Soft prosthesis implant and relaxing albugineal incision with saphenous grafting for surgical therapy of Peyronie's disease: a 5-year experience and long-term follow-up on 145 operated patients.
BACKGROUND
Most surgical therapies used to date for Peyronie's disease produce good results but cause penis retraction. The authors propose a personal surgical technique that makes use of an intracavernous cylinder, soft but axially rigid in consistency, in association with tunical relaxing incisions and saphenous vein grafting, in this exact sequence.


METHODS
Between March 1997 and March 2003, 145 patients presenting with Peyronie's disease underwent this 3-phase personal surgical procedure. Complete plaque excision was necessary only for 13 patients (8.9%); in the remaining 132, a single incision was placed in 113 cases (77.9%) and double incisions were used for 19 patients (13.1%). Penile length was measured intraoperatively, after drug-hydraulic erection, then at the later control visits. Distance follow-up ranged from a minimum of 6 months to a maximum period of 3 years (mean 13 months); the latter follow-up period was possible for 38 patients. All patients and partners with at least one year follow-up were asked to answer a questionnaire administered over the telephone at 12 months post-surgery.


RESULTS
Average penile lengthening was approximately 1.5 cm. 80 patients answered the questionnaire (70.75%): 76 expressed complete satisfaction, while 4 patients reported glans paresthesia. No major complications were noted; for 8 patients circumcision was repeated because of preputial edema. In 6 cases there was a local, postoperative infection, that was treated conservatively with a prolonged antibiotic therapy.


CONCLUSIONS
This technique allows to successfully solve penile retraction, caused by traditional surgery for Peyronie's disease. The technique is easy to carry out, has low risks of complications and ensures very high rates of patient satisfaction.
Austoni
Edoardo
E
Department of Urology, Fatebenefratelli S. Giuseppe Hospital, Via San Vittore, 12, 20123 Milan, Italy. urologia.sgiuseppe@oh-fbf.it
Colombo
Fulvio
F
Romanò
Ai Ling
AL
Guarneri
Andrea
A
Kartalas Goumas
Ioannis
I
Cazzaniga
Alberto
A
D000328:Adult; D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019935:Penile Implantation / Q000379:methods*; D010411:Penile Induration / Q000601:surgery*; D015917:Penile Prosthesis; D010413:Penis / Q000601:surgery; D012501:Saphenous Vein / Q000637:transplantation*; D016896:Treatment Outcome