Surgical Correction for Peyronie’s Disease
Surgical Correction of Peyronie’s Disease via Tunica Albuginea
Plication (TAP) Partial Plaque Excision with Pericardial Graft (PEG) with Long term Follow Up
by Frederick L. Taylor, M.D.and Laurence A. Levine, M.D.
(as reported in Journal of Sexual Medicine, 2008, voume 5)
61 patients underwent TAP and 81 underwent PEG (Plaque Incision with Tutoplast Pericardial Graft). Average followup time was 72 months and 58 month respectively. Rigidity was reported as good or better than pre-op in 81% of TAP and only 68% in PEG patients. 82% of TAP patients and 75% of PEG patients were satisfied.
The paper is critiqued by Dr. David Ralph who points out that another way of looking at the data is 32% had worsening of erections and 21% had new onset of erectile dysfunction following surgery.
The authors Taylor and Levine reply, there is no doubt that penile prosthesis insertion with manual molding should be recommended for any Peyronies’s patient with erectile impairment.
Some urologists lean towards this approach anyway. Other, as do I offer patients the options and they decide. An implant can always be installed as a fall-back procedure.
Inflatable implants have on average a 6 to 8 year survival rate before a secondary revision may be indicated.
Not emphasized but described in other recent papers is penile shortening which is to be expected with plication, but surprisingly occurs not infrequently with release of plaque by incision or excision even if the curvature is corrected.
For your correction of Peyronies, I would recommend a phalloplasty surgeon. Our phalloplasty before and after photos and phalloplasty images are posted along with phalloplasty cost. Augmentation phalloplasty may be considered as an adjunctive or followup procedure.
abstract and comments by
Harold M. Reed, M.D.