Practical Computerized Solution for Incision and Grafting in Peyronie's Disease

Area of Science:

• Urology
• Andrology
• Surgical Innovation

Background:

• Traditional plaque incision and graft (PIG) for penile curvature correction carries risks of erectile dysfunction (ED) and anatomical abnormalities.
• Existing methods may lead to mechanical and geometric issues, impacting patient outcomes.
• Need for a refined PIG technique minimizing graft size and preserving erectile function.

Purpose of the Study:

• To develop and validate a novel PIG technique (iGrafter) utilizing minimal graft area.
• To correct simple or complex penile curvature, including hourglass deformity, while avoiding adverse mechanical and geometric outcomes.
• To assess the safety and efficacy of the iGrafter technique in preserving erectile function.

Main Methods:

• A mathematical solution for PIG with no residual defects was developed using a cotton fabric model.
• Fascia lata patch corporoplasty was performed on nine men with sufficient penile rigidity using the iGrafter technique (iPad app).
• Erectile function was assessed using the International Index of Erectile Function (IIEF-5) questionnaire preoperatively and postoperatively.

Main Results:

• Complete penile straightening was achieved in all nine patients after a mean follow-up of 17.8 months.
• Mean graft area was 12.4 cm², with a mean increase of 3 cm in the short side length of the penis.
• No significant complications were noted; mean IIEF-5 scores remained stable (20.6 preop vs. 19.4 postop), and eight patients reported satisfaction.

Conclusions:

• The iGrafter technique appears to be an efficient and safe method for penile curvature correction.
• It utilizes minimal graft area, preserves erectile function, and avoids residual deformities.
• Further research is recommended to confirm the long-term efficacy of this innovative procedure.