Initial experience in the treatment of Peyronie’s disease using testicular vaginal tunica graft

2021 ◽  
pp. 205141582110166
Author(s):  
Rico Luis ◽  
Villasante Nicolás ◽  
Blas Leandro ◽  
Bonnano Nicolás ◽  
Ameri Carlos
Keyword(s):  
Sexual Function ◽  
Tunica Albuginea ◽  
Peyronie’S Disease ◽  
Sexual Life ◽  
Rank Test ◽  
Penile Curvature ◽  
Initial Experience ◽  
Level Of Evidence ◽  
Paired Samples ◽  
Peyronie's Disease

Background: Peyronie’s disease (PD) is a progressive disorder of the connective tissue of the tunica albuginea of the penis that produces an abnormal curvature, painful erections and different degrees of erectile dysfunction (ED). The aim of this study is to evaluate our initial experience in the surgical treatment of PD using an autologous graft of testicular vaginal tunica. Materials and methods: A retrospective study of 23 patients was carried out between 2015 and 2019. The successful surgical stretching rate was defined as a functional 20 degrees of curvature or less. Postoperative sexual function and complications rate were evaluated as secondary objectives. We used the abbreviated IIEF-5 questionnaire and evaluated the sexual function before and after the surgical procedure. Wilcoxon signed-rank test for paired samples (U test) was used, considering a value of p<0.05 to be statistically significant. Results: Only one patient presented a recurrence of the penile curvature, resulting in a 95.6% success rate of functional stretching. We observed a 1.6 and 0.9 difference between pre- and postoperative total score and satisfaction ( p = 0.002 and p = 0.003 respectively) Conclusion: In this series, the use of testicular vaginal tunic was found to be safe and effective with a significant change in the quality of sexual life, especially reflected in the overall satisfaction after the procedure and a low rate of complications. Level of evidence: Not applicable for this multicentre audit.

A clinico-aetiological and ultrasonographic study of Peyronie's disease

Sexual Health ◽  
2006 ◽  
Vol 3 (2) ◽  
pp. 113 ◽  
Author(s):  
Bhushan Kumar ◽  
Tarun Narang ◽  
Somesh Gupta ◽  
Madhu Gulati
Keyword(s):  
Clinical Presentation ◽  
Clinical Symptoms ◽  
Tunica Albuginea ◽  
Connective Tissue Disorder ◽  
Peyronie’S Disease ◽  
Penile Curvature ◽  
Age Group ◽  
History Of ◽  
Peyronie's Disease ◽  
Symptoms And Signs

Background: Peyronie’s disease is a localised connective tissue disorder that involves the tunica albuginea of the penis. Although long recognised as an important clinical entity of the male genitalia, the aetiology of this disease has remained poorly understood. Methods: The epidemiology and clinical presentation of Peyronie’s disease during a 10-year period was evaluated. Results: Forty-two men with Peyronie’s disease from Chandigarh, India were reviewed retrospectively. The prevalence of Peyronie’s patients was 1.97/1000 patients. Their ages ranged from 23 to 70 years. Most of them presented during the early phase of the disease. The most common presenting complaint was penile curvature in 34 (80.95%) followed by pain on erection in 28 (66.66%). History of penile trauma was revealed by four (9.52%) patients. Among the risk factors, hypercholesterolemia (60%), hypertension (33.3%) and asymptomatic hyperuricemia (28.34%) were the most common. Twenty-two patients with Peyronie’s disease were studied by ultrasonography. Ultrasonogram was more accurate than clinical assessment in delineating the extent of lesions. In one-third of the patients, sonography demonstrated the plaques to be more extensive than had been detected by clinical examination. Conclusions: The clinical symptoms and signs in our study were, in general, similar to those found in the previous studies. Higher incidence of hypertension and diabetes in patients with Peyronie’s disease may also be to an extent due to patients being in an older age group.

scholarly journals US Imaging in Peyronie's Disease

2012 ◽  
Vol 2 ◽  
pp. 63 ◽  
Author(s):  
Kiriaki Kalokairinou ◽  
Charalampos Konstantinidis ◽  
Marilena Domazou ◽  
Theodoros Kalogeropoulos ◽  
Prodromos Kosmidis ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Imaging Modality ◽  
Tunica Albuginea ◽  
Peyronie’S Disease ◽  
Low Risk ◽  
Penile Curvature ◽  
Appropriate Treatment ◽  
Peyronie's Disease ◽  
Non Palpable Lesions

