Microscopic electric rotary grinding combined with graft repairing in patients with Peyronie's disease: a report of 21 cases

Objective To explore the surgical techniques and experiences in the treatment of Peyronie's disease using electric rotary grinding of tunica albuginea plaques followed by graft repair with tunica vaginalis or bovine pericardium under a microscope. Methods A retrospective cohort study was performed on 21 patients with severe penile curvature due to Peyronie's disease admitted in our department from January 2021 and May 2023. All of them underwent microscopic electric rotary grinding of tunica albuginea plaques followed by graft repair surgery. Short-term and mid-term outcomes were observed. Results For the 21 enrolled patients, 12 (57.1%) underwent repair using unilateral tunica vaginalis, 3 (14.3%) underwent repair using bilateral tunica vaginalis, and 6 (28.6%) underwent repair using bovine pericardium. The operation time was 170~385 (average 272±69) min, and the average postoperative follow-up duration was 3~24 (average 12.1±7.2) months. Seventeen patients (81.0%) had their penis fully extended, while 4 patients (19.0%) had slight dorsal curvature, which was less than 10°. All patients were satisfied with the shape of their penis during erection. The change in penile length was +(1.1±0.5) cm, and 9 patients (42.9%) reported early postoperative penile head numbness, which spontaneously resolved after an average duration of 3.2±1.9 months. All patients were able to successfully engage in sexual activity, with an average penile erection hardness score of 3.8. The overall satisfaction rate was 90.5% postoperatively. Conclusion Meticulous dissection of Buck's fascia under a microscope is advantageous in reliably preserving dorsal neurovascular structures. Application of an electric grinding drill for plaque ablation allows for more precise release of the tunica. Graft repair of tunica albuginea defects with testicular tunica vaginalis or bovine pericardium for Peyronie's disease yields overall favorable clinical outcomes and obtains high satisfaction. It is worthy of promotion in clinical practice.