Venous patch graft for Peyronie's disease. Part II: Outcome analysis

Purpose: We evaluate the results of tunical incision and venous patch grafting for correcting penile deformity in Peyronie's disease. Materials and Methods: In 112 patients with symptoms of Peyronie's disease for more than a year indications for surgery included penile shortening, persistent pain, severe curvature, penile narrowing or indentation and/or failure of previous surgery. Preoperative evaluation included determination of patient and partner expectation, potency status, circumcision status, measurement of penile length (short and long side) and saphenous vein, and color duplex ultrasonography to evaluate possible accessory vascular communication. Patients underwent plaque incision and venous patch grafting. The configuration, size and number of tunical incisions depended on the size and shape of the lesion. Lower and upper saphenous, and deep dorsal veins served as the graft materials. Postoperative followup was as long as 18 months. Results: In 96% of patients the penis became straight, while residual curvature was 30 degrees in 3% and 15 degrees in 1%, In 94% of patients narrowing and indentation were absent and in 83% penile length was the same or longer postoperatively. Of the patients who were potent preoperatively 88% experienced the same or better erectile quality after surgery. In 10% of cases a change in sensation occurred lasting longer than 6 months. Overall satisfaction was expressed by 92% of men who believed that surgery improved the psychological state as well as the relationship with the partner. Conclusions: The. results are satisfactory and this procedure offers a reasonable solution for correction of Peyronie's disease.