Peyronie’s Disease: Still a Surgical Disease

Martinez, Daniel R; Ercole, Cesar E.; Hakky, Tariq S.; Kramer, Amihud; Carrión, Rafael

doi:10.1155/2012/206284

Cited by 15 publications

(15 citation statements)

References 17 publications

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“…These were not observed in our case. In addition, Peyronie's disease has a relatively long natural course that usually lasts for 6 -18 months (12). In contrast, the course of the disease in our patient was only 3 months.…”

Section: Discussioncontrasting

confidence: 53%

“…Penile cancer was ruled out because (i) the patient had no history of phimosis, (ii) there were no typical manifestations of exophytic penile cancer, (iii) the tumor was freely mobile and showed no aggressive growth and (iv) the tumor exhibited no significant contrast enhancement in the arterial phase. Peyronie's disease is a disorder of the penile connective tissue, which is characterized by the development of a lump on the shaft of the penis (12). It always causes curvature of the penis and, in some cases, pain.…”

Section: Discussionmentioning

confidence: 99%

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Primary Extramedullary Plasmacytoma of the Penis: A Case Report

Wang

Liang

et al. 2013

Japanese Journal of Clinical Oncology

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Extramedullary plasmacytoma involving the penis is extremely rare. Here, we describe a case of primary extramedullary plasmacytoma of the penis in a 64-year-old man who presented with a palpable penile mass. Nuclear magnetic resonance imaging revealed the presence of a large, round non-encapsulated mass in the perineum. A contrast-enhanced computed tomography scan of the pelvis showed that the mass was located in the tunica albuginea and corpora cavernosa at the base of the penis. The mass encased the urethra and demonstrated no marked enhancement during the arterial phase. The patient underwent successful surgical resection of the tumor. Histologically, the tumor was composed primarily of neoplastic plasma cells that were positive for CD38, vimentin and Ki 67. Postoperatively, the patient recovered well and exhibited no evidence of development of multiple myeloma, local recurrence or distant metastasis at 2 months post-surgery. To the best of our knowledge, our case represents the first documented case of human primary extramedullary plasmacytoma of the penis.

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Section: Discussioncontrasting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Primary Extramedullary Plasmacytoma of the Penis: A Case Report

Wang

Liang

et al. 2013

Japanese Journal of Clinical Oncology

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“…25 In spite of penile shortening (not suited for shorter phallic lengths) and long-term palpable sutures, this approach has minimal risk of ED, as well as of neurovascular damage. 3,26 Procedures that lengthen the tunica: plaque incision/ plaque excision and grafting Tunica lengthening procedures involve incising or excising the plaque, and adding graft material to cover the defect (Fig. 3).…”

Section: Tunica Plication: Procedures That Shorten the Tunicamentioning

confidence: 99%

“…The graft (usually 20% larger than the defect) is then sutured to the tunica albuginea with separate running suture. 3,27 In 1950, Lowsley and Boyce 28 were the first authors to perform plaque excision and grafting with fat for the treatment of PD, followed by Horton in Devine, in 1974, using a dermal skin graft. 29 It has the advantage of a higher tensile strength, and compliance when compared with fat but due to high rates of ED and graft retraction, they are not so popular nowadays.…”

Section: Tunica Plication: Procedures That Shorten the Tunicamentioning

confidence: 99%

“…2 It may result from macro or microtrauma to the erect penis in genetically susceptible individuals or with an underlying disease of the elastic fibers and collagen bundles of the penis. 3 It dramatically affects patient's quality of life, causing severe psychological, mental, and physical stress. Sexual intercourse is hampered: painful erections and penile curvature/deformation make penetration difficult or impossible.…”

Section: Introductionmentioning

confidence: 99%

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Recent surgical advances in Peyronie’s Disease

