Introducing the ventral sealing technique using collagen fleece for surgical therapy of patients with ventral Peyronie's curvature: initial experience.

Abstract

Ventral penile curvature in Peyronie's disease (PD) is not very common but may lead to inability for sexual intercourse, especially in severe cases > 60°. Ventral curvatures are most often addressed surgically with plication owing to fear of urethral complications, as it requires the mobilisation of the urethra. In this study, the ventral sealing technique is introduced for correction of ventral curvatures in patients with PD. The surgical approach includes the mobilisation of the neurovascular bundle and the urethra. At the point of maximum curvature on the ventral aspect of the penis, a partial plaque excision is performed and the resulting tunical defect is sealed (closed) with a self-adhesive collagen fleece (TachoSil®, Baxter, IL, USA) that does not require suture fixation. Twelve patients with severe ventral curvature were included in this study. Mean penile curvature was 98.3° (sd ± 27.6, range: 60-150). Mean operative time was 99.2 minutes (sd ± 12.4, range: 80-130). Mean follow-up was 17.9 months (sd ± 8.0, range: 9-29). Ten out of 12 patients (83.3%) showed a totally straight penis. Two patients (16.7%) had a residual curvature of < 30°, which did not interfere with sexual intercourse. All patients were able to perform satisfying sexual intercourse. Initial results of the ventral sealing technique are encouraging. However, long-term data are necessary.