NERVE-SPARING RECONSTRUCTION OF AN EXTENSIVE TUNICAL DEFECT USING AUTOLOGOUS FASCIA LATA IN PEYRONIE’S DISEASE: A CASE STUDY

Authors

DOI:

https://doi.org/10.31435/ijitss.3(51).2026.6614

Keywords:

Peyronie’s Disease, Penile Curvature, Plaque Excision, Fascia Lata, Tunica Albuginea, Reconstructive Surgery

Abstract

Background: Peyronie’s disease may result in severe penile deformity requiring surgical reconstruction of the tunica albuginea. In patients with extensive calcified plaques, plaque excision may result in a large tunical defect requiring grafting. The optimal graft material remains controversial.

Case presentation: We present the case of a 53-year-old man with Peyronie’s disease, significant penile curvature, pain during erection, and an extensive calcified plaque measuring approximately 35 × 50 mm and involving approximately two-thirds of the penile circumference. Preoperative erectile function was assessed using the International Index of Erectile Function-5 (IIEF-5), with a score of 7 points. The patient underwent excision of the calcified plaque followed by reconstruction of the resulting tunical defect using an autologous fascia lata graft measuring 40 × 60 mm. The neurovascular bundle was carefully mobilised and preserved during the procedure.

Results: At 6 weeks after surgery, complete correction of the penile deformity and resolution of penile pain were achieved. The IIEF-5 score increased from 7 points preoperatively to 23 points postoperatively. No significant residual curvature or postoperative erectile dysfunction was reported at the time of follow-up.

Conclusion: Autologous fascia lata may represent a useful reconstructive option for extensive tunical defects following plaque excision in selected patients with Peyronie’s disease. In this case, a nerve-sparing approach resulted in satisfactory early anatomical and functional outcomes. Further studies with longer follow-up are required to evaluate the durability and long-term functional outcomes of this technique.

References

Levine, L. A., & Larsen, S. M. (2013). Surgery for Peyronie’s disease. Asian Journal of Andrology, 15(1), 27–34. https://doi.org/10.1038/aja.2012.140

European Association of Urology. (2026). EAU guidelines on sexual and reproductive health: Penile curvature. EAU Guidelines Office. https://uroweb.org/guidelines/sexual-and-reproductive-health

Rice, P. G., Somani, B. K., & Rees, R. W. (2019). Twenty years of plaque incision and grafting for Peyronie’s disease: A review of literature. Sexual Medicine, 7(2), 115–128. https://doi.org/10.1016/j.esxm.2019.01.001

Natsos, A., Tatanis, V., Kontogiannis, S., Waisbrod, S., Gkeka, K., Obaidad, M., et al. (2024). Grafts in Peyronie’s surgery without the use of prostheses: A systematic review and meta-analysis. Asian Journal of Andrology, 26(3), 250–259. https://doi.org/10.4103/aja202358

Kargi, E., Yeşilli, C., Hoşnuter, M., Akduman, B., Babuccu, O., & Mungan, A. (2004). Relaxation incision and fascia lata grafting in the surgical correction of penile curvature in Peyronie’s disease. Plastic and Reconstructive Surgery, 113(1), 254–259. https://doi.org/10.1097/01.PRS.0000095951.04305.38

Kalsi, J. S., Christopher, N., Ralph, D. J., & Minhas, S. (2006). Plaque incision and fascia lata grafting in the surgical management of Peyronie’s disease. BJU International, 98(1), 110–115. https://doi.org/10.1111/j.1464-410X.2006.06251.x

Kalsi, J., Minhas, S., Christopher, N., & Ralph, D. (2005). The results of plaque incision and venous grafting (Lue procedure) to correct the penile deformity of Peyronie’s disease. BJU International, 95(7), 1029–1033. https://doi.org/10.1111/j.1464-410X.2005.05459.x

Ainayev, Y., Zhanbyrbekuly, U., Gaipov, A., Suleiman, M., Kadyrzhanuly, K., Kissamedenov, N., et al. (2021). Surgical reconstruction of penile curvature due to Peyronie’s disease by plaque incision and buccal mucosa graft. The Journal of Sexual Medicine, 18(7), 1308–1316. https://doi.org/10.1016/j.jsxm.2021.04.009

Fernández-Pascual, E., Manfredi, C., Torremadé, J., Peinado Ibarra, F., Sarquella Geli, J., Romero-Otero, J., et al. (2020). Multicenter prospective study of grafting with collagen fleece TachoSil in patients with Peyronie’s disease. The Journal of Sexual Medicine, 17(11), 2279–2286. https://doi.org/10.1016/j.jsxm.2020.07.079

Hatzichristodoulou, G., et al. (2019). Evolution of the surgical sealing patch TachoSil® in Peyronie’s disease reconstructive surgery: Technique and contemporary literature review. World Journal of Urology. https://doi.org/10.1007/s00345-019-02792-w

Soydaş, T., Ünal, S., Uzundal, H., Kaşıkcı, M., Kutluhan, M. A., Okulu, E., & Kayigil, Ö. (2024). Comparison of autologous venous grafts and three types of extracellular matrix grafts in Peyronie’s disease surgery. Turkish Journal of Medical Sciences, 54(5), 893–899. https://doi.org/10.55730/1300-0144.5865

Sarna, S., Pang, K. H., Christopher, A. N., Ralph, D. J., Muneer, A., & Alnajjar, H. (2026). Plaque incision and grafting for Peyronie’s disease: 15-year experience and functional outcomes from a high-volume andrology centre. International Journal of Impotence Research. Advance online publication. https://doi.org/10.1038/s41443-026-01296-7

Roadman, D., Quesada-Olarte, J., Langbo, W., Mossack, S., & Levine, L. (2024). Experience with extra-tunical grafting and tunica albuginea plication for correction of indentation deformity in men with Peyronie’s disease. Urology, 186, 17–22. https://doi.org/10.1016/j.urology.2023.11.040

Downloads

Published

2026-09-28

How to Cite

Yefimchuk, D., Ciepiela, A., & Zemowski , M. . (2026). NERVE-SPARING RECONSTRUCTION OF AN EXTENSIVE TUNICAL DEFECT USING AUTOLOGOUS FASCIA LATA IN PEYRONIE’S DISEASE: A CASE STUDY. International Journal of Innovative Technologies in Social Science, 5(3(51). https://doi.org/10.31435/ijitss.3(51).2026.6614

Most read articles by the same author(s)