Peyronie's Disease: Endocavernous Plaque Excision without Substitutive Graft: Critical 5-year Experience

Abstract

In 2004, the Polish colleague Darewicz published his surgical experience of endocavernous plaque excision avoiding the use of any substitutive graft. Attracted by the extreme simplification in this new technique, we decided to verify such a surgical approach. The separation of the plaque from the overlying albuginea is performed with scissors or scalpel. Once the plaque is removed, the cavernous incision is sutured and the correct straightening is verified. In 5 years, we selected 24 cases of stabilized disease and preserved erection geometrically disturbed by the severe deformity. We obtained substantial straightening in all cases, even if in 3 cases we added a complementary minimally invasive surgery in the form of a plication, and 2 cases were converted into a graft technique. Case studies and current controls allow us to say that the impression is quite good, without the need of autologous tissue or heterologous matrices to be inserted, allowing a more comfortable post-operative course and a faster and easier functional recovery.