Peyronie's disease: a modified treatment.
We evaluated 93 patients with complaints of sexual dysfunction and evidence of Peyronie's disease. Duplex ultrasonography (10-MHz probe and 4.5-MHz pulsed Doppler test) in 87 enabled definition of their penile vascular response to an intracorporeal injection of a vasoactive agent. Vascular disease was present in 70 percent of the study population. Forty-four patients had a surgical procedure. Nineteen had plications using a simultaneous pharmacological erection, 3 had dermal grafts, and 3 with severe vascular disease had primary placement of a prosthesis. One patient underwent a single Nesbit procedure. In 18 patients, we incised the plaque and grafted a segment of the deep dorsal vein, using the expertise gained from penile venous surgery. In the vein-grafted patients, rapid return of suppleness of the penile shaft, use of only a single incision, and use of the patient's own tissue, with the possible beneficial effect of endothelial-derived substances (nitric oxide) decreasing the risk of hematoma below the graft, support our belief that this modified technique may be superior to those presently in common use.
Brock
G
G
Department of Urology, University of California Medical School, San Francisco.
Kadioglu
A
A
Lue
T F
TF
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008875:Middle Aged; D010410:Penile Erection; D010411:Penile Induration / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D015917:Penile Prosthesis; D010413:Penis / Q000098:blood supply; D014463:Ultrasonography; D014656:Vascular Surgical Procedures / Q000379:methods; D014680:Veins / Q000637:transplantation