively and thus to establish sufficient cosmetic result,longitudinal imbrication on the cavernous sacculation combined with the venous grafting and Essed-Schroder plication was performed in these patients as a new surgical technique.All the patients were asked to answer the IIEF questionnaire pre and postoperatively. RESULTS The mean follow up period was 21 months. No operative complications were observed.The mean total IIEF score was 45.6±4.2 before operation, and it was reported to be 58±5.4 at the end of the follow up.Complete penile straightening was achieved in all the patients.Two patients reported penile shortening without expressing any dissatisfaction about it.One patient complained of anesthesia on part of the skin of the penile shaft.All the patients were satisfied with the final surgical results. CONCLUSIONS This approach differs from other techniques since all of the patients had Peyronie's plaque at the opposite side to the curvature, one standard tunical plication suture was used at the beginning of the correction in order to avoid extensive tunical incision and venous patch on the other side to correct residual curvature.We observed cavernous sacculation especially in the patients with complex curvature and defined this concept as albugineal elonguation except the normally morphological cavernosal stricture which caused some degree of torsion beside the angulation.We didn't satisfied with the final cosmetic results unless having performed longitudinal imbrication sutures in a group of these eight patients and performed this technique beside the venous patch and Essed-Schroder plication sutures.Combination of the surgical methods may be necessary to correct the complex deformities. Further studies with larger patient populations are needed to standardize these procedures. Ankara, Turkey© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e420 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Onder Kayigil More articles by this author Mustafa Aldemir More articles by this author Emrah Okulu More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...