You have accessJournal of UrologyInfertility, Infection, Erectile Dysfunction & Trauma1 Apr 2011V1557 SURGICAL TREATMENT OF PEYRONIE'S DISEASE BY INCISION AND GRAFTING Niels Johnsen, Brian Richardson, Limin Ma, and Wayne Hellstrom Niels JohnsenNiels Johnsen New Orleans, LA More articles by this author , Brian RichardsonBrian Richardson New Orleans, LA More articles by this author , Limin MaLimin Ma New Orleans, LA More articles by this author , and Wayne HellstromWayne Hellstrom New Orleans, LA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1580AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Peyronie's disease is an idiopathic connective tissue disorder of the penis. Growth of fibrous plaques can result in abnormal penile curvature and subsequent erectile dysfunction. While medical and intralesional injection therapies are used, surgical management remains the gold standard. A number of different surgical techniques have been used in the treatment of Peyronie's disease, such as wedge resection, incision and grafting, and placement of a penile prosthesis with additional ancillary procedures. In this video, we review our technique of incision and grafting for the treatment of severe Peyronie's disease. METHODS The surgical technique of incision and grafting for Peyronie's disease is examined in its entirety. A history of Peyronie's disease is discussed, followed by explanation of pathophysiology and subsequent erectile dysfunction. Selection of potential candidates is examined in relation to degree of curvature and adequacy of cavernosal arterial inflow. Strategic aspects of this surgical procedure are shown with a careful description of techniques employed and materials used. In this particular video, we examine the use of human cadaveric pericardial grafts or porcine small intestine submucosal grafts for the grafting of tunical defects after incision or excision of the plaque. Post-operative management, including use of phosphodiesterase type 5 inhibitors and penile stretching devices, is discussed briefly. RESULTS The use of the incision and grafting technique for the treatment of severe Peyronie's disease has shown functional and anatomical benefits in properly selected patients. Patients are discharged for outpatient follow-up and report manageable postoperative discomfort. Post-operative artificially induced erections in the majority of patients show absence of penile curvature and most patients report a return of spontaneous erections within a few weeks, with resumption of sexual intercourse in an average of 6 weeks. CONCLUSIONS Though technically demanding, surgical incision and grafting procedures provide excellent results with minimal complications for the treatment of severe Peyronie's disease. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e625 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Niels Johnsen New Orleans, LA More articles by this author Brian Richardson New Orleans, LA More articles by this author Limin Ma New Orleans, LA More articles by this author Wayne Hellstrom New Orleans, LA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...