surgical correction of peyronie's disease via tunica albuginea plication or partial plaque...
TRANSCRIPT
Surgical Correction of Peyronie’s Disease via Tunica AlbugineaPlication or Partial Plaque Excision with Pericardial Graft:Long Term Follow-Up: An Editorial Comment
DOI: 10.1111/j.1743-6109.2008.00943.x
This is an excellent article on two surgical tech-niques to straighten the penis in Peyronie’sdisease. As with other series it is evident that graft-ing, be it autologous or extracellular matrix grafts,is associated with a significant risk of erectile dys-function (ED) and a risk of some penile shortening[1,2]. In this article, 32% had worsening erectionsand 21% new onset of ED after a grafting proce-dure. There was an objective loss of length in 33%in the grafting group with 22% wishing that theyhad not had the operation.
It is clear, however, that patients who request agrafting technique usually have more severe PDwith a more significant curvature and are moreconcerned about length loss. It is, therefore, notsurprising that satisfaction is less than in the pli-cation group.
As patients with PD have significant risk factorsfor “de novo” ED at presentation, there is a sig-nificant risk that this may get worse when a graft-ing technique is performed [3].
The article highlights that in advanced andsevere disease it may therefore be better to insert a
penile prosthesis that straightens the penis andcorrects any ED while minimizing loss of length.
Informed consent is therefore imperative sothat patients can have real expectations and thenhopefully satisfaction improved.
David RalphInstitute of Urology, London, UK
References
1 Kovac JR, Brock GB. Surgical outcomes and patientsatisfaction after dermal, pericardial, and small intes-tinal submucosal grafting for Peyronie’s disease. J SexMed 2007;4:1500–8.
2 Kadioglu A, Sanli O, Akman T, Ersay A, Guven S,Mammadov F. Graft materials in Peyronie’s diseasesurgery: A comprehensive review. J Sex Med 2007;4:581–95.
3 Bella AJ, Perelman MA, Brant WO, Lue TF. Peyro-nie’s disease (CME). J Sex Med 2007;4:1527–38.
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© 2008 International Society for Sexual Medicine J Sex Med 2008;5:2229