V07-09 Penile Prosthesis Implantation With Plaque Incision and Grafting: Multiple Slice Technique

You have accessJournal of UrologySexual Dysfunction/Infertility/Andrology (V07)1 May 2024V07-09 PENILE PROSTHESIS IMPLANTATION WITH PLAQUE INCISION AND GRAFTING: MULTIPLE SLICE TECHNIQUE Andrew D. Shumaker, Aaron Smith, and Petar Bajic Andrew D. ShumakerAndrew D. Shumaker , Aaron SmithAaron Smith , and Petar BajicPetar Bajic View All Author Informationhttps://doi.org/10.1097/01.JU.0001008932.49144.fd.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Inflatable penile prosthesis (IPP) with straightening maneuvers is the optimal treatment for men with Peyronie's disease (PD) and erectile dysfunction (ED) that is refractory to medical therapy. Straightening maneuvers include IPP insertion, manual modeling, tunical plication and plaque incision and grafting (PIG). Cylinder herniation or bulging through the graft site is a known complication of IPP/PIG surgery. The "multiple slice" technique leverages several small incisions to correct deformity while minimizing the risk of cylinder complications. This video describes our technique for "multiple slice" IPP/PIG. METHODS: A 65-year-old male with PD and refractory ED presented for evaluation. He was noted to have a 60-degree leftward curvature with significant narrowing at the maximal point of curvature and associated hinge effect. Additionally, the patient noted severe length loss. He was counseled on his options and elected for IPP/PIG via a subcoronal approach with "multiple slice" PIG. After manual modeling, there was a notable residual 45-degree leftward curvature. After elevation of the neurovascular bundle, the tunica albuginea was incised with multiple small incisions in both transverse and longitudinal orientation. This allowed for correction of both curvature and girth loss. The defect was then covered with a collagen fleece graft and Buck's fascia was closed. Following this, the pump and reservoir were inserted and connected, and a multi-layer closure was performed. The device was left 50% inflated. RESULTS: The operative time was approximately 2 hours and 20 minutes. On post-operative day one, the drain was removed and the patient was discharged home. The prosthesis was completely deflated in the office two weeks post-operatively. CONCLUSIONS: We demonstrate our technique for IPP with "multiple slice" PIG. This technique is useful for patients with complex Peyronie's deformity that may require a large incision and graft that might otherwise be prone to cylinder herniation or bulging. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e470 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Andrew D. Shumaker More articles by this author Aaron Smith More articles by this author Petar Bajic More articles by this author Expand All Advertisement PDF downloadLoading ...