Gaspar¹,

Dias²,

Martins³

et al. 2016

Acta Med Port

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RESUMOIntrodução: A doença de Peyronie, uma doença fibrótica da túnica albuginea do pénis tem estado associada a encurtamento peniano e a algum grau de disfunção eréctil. Afeta a qualidade de vida do doente, levando a stress psicológico, mental e físico. A deformidade peniana perturba a vida sexual do doente, levando a episódios de depressão, disfunções sexuais e a ansiedade associada ao ato sexual. A etiologia da doença de Peyronie permanece por esclarecer. Material e Métodos: A pesquisa na literatura foi efetuada nas bases de dados da Medline, Embase e Cochrane no mês de Janeiro de 2015 no sentido de identificar artigos relacionados com a doença de Peyronie, nomeadamente o tratamento cirúrgico, técnicas, resultados bem como tratamentos complementares. Publicações que não envolvessem humanos não foram consideradas. Identificámos artigos originais, artigos de revisão e editoriais acerca do assunto em questão. Todos os artigos publicados na língua inglesa foram selecionados para screening. Os critérios de elegibilidade para inclusão envolveram a relevância associada ao tema. Resultados: Existe uma variedade de deformidades penianas associada com a doença de Peyronie que ainda não têm uma solução não cirúrgica que seja eficaz. Apresentamos uma atualização das técnicas cirúrgicas atuais bem como o algoritmo de tratamento associada a esta doença. Discussão: Todos os tratamentos cirúrgicos têm como objetivo a correção da curvatura, a preservação da função eréctil e do comprimento peniano, bem como o de minimizar a morbilidade. Conclusão: Até à data não existem estudos de medicina baseada na evidência que determinem o melhor tratamento cirúrgico para a doença de Peyronie. Após o diagnóstico, a reconstrução cirúrgica deve ter como objetivo um pénis funcional, com uma retificação da sua curvatura que permita o acto sexual. Palavras-chave: Induração Peniana; Pénis/cirurgia; Procedimentos Cirúrgicos Urológicos Masculinos; Prótese de Pénis. ABSTRACT Introduction:Peyronie's disease, a fibrotic disorder of the tunica albuginea of the penis, has been associated with penile shortening and some degree of erectile dysfunction. It affects patient's quality of life, leading to severe psychological, mental, and physical stress. Penile deformation hampers sexual life leading to depression, lack of sexual confidence, loss of sexual function and performance anxiety. Peyronie's disease etiology is yet to be known. Material and Methods: Literature search was conducted in Medline, Embase, and Cochrane databases in January 2015 in order to identify papers related to Peyronie's disease, concerning evolving surgical management, technique, outcomes as well as ancillary treatments. Publications not concerning humans were not considered. We identified original articles, review articles, and editorials addressing the subject. All articles published in the English language were selected for screening. The eligibility criteria for inclusion were based on relevance concerning the subject. Results:The variety of penile deformities associated with P...

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Excision and Patch Grafting of a Lateral Peyronie's Plaque—Utilizing a Longitudinal “Window” Approach

Lue¹,

Emtage²,

Martinez³

et al. 2015

Sexual Medicine

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IntroductionPeyronie’s disease (PD) is a debilitating disorder in which collagen deposition, fibrosis, and plaques in the tunica albuginea result in penile curvature, shortening, and pain. For severe curvatures requiring plaque incision or excision with grafting (PIEG), a subcoronal circumcising incision with penile degloving has historically been used.AimsThe aim of this study was to report our unique approach to PIEG via a longitudinal “window” incision for the correction of PD, minimizing the surgical manipulation and dissection accompanying the traditional circumcising incisional approach that may lead to increased postoperative edema, pain, and prolonged healing time.MethodsA patient presented with a stable, painless, 90-degree midshaft leftward curvature causing penetration difficulties and painful intercourse for his partner. His Sexual Health Inventory for Men (SHIM) score was 23. The patient opted for surgical correction with plaque excision and grafting via a 4-cm longitudinal incision overlying the point of maximal curvature along the left lateral penile shaft. This direct access to the left corpus cavernosum and plaque, along with dissecting skin, dartos, and Buck’s fascia, created a window with sufficient exposure for excision and patch grafting.Main Outcome MeasuresThe main outcome measures were objective data and subjective data in men undergoing PIEG via lateral longitudinal “window” incision for PD repair.ResultsThe plaque was excised and a porcine small intestinal submucosa graft was sewn in. Intraoperative artificial tumescence at the end of surgery revealed complete correction of the curvature. The patient experienced painless rigid erections by postoperative day three with minimal penile edema. By postoperative week four, he could successfully partake in coitus. His SHIM score remained unchanged. At maximum follow-up 6 months postoperatively, he still endorsed excellent cosmetic and functional outcomes with spontaneous unassisted erections and no recurrence of his curvature.ConclusionA lateral longitudinal incision for PIEG is a feasible technique and may reduce the postoperative morbidity and dissection required with traditional circumcising incision with penile degloving. Larger comparative studies are necessary for further evaluation.

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Peyronie’s Disease: Still a Surgical Disease

Cited by 15 publications

References 17 publications

Primary Extramedullary Plasmacytoma of the Penis: A Case Report

Primary Extramedullary Plasmacytoma of the Penis: A Case Report

Recent surgical advances in Peyronie’s Disease

Excision and Patch Grafting of a Lateral Peyronie's Plaque—Utilizing a Longitudinal “Window” Approach

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