Results of Surgical Treatment for Abnormal Penile Curvature: Peyronie's Disease and Congenital Deviation by Modified Nesbit Plication (Tunical Shaving and Plication)

Rehman, Jamil; Benet, Alexandru E.; Minsky, Lloyd; Melman, Arnold

doi:10.1016/s0022-5347(01)64953-x

Cited by 99 publications

(48 citation statements)

References 26 publications

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“…3,13,14,18 According to the algorithm, generally accepted as a consensus by several authors, reconstructive surgery should be preferred for these young patients since they are all potent or have a positive response to CIS test. 17,32 Our choice of surgical treatment modality was plaque incision and venous grafting technique with its several outstanding advantages such as its high success rate, low risk for loss of erectile function and restoration of the neurovascular bundle which is dissected free from ®brous extensions during this procedure. 13 We achieved complete straightening of the curvature in all cases (n 3) under age 40 after plaque incision and venous grafting technique.…”

Section: Discussionmentioning

confidence: 99%

Peyronie's disease in men under age 40: characteristics and outcome

et al. 2001

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Peyronie's disease is most commonly seen in the ®fth decade of life. However, a wide range of age (20 ± 83 y) is reported. During a 6-year period, men with Peyronie's disease presenting under the age of 40 were reviewed retrospectively and followed-up. The prevalence of Peyronie's patients presenting under age 40 was 8.2%. Their mean age was 32.47 AE 5.37 (range: 23 ± 39) y and 78.9% of them presented during the acute phase of the disease. Pain on erection was a part of presenting symptom complex in 52.6% and the majority (84%) had a degree of penile curvature`60 . Erectile dysfunction (ED) was present in 21% of patients, who responded well to intracavernous injection test. After a minimal 2-year follow-up, improvement in penile deformity was observed in 36.8%, and 42.1% had stable disease while 21% experienced deterioration of the penile curvature. The onset of Peyronie's disease is clinically more noisy and acute in patients presenting under age 40 and this forces the physicians to treat them more vigorously.

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Section: Discussionmentioning

confidence: 99%

Peyronie's disease in men under age 40: characteristics and outcome

et al. 2001

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“…Rehman, in 1997, described a novel technique with partial thickness shaving instead of conventional excision of a wedge of tunica albuginea with lesser bleeding, diminished cavernous tissue damage and improved adhesion of plicated layers, translating in high satisfaction rates. 21 The Yachia procedure involves degloving the penis and making a longitudinal incision in the tunica albuginea opposite the plaque. The edges are reapproximated horizontally (according to the HeinekeMikulicz principle) with a resulting shortening of the side opposite the plaque and overall straightening of the penis.…”

Section: Tunica Plication: Procedures That Shorten the Tunicamentioning

confidence: 99%

“…6 It's recommended in situations where the curvature is greater than 60º -70º, if there are complex deformities or the presence of an hourglass or a hingedestabilizing component. 2,21 Excision can be avoided if the surgeon is able to perform relaxing incisions on the plaque with added grafting or no grafting at all. The graft (usually 20% larger than the defect) is then sutured to the tunica albuginea with separate running suture.…”

Section: Tunica Plication: Procedures That Shorten the Tunicamentioning

confidence: 99%

“…52 Both malleable and inflatable penile prostheses (IPP) have been used with worst results from the latter. 21 Patients with extended circumferential plaques and severe corporal fibrosis may need additional surgical dilators (Rossello ® cavernotomes or the Otis ® urethrothomes). 53 The ideal IPP is the three-piece inflatable penile prosthesis because it offers more support during modeling than a malleable prosthesis.…”

Section: Penile Prosthesismentioning

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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“…Indeed, in some series, loss of sensation and postoperative ED have been reported in as many as 24 and 12%, respectively. 93,94 Figure 4 Excision of plaque. Reproduced with Permission.…”

Section: Surgical Therapymentioning

confidence: 99%

Peyronie's disease: a critical appraisal of current diagnosis and treatment

2008

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Peyronie's disease is a fibrotic disorder of the tunica albuginea of the penis resulting in varying degrees of penile curvature and sexual dysfunction. Diagnosis of the disorder is made by detailed sexual history and focused physical examination. A wide range of medical treatments has been employed to treat the disorder. Verapamil treatment administered by intraplaque injection is supported by generally consistent randomized controlled trials (RCT). Some RCT evidence exists to support the use of colchicine, potaba, L-carnitine and liposomal superoxide dismutase. Future studies of medical efficacy should focus on improving RCT design, implementation and results reporting to improve the quality of evidence generated by each study. The surgical treatment of Peyronie's disease is a viable and recommended alternative for men with compromised sexual function due to severe curvature or lesions causing penile instability. The choice of corrective procedure should be tailored to each patient after a detailed evaluation of disease severity and sexual function.

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Results of Surgical Treatment for Abnormal Penile Curvature: Peyronie's Disease and Congenital Deviation by Modified Nesbit Plication (Tunical Shaving and Plication)

Abstract: Long-term results of this modified plication demonstrate excellent clinical outcome with minimal morbidity.

Cited by 99 publications

References 26 publications

Peyronie's disease in men under age 40: characteristics and outcome

Peyronie's disease in men under age 40: characteristics and outcome

Recent surgical advances in Peyronie’s Disease

Peyronie's disease: a critical appraisal of current diagnosis and treatment

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