Volume 20, Issue 1 (January 2018) 20, 90–92; 10.4103/aja.aja_42_17
Nondegloving technique for Peyronie's disease with penile prosthesis implantation and double dorsal-ventral patch graft
Andrew Fang1, Run Wang1,2
1 Division of Urology, University of Texas McGovern Medical School, Houston, Texas 77030, USA 2 Department of Urology, University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA
Correspondence: Dr. R Wang (run.wang@uth.tmc.edu)
Date of Submission 17-Jun-2017 Date of Acceptance 08-Aug-2017 Date of Web Publication 29-Sep-2017
Abstract |
A circumcising incision to deglove the penis for penile prosthesis (PP) implantation can increase the risk of ischemic injury to the glans penis. In order to avoid vascular complications, we describe a novel technique utilizing a ventral incision to perform the PP implantation and a double-dorsal patch graft, or "sliding technique" (ST), in patients with severe Peyronie's disease (PD). Three patients with severe PD and erectile dysfunction at our institution underwent ST and PP implantation through a ventral incision. This new approach was not only successful in facilitating the ST and PP implantation in these patients but also allowed for adequate exposure of the penile shaft with no reported loss of sensation. We also conducted a review of current literature regarding the approaches for PD. While ischemic complications of PP implantation and ST are rare, there are reports of ischemic injury in patients undergoing a circumcising incision. The combination of a circumcising incision and a patient's underlying peripheral artery disease potentially raises a patient's risk of this rare complication. Our innovative ventral incision provides an alternative method for PP implantation and ST in order to avoid ischemia of the penis, while still allowing for adequate exposure.
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