TUNICA VAGINALIS FLAP FOR THE MANAGEMENT OF DISABLING PEYRONIES-DISEASE - SURGICAL TECHNIQUE, RESULTS, AND COMPLICATIONS

Objectives. To discuss the surgical technique for tunica vaginalis flap (TVF) in the management of disabling Peyronie's disease and to evaluate the results and complications. Methods. Twelve patients underwent the TVF technique. Through a scrotal incision, the most dependent part of the tunica was dissected from the testicle and epididymis. The flap measured at least 4 cm in width and its upper extremity was left attached to the cremasteric muscle. Subsequently, the flap was brought underneath a groin skin bridge to cover the dorsal penile defect. Results. All patients were pain free. Seven patients (58.3%) were able to achieve a satisfactory erection with good vaginal penetration. Five patients (41.7%) were unable to perform sexually secondary to disabling chordee in 3 patients, glanular hypoesthesia in 1 patient, and venous leakage in 1 patient. Conclusions. TVF is an adequate alternative for correction of distortions of Peyronie's plaque in patients with disabling disease. TVF is at present our first choice in the management of this disease. If penetration is still impaired following recurrent curvature, a Nesbit ventral plication can be used as a secondary procedure. UROLOGY(R).