PRACTICAL COMPUTERIZED SOLUTION FOR INCISION AND GRAFTING IN PEYRONIE’S DISEASE - UNIPLANAR CASE
This video shows the novel technique for plaque incision and graft with the help of iPad APP, called iGrafter. Here we show how to use the computerized solution step-by-step to correct a uniplanar case.
A transcrotal penile deglove is made, following by the dissection of the neurovascular bundle. An artificial erection was generated to measure the penile deviation. The present case had 53 degrees of dorsal curvature.
The beginning and end of the curvature were marked. The short side of the curvature, the long side, and the penile circumference were measured, and the results inserted into the iGrafter. The software generates 3 rules, used to mark the incision plane and the incision size. A graft mold was also generated and used to harvest the fascia lata graft. In that point, the surgeon can use a graft material of his preference (example: pericardium).
After plaque incision in a previous marked place, the corpora cavernosa defect was closed with the fascia lata graft, resulting in penile rectification without additional deformity.
A new artificial erection is not made after the curvature correction to avoid removal of the formed clots and prevent hematoma formation below the graft.
The advantages of this technique are minimum graft area, the absence of mechanical and geometric abnormalities on corpora cavernosa and also avoidance of residual deformities.
Peyronie's disease; Incision and graft; iGrafter
Hospital Federal de Ipanema - Rio de Janeiro - Brasil
Alexandre Freias Miranda