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

You have accessJournal of UrologySexual Function/Dysfunction/Andrology: Peyronie's Disease/Surgical Therapy I1 Apr 20101072 TUNICA ALBUGINEA CRURAL GRAFT FOR SEVERE PENILE CURVATURE DUE TO PEYRONIE'S DISEASE: 07 YEARS FOLLOW-UP Claudio Teloken, Patrick E. Teloken, Tulio Graziottin, Caio Schmit, and Rodrigo Blaya Claudio TelokenClaudio Teloken More articles by this author , Patrick E. TelokenPatrick E. Teloken More articles by this author , Tulio GraziottinTulio Graziottin More articles by this author , Caio SchmitCaio Schmit More articles by this author , and Rodrigo BlayaRodrigo Blaya More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.2231AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Surgery management of severe penile deformity due to Peyronie's disease is surgically challenging. Various surgical techniques and graft materials have been used; however most of them exhibited suboptimal long-term results, especially with regard to curvature recurrence and erectile dysfunction, infection and abnormal scars. We first described the use of tunica albuginea crural graft (TACRUG) and present herein the long-term follow-up results, based upon the principle that the graft comes from human in addittion from the same organ. METHODS We conducted a chart review of patients with preserved erectile function or erectile dysfunction (ED) responding to PDE-5 inhibitors who had undergone plaque incision and graft with TACRUG for stable penile deformity precluding vaginal intercourse. The TACRUG is obtained through a 3-cm longitudinal perineal incision. A longitudinal segment of proximal corpus cavernosum 2mm larger than the defect is delimited with methylene blue, preserving the cavernous artery entry point, and carefully removed. A segment of tunica from the contralateral corpus cavernosum may also be retrieved if necessary. The corpus caversonum then is closed with running 4-0 polyglactin suture. Graft is tailored accordin to the gap to be occluded. RESULTS One hundred and two patients with a mean follow up of 78 months (range 12 to 95) were included in this analysis. Mean age was 54 years (range 42 to 75). Intraoperative penile straightening was obtained in 95 % of all cases. Curvature recurrence requiring new procedure 8% OF patients. Penile shortening was observed in 7 patients and 10 reported glans numbness. Out of 74 patients who reported preoperative spontaneous erections 10 developed postoperative ED, 6 responded to PDE-5 inhibitors. Of 16 patients who preoperatively responded to PDE-5 inhibitors, 6 became unresponsive. Overall, 14 patients subsequently underwent penile prosthesis implantation. 81.7% classified the postoperative result as excellent or satisfactory CONCLUSIONS The TACRUG is easily obtained, does not carry the risk of rejection or transmission of infectious diseases, does not add costs and affords satisfactory long-term results. Despite the lack of a control group, based on our experience and published data, the TACRUG seems to be associated with less curvature recurrence and does not appear to increase the risk of ED when compared to other graft materials. Porto Alegre, Brazil© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e418 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.Metrics Author Information Claudio Teloken More articles by this author Patrick E. Teloken More articles by this author Tulio Graziottin More articles by this author Caio Schmit More articles by this author Rodrigo Blaya More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...