title: The combination of vein grafting and two different types of corporeal plication in complex curvature due to Peyronie's disease.
abstract: BACKGROUND
  This study aimed to investigate the surgical results of incision and vein grafting combined with two types of plication sutures, including Essed-Schroeder and longitudinal imbrication, to correct the cavernous sacculation in complex curvature resulting from Peyronie's disease.
  
  
  METHODS
  Between 2004 and 2008, 15 patients with complex curvature resulting from Peyronie's disease were surgically treated. Essed-Schroeder plication and venous grafting were performed in 10 patients. Five of the 15 patients had cavernous sacculation, which was defined as albugineal elongation, except for the normally morphological cavernosal structure, which caused some degree of penile torsion beside the angulation. Surgery was used to establish sufficient cosmetic results by performing longitudinal imbrication on the cavernous sacculation on the same side as that of the Essed-Schroeder plication combined with venous grafting in these five patients.
  
  
  RESULTS
  Complete penile straightening was achieved in all the patients. Two patients (13.3%) reported penile shortening without showing dissatisfaction about it. One patient complained of anesthesia on part of the skin of the penile shaft. All the patients were satisfied with the final surgical results.
  
  
  CONCLUSIONS
  A combination of the surgical methods might be necessary to correct the complex deformities due to Peyronie's disease. Further studies with larger patient populations are needed to standardize these procedures.
authors.affiliation: Department of 2nd Urology, Clinic of Ankara Atatürk Training and Research Hospital, Ankara, Turkey. kayigilo@yahoo.com.tr
authors.forename: Onder
authors.initials: O
authors.lastname: Kayigil
authors.forename: Koray
authors.initials: K
authors.lastname: Agras
authors.forename: Mustafa
authors.initials: M
authors.lastname: Aldemir
authors.forename: Emrah
authors.initials: E
authors.lastname: Okulu
mesh_terms: D000328:Adult; D006801:Humans; D008297:Male; D008875:Middle Aged; D010411:Penile Induration / Q000601:surgery*; D013536:Suture Techniques; D013521:Urologic Surgical Procedures, Male / Q000379:methods; D014680:Veins / Q000637:transplantation*