Singapore Med J 2008; 49 (10) : 805 Original Article Department of Urology, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India Goyal NK, MS Senior Resident Kumar A, MS Senior Resident Das SK, MS Senior Resident Pandey AK, MS Senior Resident Sharma GK, MS Senior Resident Trivedi S, MCh Lecturer Dwivedi US, MCh Reader Singh PB, MCh Professor Correspondence to: Prof Pratap Bahadur Singh Tel: (91) 983 961 0185 Fax: (91) 542 231 3200 Email: pburology@ gmail.com Experience with plaque excision and dermal grafting in the surgical treatment of Peyronie’s disease Goyal N K, Kumar A, Das S K, Pandey A K, Sharma G K, Trivedi S, Dwivedi U S, Singh P B ABSTRACT Introduction: Peyronie’s disease is a common cause of sexual dysfunction. We assess the technique of plaque excision and dermal grafting for the treatment of Peyronie’s disease. Methods: A total of 11 patients, aged 38–55 years, were operated for Peyronie’s disease. All patients had stable plaque on the dorsum or dorsolateral aspect of the penile shaft. All patients had penile curvature, nine (81.8 percent) had painful erections, six (54.5 percent) had penile pain and three (27.3 percent) had erectile dysfunction. All suffered difficulty in intercourse. We performed plaque excision and dermal grafting. Main outcome measures were relief of penile pain, relief of painful erection, performance of satisfactory coitus and straight penis while erection. Results: All patients had relief of penile pain and painful erection. Nine (81.8 percent) patients had straight penis and had satisfactory coitus. Two (18.2 percent) patients suffered postoperative erectile dysfunction which was mild and responded to Sildenafil tabs. Conclusion: Although experience with this technique is limited, the initial results are encouraging. We found this technique feasible with satisfactory results. Keywords: dermal graft, penile disease, penis, Peyronie’s disease, plaque excision Singapore Med J 2008; 49(10): 805-808 INTRODUCTION Peyronie’s disease (PD) is characterised by an acquired plaque-inducing penile deformity. (1) It is a common cause of sexual dysfunction in middle-aged men. Over the years, various medical and surgical therapies have been attempted with a relative lack of efficacy. Surgical treatment is opted in PD after medical management has failed. There are three general categories of surgical options for PD, namely: tunical shortening, tunical lengthening or grafting, and penile prosthesis. The ultimate goal for treatment of PD is to obtain satisfactory erection for intercourse and to relieve penile pain. We present our experience with dermal grafting in the surgical treatment of PD. METHODS This study is a retrospective analysis of 11 patients with PD treated with excision of plaque and dermal grafting from January 2001 to July 2007. The patients’ profile and clinical features are listed in Table I. All patients had calcified plaques which were stable for at least one year. All had received medical treatment in the form of oral vitamin E (400 mg thrice a day), intralesional steroid (triamcinolone, 10 mg biweekly for 12 weeks) or intralesional interferon α2b (3 million IU biweekly for Fig. 3 Operative photograph shows dermal graft placement. Fig. 1 Photograph shows severe dorsal chordee. Fig. 2 Operative photograph shows plaque excision.