1/12. Peyronie's disease: an unusual presentation with butterfly shaped calcified plaques.Peyronie's disease is characterized by the formation of a fibrotic plaque in the tunica albugenia of the penis. Two patients with calcified butterfly shaped plaques involving the ventrolateral aspect of the penis are described. These patients were managed by plaque excision and dermal grafting with excellent post-operative results.- - - - - - - - - - ranking = 1keywords = tunica (Clic here for more details about this article) |
2/12. Corporeal herniation after Nesbit plication with partial thickness shaving for congenital penile curvature.A 24-year-old man with penile congenital curvature who underwent partial thickness tunical shaving and plication with absorbable suture presented 1 month after surgery with a mass at the base of the right corpus cavernosum at the level of the original plication. We believe that corporeal herniation after tunical shaving and plication must be considered a complication of the technique independent from the type of suture used for the plicatures and probably related both to the opening of plications of the albuginea before permanent adhesion of the tunical layers, and to the decreased resistance of the albuginea, probably because of excessive shaving.- - - - - - - - - - ranking = 3keywords = tunica (Clic here for more details about this article) |
3/12. Inclusion cyst and graft contraction in Tutoplast human cadeveric pericardium following Peyronie's grafting: a previously unreported complication.Tutoplast human cadaveric pericardium has been utilized safely and successfully in numerous series of tunica albuginea grafting for Peyronie's curvature without reported rejection, cyst formation, or foreign body reaction. We describe a previously unreported complication of inclusion cyst formation and graft contraction in a 40-year-old white male following Tutoplast human cadaveric pericardial graft surgical correction of Peyronie's curvature. The complication was successfully treated with surgical graft excision and replacement with autologous temporalis fascia.- - - - - - - - - - ranking = 1keywords = tunica (Clic here for more details about this article) |
4/12. Porcine small intestinal submucosa is not an ideal graft material for Peyronie's disease surgery.PURPOSE: The incidence of Peyronie's disease is up to 7% in some series. While there are numerous nonsurgical methods of treatment, they do not have a high rate of success. Nesbit plication was once the accepted surgery for Peyronie's disease. Tunical lengthening procedures became popular because they avoided penile shortening caused by the Nesbit procedure. More urologists now perform plaque incision or excision, followed by grafting with different materials. Small intestinal submucosa offered promise as an ideal graft material. It is available off the shelf as 1 or 4-ply graft material. In several studies it appeared to function as a collagen based scaffold with graft incorporation in host tissue. MATERIALS AND methods: A single reconstructive urologist performed plaque incision and small intestinal submucosa grafting in 4 cases of Peyronie's disease using the same surgical technique. RESULTS: Although early results were positive, we have achieved less than satisfactory results with this material. The penis was straight in the immediate postoperative period but there was recurrent curvature in 3 of the 4 patients, of whom 2 had recurrence within 4 months of the procedure. CONCLUSIONS: We observed disappointing results with small intestinal submucosa for Peyronie's disease surgery with a high percent of recurrent curvature. Further studies are needed to determine if 1 or 4-ply small intestinal submucosa is an ideal graft material for the tunica albuginea.- - - - - - - - - - ranking = 1keywords = tunica (Clic here for more details about this article) |
5/12. Penile reconstruction with de-epithelized superficial external pudendal artery flap.Complete loss of skin, Buck's fascia and tunica albuginea of the corpus cavernosum occurred on both sides of the penile shaft after placement of a penile prosthesis for the treatment of Peyronie's disease. We describe this unusual complication and surgical reconstruction of the penis with a de-epithelized superficial external pudendal artery axial pattern flap (January 1988). A good result was obtained.- - - - - - - - - - ranking = 1keywords = tunica (Clic here for more details about this article) |
6/12. fibrosis of tunica albuginea: complication of long-term intracavernous pharmacological self-injection.We report 3 cases of penile curvature deformity and fibrosis of the tunica albuginea after long-term self-injection with papaverine hydrochloride and phentolamine mesylate. To our knowledge this complication has not been reported previously. The clinical presentation and possible etiology are discussed.- - - - - - - - - - ranking = 5keywords = tunica (Clic here for more details about this article) |
7/12. High-resolution real-time ultrasound in Peyronie's disease.Sonography is not considered to be a radiation hazard; it is noninvasive and can be widely used for examining external genitalia. We examined six cases of Peyronie's disease of the penis by high-resolution real-time ultrasound. The sonographic findings include a thick echogenic plaque with echogenicity similar to or higher than the tunica albuginea; a calcified plaque in thickened tunica albuginea; and are occasionally associated with calcification in the corpora cavernosa. Sonography may clearly localize the abnormal thickened area of collagen deposition and calcification. Repeated sonography after intracavernosal papaverine injection may further confirm the correlation of the plaque and the abnormally curved erectile penis. Doppler ultrasound may be used for further evaluation of the vascular condition if impotence coexists.- - - - - - - - - - ranking = 2keywords = tunica (Clic here for more details about this article) |
8/12. Transverse septum-like plaque of Peyronie's disease in a young man.An unusual case of Peyronie's disease in a 22-year-old male is presented. The patient complained of sluggish erection of the pendulous portion of the penis. A fibrous plaque in the tunica albuginea at the base of the penis extended into the corpus cavernosum cross-sectionally. histology was consistent with Peyronie's disease. Some improvement was obtained by partial excision of the plaque.- - - - - - - - - - ranking = 1keywords = tunica (Clic here for more details about this article) |
9/12. New surgical treatment for Peyronie disease.Five patients with Peyronie disease were treated successfully with a surgical technique derived from Nesbit's technique for the treatment of congenital curvature of the penis. Excision of ellipses of tunica albuginea from the convex side of the penis as described by Nesbit was not done, but instead the tunica was reeved with nonresorbable sutures to achieve straightening. The surgical technique combined with prior radiotherapy was successfully applied to patients with severe forms of Peyronie disease. More experience is necessary to establish the value of the proposed treatment concept.- - - - - - - - - - ranking = 2keywords = tunica (Clic here for more details about this article) |
10/12. Circumferential Peyronie's disease involving both the corpora cavernosa.An extraordinary form of Peyronies disease is reported. The patient was a 52 year old male, who died of a malignant thymoma with multiple bone metastasis, extensive pleural carcinomatosis of the left lung and some metastatic nodules in the liver and the mesenterium. At autopsy, the proximal and middle portions of the penis were very hard. Macroscopically, the entire tunica albuginea of both the corpora cavernosa was markedly thickened, 2-4 mm; and calcified. Microscopically, the tunica albuginea showed extensive hyaline degeneration, calcification and ossifying foci with osteoblasts and osteoclasts. Inflammatory cells were frequently found beneath the thickened tunica albuginea. In the corpus cavernosum, cavernous arteries showed marked intimal thickening and medial muscular degeneration with a few inflammatory cells. Smooth muscles of the stroma were extensively atrophic and degenerative, and some of them were infiltrated with a few inflammatory cells. In the corpus spongiosum, the tunica albuginea was not thickened, but the smooth muscle in the stroma was atrophic and degenerative and a few inflammatory cells were also found. Surprisingly, there was no Littres gland around the urethra. In Peyronies disease, the dorsal part of the penis is usually involved, and less frequently lateral or ventral sites are involved. The circumferential involvement of both the corpora cavernosa has not been reported until now, as far as the authors know.- - - - - - - - - - ranking = 4keywords = tunica (Clic here for more details about this article) |
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