Corporoplasty with ossified plaque excision and surgisis graft
Ferreiro, C1; Torremadé, J2; Beato, S2; Pujol, L2; Cocera, R2; Riera, L2; Vigués, F2
1: Hospital Universitari de Bellvitge, Spain; 2: Hospital Universitari de Bellvitge
Objective: Penile corporoplasty with grafting technique is the preferred surgical treatment for stable Peyronie disease when curvature is >60º or when there is a complex curvature. This technique usually requires plaque incision, but in those cases with ossified plaque it could be necessary to perform plaque excision.
Material and Methods: We present the case of a 45 year old man, active smoker, with history of spontaneous pneumothorax, who came to our consultation with a 90º dorsal curvature. The disease started one year ago and it has been stable during the last 6 months, preserving the erectile function but being unable to penetrate. On the clinical examination, he presented a huge dorsal ossified plaque of 2 cm x 3 cm so we decided to make excision in it and to use a Surgisis graft. We perform circumcision, penile deglobing and opening of paraurethral Buck’s fascia. Dissection and lifting of the neurovascular bundle. Gittes’ test: dorsal curvature of 100º. We make excision of the ossified plaque. This result in a tunica albuginea defect which is posteriorly closed by a Surgisis graft. New Gittes’ test shows complete correction of the curvature. Finally, closing of Buck’s fascia, dartos and skin. At 12 months of follow up, he presents with complete resolution of the curvature, good erectile function being able to penetrate and refers satisfactory intercourse.
Conclusions: Plaque incision and grafting remains the gold standard for complex or severe curvatures. However, plaque excision is sometimes necessary, for example in the case of ossified plaques. Despite being a little bit more aggressive technique, the aesthetical and functional outcomes are similar to incision techniques.
Work supported by industry: no.Go Back