scholarly journals Alei II Technique: Minimally Invasive Technique for the Correction of Penile Curvature without Circumcision

2016 ◽  
Vol 9 (1) ◽  
pp. 70-70
Author(s):  
P. Letizia ◽  
◽  
G. Alei ◽  
A. Rossi ◽  
◽  
...  
Keyword(s):  
Surgical Technique ◽  
Sagittal Plane ◽  
Peyronie’S Disease ◽  
Invasive Technique ◽  
Penile Curvature ◽  
Penile Deviation ◽  
Aesthetic Results ◽  
Peyronie's Disease ◽  
New Surgical Technique

Objective: We describe a new surgical technique for the treatment of penile curvature. In 2012, we developed a new surgical technique for the correction of congenital and acquired penile curvature without circumcision called “track” corporoplasty or Alei II technique Design and Method: For the penile ventral curvature repair an infrapubic transverse dorsal incision is made to correct a ventral curvature or when removing or cutting the plaque in Peyronie’s disease A single 0 non-absorbable synthetic multifilament suture is placed in order to perform a special placation on two parallel lines and therefore called “track”. Laterally to the corporoplasty described, two corporoplasties should be performed along the line that goes from the dorsal neurovascular bundle to the lateral end of the corpus cavernosus at 30° and 60° on the penile sagittal plane. The two corporoplasties should measure 50% at 30° and 25% at 60. Results: Mean age was 43 years for patients with Peyronie’s disease and 31 years for patients with congenital penile deviation. The mean follow-up period was 36 months. No major complications, no circumcision, overall satisfaction 98%. Intraoperative correction of the curvature was achieved in 100%, significant relapse occurred in 2%. Conclusions: This original technique is associated with low morbidity, low recurrence rate and excellent aesthetic results.

Role of Shock wave Therapy in Peyronie's Disease

2006 ◽  
Vol 73 (2) ◽  
pp. 234-236
Author(s):  
L. Aresu ◽  
R. Ballario ◽  
P. Beltrami ◽  
L. Ruggera ◽  
D. Schiavone ◽  
...  
Keyword(s):  
Shock Wave ◽  
Sexual Activity ◽  
Peyronie’S Disease ◽  
Shock Wave Therapy ◽  
Invasive Treatment ◽  
Penile Deviation ◽  
Peyronie's Disease ◽  
Size Modification ◽  
Surgical Treatments

Shock wave therapy (ESWT) for the treatment of Peyronie's Disease (PD) is still controversial. The aim of this study is to evaluate the efficacy of shock wave therapy in patients candidates for surgical treatment of stable PD for at least 12 months. 238 patients affected by PD were treated with ESWT since January 2000. We selected those patients (65 cases) who were having a stable disease for at least 12 months, previously treated unsuccessfully with different therapy (pharmacological, ionophoresis or infiltrations), and with an adequate follow-up. The parameters considered were the size modification of the lesion, the reduction of the penile deviation and the overall satisfaction for reaching an adequate sexual activity after the ESWT treatment. All patients received a 3000 shock waves treatment in 4 occasions during 2 weeks according to the institutional protocol. All the study patients reported to have an inadequate sexual function before the ESWT treatment. The mean age was 57 years, the penile deviation varied between 30° and 90° and the average follow-up was 18 months. In 43 cases (66%) the ultrasounds revealed a significant reduction of the penile deviation and 39 patients (60%) reported to have reached an adequate sexual activity after the ESWT treatment. ESWT represents a valid option in the treatment of PD considering that the patients’ main goal is to regain a satisfactory sexual activity. Therefore this non-invasive treatment should be included in the therapeutic guidelines of PD together with other non-surgical treatments.

scholarly journals Laser Therapy for Peyronie’s Disease: A Randomized Control Double-Blind Pilot Study

2019 ◽  
Vol 10 (5) ◽  
pp. S37-S42
Author(s):  
Farzad Allameh ◽  
Mohammadreza Razzaghi ◽  
Seyed Mansoor Rayegani ◽  
Morteza Fallah-Karkan ◽  
Arash Ranjbar ◽  
...  
Keyword(s):  
Erectile Function ◽  
Peyronie’S Disease ◽  
Penile Curvature ◽  
Double Blind ◽  
Intralesional Administration ◽  
Peyronie's Disease ◽  
Group 2 ◽  
No Gold Standard ◽  
Intensity Laser

Introduction: The management of Peyronie’s disease (PD) has remained a therapeutic dilemma for physicians and there is no gold standard treatment. In this paper, we decided to investigate the beneficial effect of the intralesional administration of verapamil compared with the intralesional administration of verapamil plus a low-intensity laser (LIL). Methods: Research was activated from May 2016 to May 2018 and a total of 38 men aged 18 years and older completed the investigation. The subjects were randomly divided into 2 groups. Group 1 was composed of 22 patients that were treated only by verapamil (5 mg) plus a sham laser weekly for 6 weeks, and group 2 consisted of 22 patients that received a laser, using the BTL–6000 HIGH-INTENSITY LASER 12 W machine and the same protocol of intralesional verapamil injection. The visual analogue scale (VAS) was used to evaluate pain during an erection, penile ultrasonography was used to measure plaque size, the penile curvature angle degree was measured using the photographs taken during an erection, and the International Index of Erectile Function questionnaire was used to assess erectile function. The follow-up treatment lasted for nine months, with visits performed in the 3rd and 9th months. Results: All study parameters decreased significantly after treatment in both arms, but the reduction in pain and penile curvature improvements in combination therapy revealed more significant changes in 3 months (p = .035, p=.032). Nevertheless, these improvements were not seen in the follow-up session after 9 months. Conclusion: A laser appears to be safe treatment modality in carefully-selected patients with PD. It has moderate efficacy in the short term.

