Peyronie's plaque: surgical treatment with the carbon dioxide laser and a deep dorsal vein patch graft

We describe a procedure for ablation of Peyronie's plaque using the carbon dioxide laser, which allows one to remove all palpable evidence of plaque while at the same time avoiding the creation of a large defect in the tunica albuginea requiring coverage with a large graft. The plaque is removed by making either a longitudinal or transverse incision in the plaque with a focused carbon dioxide laser beam from a hand held probe, and evaporating the plaque substance from the undersurface by tangentially directing the laser beam. It is possible to remove large dystrophic calcifications from within the plaque and to augment the repair in the area of greatest curvature using the deep dorsal vein as a patch graft. In cases of narrow plaques relaxation incisions and venous patch grafting alone are usually sufficient to correct the deformity. Our experience with 12 patients is summarized and 2 cases are reported in detail to illustrate the versatility of the procedure.