The results of plaque incision and venous grafting (Lue procedure) to correct the penile deformity of Peyronie's disease.

Abstract

To assess plaque incision and venous grafting (the Lue procedure) to correct the deformity associated with Peyronie's disease and to maintain penile length, evaluating the results over an 8-year period. The penile deformity of 113 patients (mean age 45 years, range 17-71) with Peyronie's disease was corrected by plaque incision and saphenous vein grafting. All patients had stable Peyronie's disease and had a mean (range) penile deformity of 64.5 (20-180) degrees; the mean follow-up was 12 months. The result was excellent or satisfactory in 105 patients (93%), and the penis completely straightened in 97 (86%). Erectile dysfunction after surgery developed in 10 of 68 potent patients (15%) although they had arterial risk factors of diabetes, hypertension or cardiac disease that may also have contributed. There was penile shortening of > 1 cm in 29 men (25%) but this only prevented intercourse in two. Of the 51 patients with > or = 5 years of follow-up, the penis remained completely straight in 80% but the incidence of erectile dysfunction increased to 22.5% and penile shortening of > 1 cm to 35%. The Lue procedure is an effective long-term option in the surgical management of Peyronie's disease, but penile shortening after surgery remains a risk, and patients with vascular risk factors must be warned of the possibility of later erectile dysfunction.