The presented protocol describes a microscopic surgical method for the treatment of Peyronie's disease by using electric rotary grinding of the plaques followed by using the tunica vaginalis or bovine pericardium as a graft for the repairing of the defects of the tunica albuginea.
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Method Article
Microscopic Electric Rotary Grinding of Plaques Combined with Graft Repair in the Management of Peyronie's Disease
In This Article
Summary
Abstract
Peyronie's Disease (PD) is clinically characterized by the development of localized fibrous plaques, primarily on the tunica albuginea, especially on the dorsal area of the penis. These plaques are the hallmark feature of this condition, resulting in penile curvature, deformity, and painful erections for affected individuals. Although various nonsurgical treatment options exist, their overall effectiveness is limited. As a result, surgical intervention has become the ultimate choice for patients with severe penile curvature deformities and associated erectile dysfunction. Our research team has successfully employed a combined approach involving microscopic electric rotary grinding of the fibrous plaques and the use of tunica vaginalis or bovine pericardium as graft materials for the repairing of the defects of tunica albuginea in the treatment of PD. This approach has consistently yielded highly satisfactory results regarding the restoration of penile shape, with excellent cosmetic results and significantly improved sexual satisfaction.
This protocol aims to present a comprehensive surgical management strategy utilizing electric rotary grinding of the plaques and repairing the defects of tunica albuginea by using the tunica vaginalis, which represents an optimal surgical strategy for treating PD.
Introduction
Peyronie's disease (PD) is a chronic fibrotic condition that contributes to penile deformity, curvature, pain, sexual disability, and even leading to psychological distress1. PD likely represents a heterogeneous condition, with both heritable and environmentally-driven epigenetic factors contributing to its development and progression2.
The reported epidemiology of PD varies and may be under-reported because of embarrassment and misconceptions about the available treatment options, with 0.4%-20.3% among different ethnicities and cohorts2,3<....
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Protocol
The protocol was carried out in accordance with the principles of the Helsinki Declaration, and all the methods described here have been approved by the ethics committee of Daping Hospital (IRB: 2023168). Written consent was obtained from the patients.
1. Instruments for operation
- Conduct all the procedures under a surgical microscope. Ensure the availability of sterilized instruments and other equipment mentioned in the Table of Materials. Set the magnification between 3x-6x during the surgery, which is enough for dissection.
2. Inclusion and exclusion c....
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Results
A total of 21 patients were included from January 2021 to May 2023. The patient's age ranges from 34 to 68 years, with an average of 51.5 ± 9.4 years old. Of the total number of patients, 8 (38.1%) had diabetes. A total of 16 patients (76.2%) showed significant simple dorsal curvature of the penis, with a curvature angle of 60-90° and 5 patients (23.8%) presented with complex hourglass-like deformities with both dorsiflexion and lateral curvature, or accompanied by constriction like deformities, with bending angles rangi.......
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Discussion
In this study, we developed a new surgical strategy combining microscopic electric rotary grinding of plaques with graft repair to manage PD. The preliminary results showed that the corrective effect is satisfactory. To the best of our knowledge, this is the first study on the combined application of microscopic technology and an electric grinding drill for the surgical correction of PD.
Currently, various treatment options are recommended for PD patients, ranging from oral medications and in.......
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Disclosures
The authors have nothing to disclose.
Materials
| Name | Company | Catalog Number | Comments |
|---|---|---|---|
| Bovine pericardium | Guanhao Biotech, Guangzhou, Co. | TB-S6050/TB-S3050 | |
| Cefuroxime sodium | Yiyi Saite, Co., Ltd | N/A | 0.75 g |
| Disposable Radiofrequency Ablation Electrode (Multifunctional Surgical Dissector) | Chongqing Andiyingge Techology Developement Co.,Ltd | SZ02068 | |
| Operating microscope system | Carl Zeiss Co., Ltd | OPMI VARIO 700 | |
| Polyglactin thread | Ethicon, LLC | Vicryl, W9981 | |
| Ropivacaine | Yiyi Saite, Co., Ltd | N/A | 0.5%,2.5 mL |
| Vacuum device | Shenzhen Chunyu Biotech Co. | CY078 |
References
- Tsambarlis, P., Levine, L. A. Nonsurgical management of Peyronie's disease. Nat Rev Urol. 16 (3), 172-186 (2019).
- Sharma, K. L., Alom, M., Trost, L. The etiology of Peyronie's disease: Pathogenesis and genetic contributions. Sex Med Rev. 8 (2), 314-323 (2020).
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