Peyronie's disease: surgical correction of 40 patients with relaxing incision and duramater graft.

Abstract

Assessment of a long-term follow-up of a previously described technique to correct the curvature of the penis in Peyronie's disease. Forty patients (43-69 years old) were operated between 1989 and 1999. The eligibility criteria for surgery were: lesion stabilised during, at least, one year; angulation of 40 degrees or more; and difficult or impossible sexual intercourse. Moreover, the patients had to have good libido, maintained erections and interested sexual partners. The operative technique consisted in making an I-shaped relaxing incision in the zone of higher angulation of the tunica albuginea and the defect created in the tunica was covered with a human duramater graft. The follow-up varied from 1 to 6 years (70%, > or =2 years). Cosmetic results: 95% good, 5% satisfactory (not needing further correction). Functional results: 85% good, 15% erectile dysfunction (10% moderate and 5% severe). one recurrence, one partial necrosis of the foreskin, nine decreases in the sensibility of the glans (eight recovered after 4-12 months post-operatively). The I-shaped relaxing incision and duramater graft procedure had a satisfactory success rate in the correction of severe Peyronie's disease. The utilisation of ready to use material (homo or hetero graft) avoids additional surgery, reduces the operative time and possible complications. Like in other procedures, the major problem of this surgery is the erectile dysfunction rate.