Experience of surgical treatment of peyronie's disease with deep dorsal venous patch graft in Taiwanese men.
BACKGROUND
Using venous graft to repair the defect of tunica cavernosal plaque incision has been a mainstay of surgical intervention for Peyronie's disease. The greater saphenous vein is generally believed to be the graft of choice. However, the increased discomfort as well as the chance of morbidity in harvesting saphenous vein is occasionally reported. The other alternative for donor vein graft is from the deep dorsal vein of the penis. The major concern in using the deep dorsal vein is its lack of thickness and its limitation in the size to cover the defect. This study is to assess the feasibility of the deep dorsal vein graft in repairing the defect after plaque incision for Peyronie's disease in Taiwanese men.


METHODS
Twenty-four men of Peyronie's disease were included from 1992 to 2001 in our institution. The mean age was 56.3 years (range 51-70). All patients underwent tunica plaque incision and deep dorsal vein patch grafting. The mean followup was 2.6 years (range 1-8). Penile straightness, potency status and possible complications after this procedure were evaluated during the followup.


RESULTS
The location of the plaque(s) was at left lateral penile shaft for 10 patients, right lateral for 6, ventral for 5 and dorsal for 3. The mean curvature angle was 45 degrees (range 35 degrees - 75 degrees). The penis became straight in 23 out of 24 (96%) of the patients after the operation, while the other one had a residual curvature about 20 degrees. Twenty-three patients (96%) remained similar potency as in preoperative status. The other one had less rigidity but can still accomplish successful intercourse. Three patients experienced sensation change at the glans, and it recovered gradually within 8 months. They were all satisfied with the operation.


CONCLUSIONS
Deep dorsal vein patch harvested from patients' own penis had a satisfied outcome from a Taiwanese cohort. For smaller Peyronie's defect, especially in Asian men, deep dorsal vein patch is a graft of choice.
Hsu
Yen-Shen
YS
Division of Urology, Department of Surgery, Taipei Veterans General Hospital, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.
Huang
William J
WJ
Kuo
Junne-Yih
JY
Chung
Hsiao-Jen
HJ
Chen
Kuang-Kuo
KK
Chang
Luke S
LS
D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D010411:Penile Induration / Q000601:surgery*; D010413:Penis / Q000098:blood supply* / Q000601:surgery*; D014680:Veins / Q000637:transplantation