(410) Multiple Slit Incisions with Tachosil® Grafting for Treatment of Peyronie’s Disease and ED

Abstract

Abstract Introduction Plaque incision or partial excision with collagen fleece grafting and IPP implantation is a well-established treatment for severe penile curvatures associated with ED. Nevertheless, multiple plaque incisions combined with Tachosil® grafting may have added advantages. Objective We demonstrate step-by-step the treatment of a case of severe ED with an over 60 degree dorsal curvature mainly on the left side and an hour glass indentation on the right side of the penile shaft. We highlight the advantages of multiple plaque incisions and Tachosil® grafting combined with IPP implantation for these specific cases. Methods After IPP implantation via the penoscrotal approach, the neurovascular bundle was mobilized. For the left sided curvature we underwent multiple deep transverse slits starting from and around the point of maximum curvature using a low energy cutting current (20 to 30 Watts). Our transverse incisions were complimented with the modeling technique. For the right sided waist formation we underwent longitudinal slits. The area of incisions was covered by a Tachosil® graft. Results The multiple horizontal incisions led to a vertical release thus straightening of the curved penile shaft. Longitudinal slits led to a horizontal release, therefore expanding and obliterating of the waist formation. Conclusions The multiple slit technique together with Tachosil® grafting may have added advantages compared to the conventional plaque incision/excision utilizing the same graft. The smaller defects created by the multiple tunical incisions may avoid potential cylinder protrusion, facilitate better sealing of the collagen fleece, lower the incidence of hematoma and/or infections and allow complimentary modeling of the penis. Moreover, complex deformities may also be treated simultaneously with success. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Coloplast.