Introduction: Penile plaque incision and grafting (PIG) has slowly replaced penile plaque excision and grafting (PEG) as the mainstay of severe Peyronies with curvatures > 60°. PIG is currently the treatment of choice for hourglass or hinge deformities, severe penile shortening. it is our Aim to describe a difficult procedure that is not commonly performed
Methods: The patient is positioned supine, prepped and draped in a sterile fashion. We perform a penile plaque incision and grafting described in 5 broad steps. We first perform a circumcision incision and deglove the penis. We then mobilize the neurovascular bundle laterally. A double Y/double Lamda tunica incision is made. We then place our graft followed by closure. Our patients are discharged same day with 7 days of antibiotics with follow-up in 1 month.
Results: A successful penile plaque incision and grafting was performed with resolution of curvature and the hourglass deformity. Our patient was discharged the same day with 1 month follow-up.
Conclusions: PIG is the surgical treatment of choice for those with >60°curvature and good baseline erectile function, hourglass or hinge deformities, and/or severe penile shortening. Penile rehab is important to maximize baseline function. Currently no incision type or grafting material has shown superiority.