Venogenic impotence following dermal graft repair for Peyronie's disease

Peyronie's plaque excision with dermal grafting generally offers good cosmetic results for patients who require surgical intervention for Peyronie's disease. However, postoperative impotence has been reported in 12 to 100% of such patients. The mechanism of impotence in this setting is not well defined. We present 3 men who had venogenic impotence after plaque excision and dermal grafting for Peyronie's disease. One patient has subsequently responded well to dorsal vein ligation, 1 has chosen an effective nonoperative method of management and 1 continues to consider the options. We report venous leak as an organic cause of impotence after plaque excision and dermal grafting for Peyronie's disease, and its successful management by dorsal vein ligation. The implications of these findings in the surgical management of Peyronie's disease are discussed.