Abstract

OBJECTIVE To assess plaque incision and venous grafting (the Lue procedure) to correct the deformity associated with Peyronie's disease and to maintain penile length, evaluating the results over an 8-year period. PATIENTS AND METHODS The penile deformity of 113 patients (mean age 45 years, range 17-71) with Peyronie's disease was corrected by plaque incision and saphenous vein grafting. All patients had stable Peyronie's disease and had a mean (range) penile deformity of 64.5 (20-180) degrees; the mean follow-up was 12 months. RESULTS The result was excellent or satisfactory in 105 patients (93%), and the penis completely straightened in 97 (86%). Erectile dysfunction after surgery developed in 10 of 68 potent patients (15%) although they had arterial risk factors of diabetes, hypertension or cardiac disease that may also have contributed. There was penile shortening of > 1 cm in 29 men (25%) but this only prevented intercourse in two. Of the 51 patients with > or = 5 years of follow-up, the penis remained completely straight in 80% but the incidence of erectile dysfunction increased to 22.5% and penile shortening of > 1 cm to 35%. CONCLUSION The Lue procedure is an effective long-term option in the surgical management of Peyronie's disease, but penile shortening after surgery remains a risk, and patients with vascular risk factors must be warned of the possibility of later erectile dysfunction.

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