Peyronieʼs disease in men with significant penile curvature is often treated with plaque incision/excision and grafting; when erectile dysfunction is associated, a penile prosthesis implantation is mandatory. We present our initial experience of plaque incision surgery with tunica vaginalis patch and concomitant implantation of penile prosthesis in patients with severe curvature due to IPP.

Nine patients, with severe penile curvature and erectile dysfunction, due to IPP, were considered from January 2006 to October 2007. A circumferential subcoronal and a longitudinal penoscrotal incisions were made. An H-shaped incision was made on the tunica albuginea. The albuginea defect was measured. Through the penoscrotal incision, an adequate tunica vaginalis patch was obtained to restore the defect and it was sutured to the albuginea. Then the penile prosthesis was placed in a standard fashion.

The mean operative time was 200 + 15 min. In four patients with mild erectile dysfunction a soft penile implant was placed; in five patients with complete erectile dysfunction an inflatable penile prosthesis was positioned. The mean follow up is 13.4 months. We recorded complications in only 1 patient (scrotal hematoma with spontaneous resolution). All patients are able to achieve sexual intercourse. No recurrence of penile curvature have been observed. Only one patient is unsatisfied, due to penile shortening.

Our experience shows that the plaque incision surgery with tunica vaginalis patch and concomitant implantation of penile prosthesis in patients with severe curvature due to IPP is a safe and efficacious technique, with encouraging satisfaction rate for patients.