The aim of this study is to assess the role of ultrasound (US) in Peyronie's Disease (PD). PD is a psychologically and physically devastating disorder that manifests in middle-aged men. Fibrous inelastic plaques in the tunica albuginea, result in palpable penile scar in the flaccid condition and cause painful erections and penile deformity, including penile curvature, hinging, narrowing, and shortening of penis. Penile deformity is the most common (52%) first symptom of PD and is present in 94% of affected men. US is the primary imaging modality of choice due to its easy availability, low risk, and ability to image and quantify both calcified and soft tissue elements of PD. US provides identification of smaller and non-palpable lesions and shows the extent of fibrosis. Detection of calcifications within the plaque suggests stabilization of the disease and provides information useful to select patients for appropriate treatment.

scholarly journals Use of inflatable penile prostheses AMS CX with momentary squeeze in a patient with Peyronie’s disease after removal of two previously implanted penile prostheses

2014 ◽  
Vol 86 (1) ◽  
pp. 46
Author(s):  
Patrizio Vicini ◽  
Ferdinando De Marco ◽  
Gabriele Antonini ◽  
Ettore De Berardinis ◽  
Riccardo Giovannone ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Tunica Albuginea ◽  
Penile Prosthesis ◽  
Longitudinal Axis ◽  
Peyronie’S Disease ◽  
Neurovascular Bundle ◽  
Complex Case ◽  
Sexual Life ◽  
Penile Prostheses ◽  
Peyronie's Disease

Objective: Peyronie's disease (PD) is a fibrotic wound-healing condition of the tunica albuginea that results in penile deformity, curvature, hinging, narrowing and shortening, penile pain, and in some cases, erectile dysfunction (ED). Surgery remains the gold standard treatment option, ensuring the faster and trustworthy treatment. For those patients who have erectile dysfunction and PD, penile prosthesis placement with straightening procedure is the best method to solve both diseases. The aim of this article is to present the use of hydraulic penile prostheses AMS CX with Momentary Squeeze associated with a complete isolation of the neurovascular bundle in a complex case after removal of two previously implanted prostheses in a man suffering from Peyronie’s disease and erectile dysfunction. Material and method: A 50 year-old patient underwent two previous prosthetic implants in another hospital. The first implantation was performed using an infrapubic approach followed by placement of a three-component hydraulic penile prosthesis. After six months the prosthesis was removed using an infra-pubic approach and two soft prosthesis Virilis II were implanted during the same surgery. One year after the second operation we implanted a hydraulic penile prosthesis AMS CX with Mo - mentary Squeeze after complete isolation of the neurovascular bundle, fixing the two crural tips at the same level of albuginea of the two corpora cavernosa. Result: Twelve months after surgery the penis was completely straight without penile shortening and the patient was fully satisfied with his sexual life. Conclusion: The procedure enabled a perfect alignment of the cylinders along the longitudinal axis and penile prosthetic symmetry to obtain a good penile rigidity and a perfect penile straightening.

scholarly journals The use of penile traction therapy in the management of Peyronie's disease: current evidence and future prospects

2019 ◽  
Vol 11 ◽  
pp. 175628721983813
Author(s):  
Robert Valenzuela ◽  
Matthew Ziegelmann ◽  
Sam Tokar ◽  
Joel Hillelsohn
Keyword(s):  
Patient Compliance ◽  
Tunica Albuginea ◽  
Therapeutic Option ◽  
Patient Characteristics ◽  
Peyronie’S Disease ◽  
Current Evidence ◽  
Penile Curvature ◽  
Duration Of Treatment ◽  
Improved Outcomes ◽  
Peyronie's Disease