scholarly journals Penile prosthesis implant with bi-triangular excision and graft for surgical therapy of Peyronie’s disease: A case report

2016 ◽  
Vol 87 (4) ◽  
pp. 337
Author(s):  
Alexandre De Freitas Miranda ◽  
Bruno Lopes Cançado Machado
Keyword(s):  
Erectile Dysfunction ◽  
Penile Prosthesis ◽  
Peyronie’S Disease ◽  
Penile Curvature ◽  
Prosthesis Implantation ◽  
Inflatable Penile Prosthesis ◽  
High Satisfaction ◽  
Patient Reported ◽  
Penile Deviation ◽  
Peyronie's Disease

We present a case of a 65-year-old man, who presented with moderate erectile dysfunction and a dorsal penile deviation of 60° caused by Peyronie’s disease. The patient underwent bi-triangularshaped plaque excision, followed by grafting and implantation of inflatable penile prosthesis. Complete penile straightening, without mechanical or geometric abnormalities, was achieved using bi-triangular excision and grafting. Postoperatively, the patient reported high satisfaction with the results and could perform sexual intercourse naturally. This novel technique corrects any degree of penile curvature, permits malleable and semi-rigid penile prosthesis implantation, avoids penile length loss, and eliminates additional incisions. To our knowledge, this case is the first in the literature in which the bi-triangular technique was successfully used for penile prosthesis implantation secondary to Peyronie’s disease. This new technique appears to be a good solution to correct penile curvature during penile prosthesis implantation for the treatment of Peyronie’s disease associated with erectile dysfunction.

1072 TUNICA ALBUGINEA CRURAL GRAFT FOR SEVERE PENILE CURVATURE DUE TO PEYRONIE'S DISEASE: 07 YEARS FOLLOW-UP

2010 ◽  
Vol 183 (4S) ◽  
Author(s):  
Claudio Teloken ◽  
Patrick E. Teloken ◽  
Tulio Graziottin ◽  
Caio Schmit ◽  
Rodrigo Blaya
Keyword(s):  
Tunica Albuginea ◽  
Peyronie’S Disease ◽  
Penile Curvature ◽  
Peyronie's Disease

scholarly journals Buccal mucosa graft in surgical management of Peyronie’s disease: Ultrasound features and clinical outcomes

2021 ◽  
Vol 93 (1) ◽  
pp. 107-110
Author(s):  
Andrea Fabiani ◽  
Fabrizio Fioretti ◽  
Maria Pia Pavia ◽  
Luca Lepri ◽  
Emanuele Principi ◽  
...  
Keyword(s):  
Surgical Management ◽  
Buccal Mucosa ◽  
De Novo ◽  
Surgical Complication ◽  
Peyronie’S Disease ◽  
Penile Curvature ◽  
Ultrasound Evaluation ◽  
Dynamic Ultrasound ◽  
Peyronie's Disease

Introduction: Plaque incision and grafting represent the best surgical approach to the Peyronie’s Disease (PD). The grafting procedures must be restricted to patients with normal preoperative status, excessive curvature and/or deformities. However, the ideal graft has not been identified yet. Buccal mucosa grafts (BMG) provided excellent short-term results, ensuring the fast return of spontaneous erections and preventing shrinkage, which is the main cause of graft failure. Another fearsome surgical complication is de novo erectile dysfunction (ED). We report our results with BMG focusing on the analysis of ultrasonographic and clinical data demonstrating buccal mucosa as determinant factor that allow to avoid complications. Materials and methods: From 2013 to 2019 we performed at our Urology Unit 27 corporoplasties with BMG to correct complex penile curvature due to PD. Clinical, post-surgical and ultrasound follow up data were evaluated. All patients were no responders to medical treatment or previous surgical procedures. The evaluation period was 72 months. Data regarding pre-operative work-up, including IIEF (IIEF-5) questionnaire administration, detailed clinical history and penile dynamic ultrasound (PGE1-induced erection) were collected. The time of spontaneous erection resumption was recorded for each patient. To improve blood supply to the graft, a low-dose PDE5-i was prescribed for all patients for a period of two months, starting immediately after discharge. Check-ups were scheduled every 3 months, starting from 1 month after surgery. In each visit, patients underwent a penile ultrasound evaluation of graft features. After 6 and 12 months, all patients underwent a penile dynamic ultrasound for Erection Hardness Score determination, then standard ultrasound and clinical evaluation yearly. Our analyses were focused on BMG as a major determinant of the surgical success. Results: Mean age of 27 patients was 57 years (42-71) with a maximum follow up time of 72 months and minimum of 3. Site of penile curvature was dorsal in 18 (67%) patients, ventral in 2 (7%), complex in 7 (26%). The degree of the curvature was < 60° in 11 (41%) patients, > 60° in 16 (59%). Straightening of penis was reached in 100% of cases. Penile shortening resulted in 7.4% (2/27). De novo ED appeared in 2/27 cases with a post-operative rate of PDE5i users increasing from 12 to 14 patients (45% vs 52%). Ultrasound aspects of BMG, recorded at every follow up visit, results in a hypoechoic plaque with an iperechoic rim that become isoechoic over the time in all cases. No case of scars or seroma was registered. Small intra-graft cystic lesions were highlighted in 3 cases (11%).Conclusions: BMG may represent a good choice in grafts procedures for PD surgical management. The functional results obtained by BMG procedures were related to the good anatomical characteristics of the patch and were highlighted in our series by use of penile ultrasound, during the follow up period.

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.

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