T05-P-08 Intracavernal excision of plaque for Peyronie's disease: a preliminary report

Abstract

Objective outside of the growing problem on the ideal graft after plaque excision, the polish colleague Darewicts publishes his surgical experience of intracavernal ablation of plaque requiring no grafting additional procedure. We verified possibilities and limits of the technique. Methods the operation can be perforrne under every kind of anaesthesia. We prefer local anaesthesia with Bupivacaine 5% 20 ml. After coronal incision, penile degloving exposes urethra and the corpora cavernosa. Just on the corpora where the plaque is more extended, remaining few millimetres laterally, albuginea is incised all along it, for all its thickness reaching the erectile tissue. Pressing with a finger outside the corpora the plaque is then exposed and carefully excised by scalpel or scissor, keeping intact the overlaying tunica albuginea, then the corpora is sutured. The geometrical result in terms of straightening is then checked by hydraulic artificial erection. N.12 selected patients underwent the operation. Results with 6 to 18 months follow up the outcomes are effective both in terms of straightening and erection. Minimal skin haematoma, mild decrease of gland sensibility as well as some hardness at the side of corpora operation or pain in erection can appear but quickly and confortably disappear in comparison with traditional procedures. Conclusions our experience is limited, nethertheless it is easy to appreciate the advantages of this technique: no nerve-vascular bundle to be isolated, no graft, only one cavernosal suture, local anaesthesia and hospitalization-day management, less complications, more satisfaction of the patients for quicker and confortable restoration of sexual function.