Peyronie’s disease is a disorder of abnormal and dysregulated wound healing leading to scar formation in the tunica albuginea of the penis. Penile traction therapy has emerged as an attractive therapeutic option for men with Peyronie’s disease in both the acute and chronic phases. Currently, clinical studies are limited by lack of randomization, small cohorts, and lack of patient compliance with therapy. Despite these shortcomings, studies have shown a potential benefit with minimal morbidity. Specifically, penile traction may help to preserve or increase penile length and reduce penile curvature when used as monotherapy or as adjuvant therapy for surgical and intralesional treatments. Further study is necessary to define patient characteristics that are predictive of improved outcomes, determine the duration of treatment needed for clinical effect, and improve patient compliance.

scholarly journals Peyronie's Disease: Evolving Surgical Management and the Role of Phosphodiesterase 5 Inhibitors

2009 ◽  
Vol 9 ◽  
pp. 822-845 ◽  
Author(s):  
Tariq F. Al-Shaiji ◽  
Gerald B. Brock
Keyword(s):  
Tunica Albuginea ◽  
Surgical Techniques ◽  
Peyronie’S Disease ◽  
Surgical Approaches ◽  
Penile Curvature ◽  
Advantages And Disadvantages ◽  
Phosphodiesterase 5 Inhibitors ◽  
Peyronie's Disease ◽  
Phosphodiesterase 5

Peyronie's disease (PD) is a fibrotic disorder of the tunica albuginea of the penis. It is characterized by different degrees of penile curvature and sexual dysfunction. Several medical treatments have been employed to manage the disorder, with variable success rates. Surgical therapy is reserved for patients with severe penile deformity that fails to improve with medical treatment and impedes coital function. The advantages and disadvantages of various surgical approaches have long been debated. Herein, we describe the evolving surgical techniques for PD using knowledge obtained from the contemporary literature. In addition, we discuss the emerging data regarding the role of phosphodiesterase 5 inhibitors in the management of PD.

Peyronie’s disease, congenital curvature, and chordee

2017 ◽  
Author(s):  
Laurence A. Levine ◽  
William Brant ◽  
Stephen M. Larsen
Keyword(s):  
Sexual Intercourse ◽  
Tunica Albuginea ◽  
The United States ◽  
Peyronie’S Disease ◽  
Penile Curvature ◽  
Medical Treatments ◽  
Congenital Penile Curvature ◽  
Peyronie's Disease ◽  
Surgical Treatments ◽  
Recurrent Deformity

Penile curvature is usually secondary to Peyronie’s disease, which is a fibrotic wound healing disorder of the tunica albuginea. Other causes include congenital penile curvature and chordee. Penile deformity, if severe, results in significant difficulties with sexual intercourse and may make sexual intercourse impossible. The mainstay of treatment, if the deformity is stable and interfering with intercourse is surgery, while a variety of surgical treatments exist. Side effects of treatment include penile shortening, erectile dysfunction, and recurrent deformity. Medical treatments are usually ineffective, although recently, injections of intralesional collagenase have been licensed in the United States for Peyronie’s disease.

scholarly journals Penile fracture in a Peyronie’s disease patient: a case report

2020 ◽  
Vol 26 (1) ◽  
Author(s):  
Nur Hidayatullah ◽  
Khoirul Kholis ◽  
Muhammad Asykar Palinrungi ◽  
Syakri Syahrir ◽  
Syarif Syarif ◽  
...  
Keyword(s):  
Tunica Albuginea ◽  
Disease Patient ◽  
Clinical History ◽  
Fracture Repair ◽  
Peyronie’S Disease ◽  
Penile Curvature ◽  
Current Standard ◽  
Penile Fracture ◽  
Penile Plication ◽  
Peyronie's Disease

Abstract Background Penile curvature in men with Peyronie’s disease (PD)—caused by tunica anchoring plaques with loss of focal fiber elasticity—theoretically increases the risk of penile fracture during sexual activity. Penile fracture is the result of tearing of the tunica albuginea of one or both corpora cavernosa, usually during sexual intercourse, and is among the most serious urological emergencies. Generally, a patient presented to a surgical emergency within 48 h of injury can be handled successfully with minimum complications. Immediate surgical treatment is the current standard of care and has a relatively low risk of late complications. Case presentation We present a case of penile fracture in a male with a history of PD referred to the emergency department with severe pain. Clinical history assessment and physical examination revealed a penile fracture with underlying PD. He underwent emergency surgical exploration via subcoronal incision. Penile plication was not necessary for our case because the angulation of the penis was less than 15° after examination of artificial erection. Conclusion Penile fracture in a patient with underlying PD is a rare urological emergency that should be treated surgically with fracture repair as early as possible. Penile plication might be necessary in severe cases (angulation > 60°).

