A New, Innovative, Lengthening Surgical Procedure for Peyronie's Disease by Penile Prosthesis Implantation with Double Dorsal-Ventral Patch Graft: The “Sliding Technique”

Authors

  • Luigi Rolle MD, PhD,

    Corresponding author
    1. Divisione Universitaria di Urologia II, Dipartimento di Discipline Medico-Chirurgiche, Ospedale “San Giovanni Battista—Molinette,” Università degli Studi di Torino, Torino, Italy
      Luigi Rolle, MD, Ospedale “San Giovanni Battista—Molinette,” Divisione Universitaria di Urologia 2, Corso Bramante 88, 10126 Torino, Italy. Tel: +390116336527; Fax: +390116335707; E-mail: luigi.rolle@unito.it
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  • Carlo Ceruti MD, PhD,

    1. Divisione Universitaria di Urologia II, Dipartimento di Discipline Medico-Chirurgiche, Ospedale “San Giovanni Battista—Molinette,” Università degli Studi di Torino, Torino, Italy
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  • Massimiliano Timpano MD,

    1. Divisione Universitaria di Urologia II, Dipartimento di Discipline Medico-Chirurgiche, Ospedale “San Giovanni Battista—Molinette,” Università degli Studi di Torino, Torino, Italy
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  • Omidreza Sedigh MD,

    1. Divisione Universitaria di Urologia II, Dipartimento di Discipline Medico-Chirurgiche, Ospedale “San Giovanni Battista—Molinette,” Università degli Studi di Torino, Torino, Italy
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  • Paolo Destefanis MD,

    1. Divisione Universitaria di Urologia II, Dipartimento di Discipline Medico-Chirurgiche, Ospedale “San Giovanni Battista—Molinette,” Università degli Studi di Torino, Torino, Italy
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  • Elisa Galletto MD,

    1. Divisione Universitaria di Urologia II, Dipartimento di Discipline Medico-Chirurgiche, Ospedale “San Giovanni Battista—Molinette,” Università degli Studi di Torino, Torino, Italy
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  • Marco Falcone MD,

    1. Divisione Universitaria di Urologia II, Dipartimento di Discipline Medico-Chirurgiche, Ospedale “San Giovanni Battista—Molinette,” Università degli Studi di Torino, Torino, Italy
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  • Dario Fontana MD

    1. Divisione Universitaria di Urologia II, Dipartimento di Discipline Medico-Chirurgiche, Ospedale “San Giovanni Battista—Molinette,” Università degli Studi di Torino, Torino, Italy
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Luigi Rolle, MD, Ospedale “San Giovanni Battista—Molinette,” Divisione Universitaria di Urologia 2, Corso Bramante 88, 10126 Torino, Italy. Tel: +390116336527; Fax: +390116335707; E-mail: luigi.rolle@unito.it

ABSTRACT

Introduction.  Peyronie's disease is the result of the formation of fibrous plaques in the tunica albuginea of the penis; typical presentations of the disease are represented by pain during erection, erectile dysfunction, and penile deformities, such as curvature, narrowing, and penile shortening. The most complex treatment is related to penile shortening.

Aim.  To find a safe procedure in penile shortening due to Peyronie's disease providing a satisfactory lengthening, allowing an early stabilization of the penis, and preventing axial tension on the neurovascular bundles during dilation.

Methods.  We describe a new lengthening surgical procedure based on a ventro-dorsal incision of the tunica albuginea, penile prosthesis implantation, and double dorsal-ventral patch grafting with porcine small intestinal submucosa. Three patients, affected by Peyronie's disease with penile shortening and erectile dysfunction, underwent this procedure with approval of our local ethical committee.

We evaluated the penis lengthening, intraoperative and postoperative complications, patient's preoperative and postoperative sexual life satisfaction (International Index of Erectile Function [IIEF] questionnaire).

Results.  The average operative time was 2 hours and 50 minutes. No major intraoperative nor postoperative complications occurred. No significant bleedings were recorded. Patients were discharged after 48–72 hours.

The average increase in length obtained was 3.2 cm. All patients resumed sexual intercourses with satisfaction; no significant loss of sensitivity or any sign of vascular distress of the glans was recorded. The follow-up is 13 months. The average IIEF score is 60.

Conclusions.  The lengthening of the penis by a double dorsal-ventral patch graft is an innovative procedure that is based on current techniques of plaque incision and grafting, and that can easily resolve severe shortening of the penis due to Peyronie's disease. In the cases presented, this procedure resulted easily, effectively, and safely. Nevertheless, the technique proposed in this article shall be validated through prospective studies with larger samples. Rolle L, Ceruti C, Timpano M, Sedigh O, Destefanis P, Galletto E, Falcone M, and Fontana D. A new, innovative, lengthening surgical procedure for Peyronie's disease by penile prosthesis implantation with double dorsal-ventral patch graft: The “sliding technique.” J Sex Med 2012;9:2389–2395.

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