Corporoplasty with small soft axial prostheses (VIRILIS IH) and bovine pericardial graft (HYDRIXH) in Peyronie’s disease

The surgical techniques used by Austoni and Egydio in the treatment of Peyronie’s disease are based on geometric principles. The aim of this paper is to report our multicentric experience and technical changes to Austoni’s original technique, focusing on several tips and tricks to make this technique easy to perform, even by less experienced practitioners. We performed operations in three different Italian institutions. Weimplanted a small soft Virilis IH axial prostheses (Ø 7 Fr.), using a bovine pericardium collagen matrix patch (HydrixH) to cover the defect in the tunica albuginea. Sixty patients with a mean age of 58 years (range 44–76 years) underwent surgery between September 2005 and January 2010. After surgery, mean lengthening of the shaft was 2 cm (range 1.2–2.3 cm) with complete correction of penile recurvatum. Thirty-nine patients resumed sexual activity 60 days later, 14 after 90 days and 7 after 120 days. The international index of erectile function (IIEF) score was 15.5 before surgery and it improved to 23 at 12 and 24 months after surgery. Furthermore, the visual analogue scale (VAS) showed good results in terms of the recovery of natural sexual intercourse (over 80% of couples) and of the original length and girth of the penis. The soft implant we used takes advantage of erection that occurs spontaneously, using the residual erection of the spared cavernous tissue. The method is easy to learn and reproducible, and the use of pericardium speeds up the operation, while also covering large defects of the tunica albuginea that result from complex recurvatum.