scholarly journals Use of Li-ESWT, Tadalafil, and a Vacuum Device to Preserve Erectile Function in Subjects Affected by Peyronie’s Disease and Undergoing Grafting Surgery

Uro ◽  
2021 ◽  
Vol 1 (3) ◽  
pp. 187-194
Author(s):  
Francesco Trama ◽  
Antonio Ruffo ◽  
Ester Illiano ◽  
Giuseppe Romeo ◽  
Filippo Riccardo ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Erectile Function ◽  
Tunica Albuginea ◽  
Penile Prosthesis ◽  
Peyronie’S Disease ◽  
Penile Curvature ◽  
Rehabilitation Protocol ◽  
Extracorporeal Shock Wave ◽  
Vacuum Device ◽  
Peyronie's Disease

Background: Peyronie’s disease (PD) is a little-known disease characterized by pain during erections, the presence of penile curvature, and consequent psychological disorders. In addition, concomitant erectile dysfunction may be present. The treatment of PD is adapted to the patient, especially when the penile curvature is >60°; with stabilized pathology, it is preferable to perform penile straightening approaches, such as penile plication and plaque incision, or partial excision and grafting. The most frequent side effect of straightening approaches is the onset of erectile dysfunction due to the formation of venous leakage appearing after the excision of calcific plaque. Materials and methods: All enrolled patients had PD, a curvature >60°, had an IIEF subdomain erectile function score >16, and refused penile prosthesis implantation concurrent with tunica albuginea grafting surgery. Subsequently, 4 weeks after surgery, all patients underwent a rehabilitation protocol that consisted of low-intensity extracorporeal shock wave therapy (Li-ESWT), the administration of 5 mg/daily of tadalafil, and the use of a vacuum device. Results: From January 2014 to March 2016, 15 subjects affected by PD with severe penile curvatures were enrolled in the study. At 6 months after surgery, the IIEF scores for erectile function were not statistically significantly different before and after surgery (p > 0.05); the other items, especially orgasmic function (p = 0.01), sexual desire (p < 0.01), intercourse satisfaction (p = 0.01), and overall satisfaction (p = 0.04), were all statistically significant. The modified EDITS questionnaire reported that 80% of patients were satisfied, that 13.3% were dissatisfied, and that 1 patient (6.6%) was dissatisfied with the surgery. Moreover, there was no statistically significant decrease in the patients’ penile lengths. The aim of this study was to use a rehabilitation protocol consisting of Li-ESWT, the administration of 5 mg/daily, and the use of a vacuum device in order to preserve the erectile function of patients undergoing straightening approaches using surgical grafting. In addition, patient satisfaction following surgery was analyzed.

scholarly journals Medical Management of Peyronie’s Disease: Review of the Clinical Evidence

2019 ◽  
Vol 7 (9) ◽  
pp. 96
Author(s):  
Teloken ◽  
Katz
Keyword(s):  
Medical Management ◽  
Clinical Evidence ◽  
Tunica Albuginea ◽  
Peyronie’S Disease ◽  
Penile Curvature ◽  
Extracorporeal Shockwave ◽  
Peyronie's Disease ◽  
Meta Analyses ◽  
Surgical Treatments

Peyronie’s disease is a condition that causes abnormal healing of the tunica albuginea, causing penile curvature. It is difficult to treat and its management is continuing to evolve. Proposed non-surgical treatments have included oral, topical, intralesional, extracorporeal shockwave, and traction therapy. The study of Peyronie’s disease is made difficult by heterogeneity in the timing of presentation, severity and characteristics of deformity, and associated complaints. Moreover, meta-analyses of studies are difficult due to inconsistencies across study endpoints and the duration of treatments. This article reviews the current clinical evidence and guideline recommendations, with a focus on an improvement in penile curvature.

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