Plication for Peyronie disease

Peyronie's disease

Penile plication

  1. Once patient intubated, position supine and inject 20ug alprostadil in 1mL sterile water (do not use saline), inject into lateral corpus
  2. Prep, drape, give cefazolin, and place catheter (capped)
  3. Assess penile curvature, making longitudinal incision opposite maximal curvature (ventral midline if dorsal curvature only)
  4. Incise layers down to tunica albuginea over corpora, taking care to avoid urethra
  5. Use small retractors to assess corpora, choose proximal and distal areas at point of maximal bulge
  6. Place non-absorbable braided stitch in a 2-1-4-3 fashion, tie down to bury the knot
  7. After placing 3-4 stitches, assess erection for residual curvature
  8. Close deep layers x2 with monocryl or vicryl then close skin with subcuticular 4-0 monocryl, apply dermabond, telfa, and compressive dressing