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.
Department of Urology, University of California Medical School, San Francisco.
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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