Modified Extra-tunical grafting for Peyronie’s Disease Associated Indentation Deformity

  • Kohler, T., Ziegelmann, M., Helo, S., Kemble, J.
  • Kemble J., Helo S., Kohler T., Ziegelmann M.
  • VJPU 2023 7: 231
  • 07:52
Image

Abstract

Authors

Kemble J., Helo S., Kohler T., Ziegelmann M.

Key Words

Peyronies, Grafting, Indentation Deformity

Description

This video demonstrates a modified approach to Extra-Tunical Grafting for peyronie’s disease indentation deformity. Peyronie’s disease is characterized by penile plaque or scar within the tunica albuginea. This results in penile deformity, most commonly penile curvature but also volume loss deformity such as hourglass or indentation. This volume loss occurs in up to 65% of men with Peyroine’s disease. Surgical management for patients with significant deformity includes plaque incision/partial excision and penile grafting with an absorbable grafting material. In the original description of extra-tunical grafting, the grafting material was placed over Buck’s fascia via a ventral longitudinal incision. In our modified technique, the grafting material is placed under Buck’s fascia and superficial to the tunica albuginea, which allows the grafting material to be less palpable in the flaccid condition.

 

References


References:

1. Margolin EJ, Pagano MJ, Aisen CM, Onyeji IC, Stahl PJ. Beyond Curvature: Prevalence and Characteristics of Penile Volume-Loss Deformities in Men With Peyronie's Disease. Sex Med. 2018 Dec; 6(4): 309-315

2. Nehra A, Alterowitz R, Culkin DJ, Faraday MM, Hakim LS, Heidelbaugh JJ, Khera M, Kirkby E, McVary KT, Miner MM, Nelson CJ, Sadeghi-Nejad H, Seftel AD, Shindel AW, Burnett AL; Peyronie's Disease: AUA Guideline. J Urol. 2015 Sep; 194(3): 745-53

3. Osmonov D, Ragheb A, Ward S, Blecher G, Falcone M, Soave A, Dahlem R, van Renterghem K, Christopher N, Hatzichristodoulou G, Preto M, Garaffa G, Albersen M, Bettocchi C, Corona G, Reisman Y. ESSM Position Statement on Surgical Treatment of Peyronie's Disease. Sex Med. 2022 Feb; 10(1): 100459

4. Levine LA, Larsen SM. Surgery for Peyronie's disease. Asian J Androl. 2013 Jan;15(1):27-34. doi: 10.1038/aja.2012.92. Epub 2012 Nov 26.

5. Clavell-Hernnandez J, Ziegelmann MJ. Peyronie’s Disease: Surgical Management. AUA Core Curriculum. Feb 2023

6. Reed-Maldonado AB, Alwaal A, Lue TF. The extra-tunical grafting procedure for Peyronie's disease hourglass and indent deformities. Transl Androl Urol. 2018 Mar;7(Suppl 1):S1-S6.

7. Diao L, VanDyke ME, Joice GA, Lewis ZB, Dropkin BM, Sanders SC, Hudak SJ, Morey AF. Penile Extra-Tunical Graft Reconstruction of Peyronie's Disease Concavity Deformities. Urology. 2021 Dec;158:237-242.

Submit your own video!

We welcome you to participate in the Journal of Sexual Medicine (VJSM)

No comments

Leave your comment

In reply to Some User