Vein grafting of tunical incisions combined with contralateral plication in the treatment of penile curvature

Abstract

Objective: To evaluate whether multiple incisions of Peyronie's plaque with placement of vein grafts to cover the tunical defects coupled with contralateral tunical plication is effective in straightening the penis while allowing preservation of normal erectile function.

Methods: Nine patients with Peyronie's disease and 2 patients with congenital curvature of the penis were surgically treated with a vein patch graft technique to correct their penile curvature. All patients underwent relaxing transverse incisions of their plaque with placement of a vein graft from the deep dorsal vein of the penis and/or the saphenous vein. Transverse relaxing incisions about 1 to 2 cm long were made on the tunica albuginea where a curvature was identified by an artificial erection. A corresponding size of the harvested vein was sewn into the defect created by the relaxing incisions. If there was evidence of a residual curvature after the vein grafts were sewn in, a plication of the contralateral surface of the tunica albuginea was performed.

Results: Of 10 patients who were potent preoperatively, 9 retained their potency post-operatively. Complete straightening of the erect penis occurred in 9 of 11 patients. Penile shortening occurred in three men. None of the patients permanently lost sensation in the shaft or glans of the penis. Two patients have anesthesia on part of the skin of the penile shaft. In all patients, the grafts were unable to straighten the penis 100 percent, thereby requiring at least one plication suture in the contralateral corpus.

Conclusions: The use of vein grafts to cover multiple incisions of the tunica albuginea combined with contralateral corporeal plication is an easy alternative and an effective way to treat penile curvature while attempting to preserve erectile function.