Tunica-sparing ossified Peyronie's plaque excision

Michael L. Eisenberg, James F. Smith, Alan W Shindel, Tom F. Lue

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Study Type - Diagnostic (non-consecutive series) Level of Evidence 3b What's known on the subject? and What does the study add? Peyronie's disease with heterotopic, ossified plaques require surgical removal. While conventional tunical excision techniques risk erectile and sensory compromise, we describe a tunical-sparing technique which maintains potency with durable results. OBJECTIVE Ossified Peyronie's plaques may require surgical excision because of the palpable problems and penile curvature that result. As tunical excision can result in impotence and decrease penile sensation, we describe a novel method of tunical preserving excision of such lesions. PATIENTS AND METHODS We evaluated 12 men with dorsal penile curvature between 10° and 90°. Penile plaque size ranged from 1 to 5 cm. 80% had painful erections. An artificial erection was induced with intracavernous injection of papaverine to assess penile deformity. Via a circumcising or ventral incision, plication sutures were placed to correct penile curvature. A lateral longitudinal corporotomy was made and the calcified/ossified portion was dissected free from the tunica albuginea/plaque of the corpora cavernosa. Watertight tunical closure was then performed. RESULTS Postoperatively, 80% of men reported erections always adequate for intercourse and normal sensation with a mean follow-up of 7 months (range 2.1-14.5 months). All patients required simultaneous penile plication to ensure a straight phallus. Pathologic evaluation of plaque specimens all showed bone fragments. CONCLUSION Tunica-sparing excision of the ossified/calcified portion of Peyronie's plaques shows a durable benefit for large, ossified lesions and maintains potency and penile sensation.

Original languageEnglish (US)
Pages (from-to)622-625
Number of pages4
JournalBJU International
Volume107
Issue number4
DOIs
StatePublished - Feb 2011
Externally publishedYes

Fingerprint

Penile Induration
Papaverine
Erectile Dysfunction
Sutures
Bone and Bones
Injections

Keywords

  • corpus cavernosum
  • curvature
  • erectile dysfunction
  • heterotopic ossification
  • peyronie's disease
  • plaque
  • tunica albuginea

ASJC Scopus subject areas

  • Urology

Cite this

Tunica-sparing ossified Peyronie's plaque excision. / Eisenberg, Michael L.; Smith, James F.; Shindel, Alan W; Lue, Tom F.

In: BJU International, Vol. 107, No. 4, 02.2011, p. 622-625.

Research output: Contribution to journalArticle

Eisenberg, Michael L. ; Smith, James F. ; Shindel, Alan W ; Lue, Tom F. / Tunica-sparing ossified Peyronie's plaque excision. In: BJU International. 2011 ; Vol. 107, No. 4. pp. 622-625.
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abstract = "Study Type - Diagnostic (non-consecutive series) Level of Evidence 3b What's known on the subject? and What does the study add? Peyronie's disease with heterotopic, ossified plaques require surgical removal. While conventional tunical excision techniques risk erectile and sensory compromise, we describe a tunical-sparing technique which maintains potency with durable results. OBJECTIVE Ossified Peyronie's plaques may require surgical excision because of the palpable problems and penile curvature that result. As tunical excision can result in impotence and decrease penile sensation, we describe a novel method of tunical preserving excision of such lesions. PATIENTS AND METHODS We evaluated 12 men with dorsal penile curvature between 10° and 90°. Penile plaque size ranged from 1 to 5 cm. 80{\%} had painful erections. An artificial erection was induced with intracavernous injection of papaverine to assess penile deformity. Via a circumcising or ventral incision, plication sutures were placed to correct penile curvature. A lateral longitudinal corporotomy was made and the calcified/ossified portion was dissected free from the tunica albuginea/plaque of the corpora cavernosa. Watertight tunical closure was then performed. RESULTS Postoperatively, 80{\%} of men reported erections always adequate for intercourse and normal sensation with a mean follow-up of 7 months (range 2.1-14.5 months). All patients required simultaneous penile plication to ensure a straight phallus. Pathologic evaluation of plaque specimens all showed bone fragments. CONCLUSION Tunica-sparing excision of the ossified/calcified portion of Peyronie's plaques shows a durable benefit for large, ossified lesions and maintains potency and penile sensation.",
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