Extratunical Grafting and Penile Plication for Peyronie's Disease

Abstract

ABSTRACT Introduction Extratunical grafting is a surgical option for men with Peyronie's disease who have an hourglass deformity or indentation defect. Rather than necessitating neurovascular bundle elevation and tunical incision, the procedure can be done without mobilization of the bundle. This benefit limits the risk of de novo erectile dysfunction and glans hypoesthesia. Here we present a case of a penile plication combined with extratunical grafting for a man with dorsal curvature and a right sided indentation defect. Objective To present a video presentation of extratunical grafting during penile plication for Peyronie's disease Methods An artificial erection is done to confirm the location and extent of the penile deformity and curvature. A midline ventral penile incision is made and carried down to the tunica albunigea as is standard for a penile plication. A penile plication is performed with 2-0 polyester suture to correct the dorsal curvature. At the site of the indentation defect, a pericardium allograft is doubly-folded on itself and sewn to the tunica albuginea. The indentation repair is demonstrated, and the surgical site is closed. Results The patient reports high satisfaction with the indentation correction and improvement in dorsal curvature with no new erectile dysfunction or hypoesthesia. Conclusions Extratunical grafting is a viable, straightforward option for men with Peyronie's disease and indentation defects or an hourglass deformity that can be combined with penile plication to treat symptomatic men. Disclosure No