Nerve-Sparing Reconstruction of an Extensive Tunical Defect Using Autologous Fascia Lata in Peyronie’s Disease: A Case Study

Background: Peyronie’s disease may result in severe penile deformity requiring surgical reconstruction of the tunica albuginea. In patients with extensive calcified plaques, plaque excision may result in a large tunical defect requiring grafting. The optimal graft material remains controversial. Case presentation: We present the case of a 53-year-old man with Peyronie’s disease, significant penile curvature, pain during erection, and an extensive calcified plaque measuring approximately 35 × 50 mm and involving approximately two-thirds of the penile circumference. Preoperative erectile function was assessed using the International Index of Erectile Function-5 (IIEF-5), with a score of 7 points. The patient underwent excision of the calcified plaque followed by reconstruction of the resulting tunical defect using an autologous fascia lata graft measuring 40 × 60 mm. The neurovascular bundle was carefully mobilised and preserved during the procedure. Results: At 6 weeks after surgery, complete correction of the penile deformity and resolution of penile pain were achieved. The IIEF-5 score increased from 7 points preoperatively to 23 points postoperatively. No significant residual curvature or postoperative erectile dysfunction was reported at the time of follow-up. Conclusion: Autologous fascia lata may represent a useful reconstructive option for extensive tunical defects following plaque excision in selected patients with Peyronie’s disease. In this case, a nerve-sparing approach resulted in satisfactory early anatomical and functional outcomes. Further studies with longer follow-up are required to evaluate the durability and long-term functional outcomes of this technique.