Practical Computerized Solution for Incision and Grafting in Peyronie's Disease

Abstract

IntroductionPenile curvature correction with plaque incision and graft (PIG) increases the risk of erectile dysfunction (ED) and is associated with mechanical and geometric abnormalities.AimsThe aim of this study was to create and validate a new PIG technique using minimum graft area to correct simple or complex penile curvature with or without hourglass deformity, while avoiding mechanical and geometric abnormalities.MethodsUsing our cotton fabric model, we created a mathematic solution for PIG with no residual defects. This was applied in nine men who had sufficient penile rigidity while penetrating their respective partners. They underwent fascia lata patch corporoplasty using the new developed technique (iPad [Apple Corp, Palo Alto, CA, USA] app: iGrafter). Subjects answered the 5-item version of the International Index of Erectile Function (IIEF-5) questionnaire preoperatively and at the end of follow-up.Main Outcome MeasuresThe main outcome measures used were patient demographics, erectile function, residual curvature, patient satisfaction, graft area, and complications.ResultsAfter a mean follow-up of 17.8 months, no significant complication was noted. Complete penile straightening was achieved in all patients. The short side of the penis increased a mean of 3 cm in length, and the mean graft area was 12.4 cm2. At the end of the follow-up, three patients developed recurrent deformity. One patient presented severe fibrosis in the corpora cavernosa and severe ED. There was no significant difference between the mean preoperative and postoperative IIEF-5 scores (20.6 vs 19.4, respectively). At the end of follow-up, all patients were able to have sexual intercourse (two with and seven without pharmacological aid). Eight of the nine patients were satisfied with the surgical result.ConclusionPenile curvature surgical correction using the iGrafter seems to be an efficient and safe procedure, which uses minimum graft area and preserves erectile function after penile rectification, without resulting in residual deformities. Further research is needed to confirm the efficacy of this procedure.

3D-Printed Flexible Penile Model Simulator for Plaque Incision and Graft for Peyronie's Disease

“…The procedure was first explained in detail via video tutorials of a uniplanar case of PD with a 53° dorsal curvature using the previously described iGrafter 2.0 smartphone app. 7 , 8 All participants downloaded a new version of the app (iGrafter 2.0, www.igrafter.com ) to their smartphones. After calibrating the app to their smartphone's screen size, they performed the correction following the app instructions.…”

Auxetic Expansion of the Tunica Albuginea for Penile Length and Girth Restoration Without a Graft: A Translational Study

“…In order to test the application of this new auxetic incision on the TA, a model study approved by our review board, using 2 previously published penile model simulators, [12][13][14] was performed to analyze the result of the auxetic incisions in different penile deformities.…”

A decade of grafting techniques as a sole treatment for Peyronie’s disease

“…Almost 90% of the patients were satisfied. Computer‐planned grafting may seem appealing but still awaits more scientific support as well as improvement to be both surgeon‐friendly and time‐efficient 40 …”

“…Computer-planned grafting may seem appealing but still awaits more scientific support as well as improvement to be both surgeon-friendly and time-efficient. 40 During the same year, the Otero group used bovine pericardium for grafting after total plaque excision in 43 patients. Fourteen months post-grafting, they reported a penile straightening rate of 80%, 75% of which were able to perform satisfactory sexual intercourse needless of drugs.…”