Abstract
Adjunctive residual curvature correction by plaque incision and grafting with a sutureless graft during inflatable penile prosthesis (IPP) implantation in patients with Peyronie’s disease (PD) is our preferred technique. The PICS Technique (Penile Implant in Combination with the Sealing Technique) uses a self-adhesive collagen fleece (TachoSil®, Corza Medical, MA, USA) to cover the defect after plaque incision. The graft does not require sutures improving operative speed and avoiding needle stick of the implant cylinders. In this article, we present the first known application worldwide of a Rigicon Infla10® X (Rigicon, Ronkonkoma, NY, USA) device to Peyronie’s ventral curvature. The patient’s residual curvature of 80° after implantation was corrected by PICS through an additional subcoronal incision. At the conclusion of surgery, the penis was totally straight and rigid. No intra- and postoperative complications occurred. At the early follow-up of 12 weeks postoperatively, the patient was able to inflate and deflate the device and sexual intercourse was possible. A combination of the Rigicon Infla10® X and the PICS Technique represents a safe and successful approach for residual curvature correction during IPP in patients with ventral Peyronie’s curvature. The Rigicon Infla10® X device showed excellent rigidity, and controlled expansion of the X cylinders means it can be used with the PICS Technique without restrictions. Early results are promising. Long-term follow-up and more patients are needed.
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References
Salonia A, Bettocchi C, Boeri L, Capogrosso P, Carvalho J, Cilesiz NC, et al. European Association of Urology Guidelines on Sexual and Reproductive Health - 2021 Update: Male Sexual Dysfunction. Eur Urol. 2021;80:333–57.
Sokolakis I, Pyrgidis N, Mykoniatis I, Dimitriadis F, Hatzichristodoulou G. A comprehensive narrative review of residual curvature correction during penile prosthesis implantation in patients with severe erectile dysfunction and concomitant Peyronie’s disease. Transl Androl Urol. 2021;10:2669–81.
Osmonov D, Ragheb A, Ward S, Blecher G, Falcone M, Soave A, et al. ESSM Position statement on surgical treatment of Peyronie’s disease. Sex Med. 2022;10:100459.
Hatzichristodoulou G. The PICS Technique: A Novel Approach for Residual Curvature Correction During Penile Prosthesis Implantation in Patients With Severe Peyronie’s Disease Using the Collagen Fleece TachoSil. J Sex Med. 2018;15:416–21.
Kadioglu A, Tefekli A, Erol B, Oktar T, Tunc M, Tellaloglu S. A retrospective review of 307 men with peyronie’s disease. J Urol. 2002;168:1075–9.
Hatzichristodoulou G. Introducing the ventral sealing technique using collagen fleece for surgical therapy of patients with ventral Peyronie’s curvature: initial experience. Int J Impot Res. 2018;30:306–11.
Hatzichristodoulou G, Fiechtner S, Pyrgidis N, Gschwend JE, Sokolakis I, Lahme S. Suture-free sealing of tunical defect with collagen fleece afer partial plaque excision in 319 consecutive patients with Peyronie’s disease: The Sealing Technique. J Urol. 2021;206:1276–82.
Wilson SK, Delk JR II. A new treatment for Peyronie’s disease: modeling the penis over an inflatable penile prosthesis. J Urol. 1994;152:1121–3.
Wilson SK, Cleves MA, Delk JR II. Long-term follow-up of treatment for Peyronie’s disease: modeling the penis over an inflatable penile prosthesis. J Urol. 2001;165:825–9.
Wilson SK, Simhan J. Is modeling an inflatable penile prosthesis obsolete for patients with Peyronie’s disease? Int J Impot Res. 2020;32:267–73.
Mulhall JP, Schiff J, Guhring P. An Analysis of the Natural History of Peyronie’s Disease. J Urol. 2006;175:2115–18.
Sokolakis I, Pyrgidis N, Ziegelmann MJ, Mykoniatis I, Köhler TS, Hatzichristodoulou G. Penile Prosthesis Implantation Combined With Grafting Techniques in Patients With Peyronie’s Disease and Erectile Dysfunction: A Systematic Review. Sex Med Rev. 2022;10:451–9.
Anaissie J, Yafi FA. A review of surgical strategies for penile prosthesis implantation in patients with Peyronie’s disease. Transl Androl Urol. 2016;5:342–50.
Falcone M, Preto M, Ceruti C, Timpano M, Garaffa G, Sedigh O, et al. A Comparative Study Between 2 Different Grafts Used as Patches After Plaque Incision and Inflatable Penile Prosthesis Implantation for End-Stage Peyronie’s Disease. J Sex Med. 2018;15:848–52.
Falcone M, Preto M, Peretti F, Gontero P, Pyrgidis N, Sokolakis I, et al. The use of collagen fleece to correct residual curvature during inflatable penile prosthesis implantation (PICS technique) in patients with complex Peyronie disease: a multicenter study. J Sex Med. 2023;14:229–35.
Hatzichristodoulou G, Yang DY, Ring JD, Hebert KJ, Ziegelman MJ, Köhler TS. Multicenter Experience Using Collagen Fleece for Plaque Incision With Grafting to Correct Residual Curvature at the Time of Inflatable Penile Prosthesis Placement in Patients With Peyronie’s Disease. J Sex Med. 2020;17:1168–74.
Wilson SK, Haxhimolla H, Kua B, Testa G, Love C, Rossello M, et al. Survival From Revision Surgery for New Rigicon Infla10 Three-piece Inflatable Penile Prosthesis Is Comparable to Preceding Devices. Urology. 2023;180:257–61.
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Conception and design of the study: GH, EA. Data acquisition: GH, MHG, HÖ, EA. Analysis and interpretation of data: GH, MHG, HÖ, EA. Drafting the manuscript: GH. Style revision: GH, MHG, HÖ, EA. All authors revised the manuscript and read and approved the version submitted.
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Hatzichristodoulou, G., Gültekin, M.H., Özkara, H. et al. First worldwide correction of ventral Peyronie’s disease utilizing rigicon inflatable penile prosthesis combined with plaque incision & grafting with collagen fleece (PICS-technique) for residual curvature. Int J Impot Res (2024). https://doi.org/10.1038/s41443-024-00873-y
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DOI: https://doi.org/10.1038/s41443-024-00873-y
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Response to the Commentary on “Intermediate-term results of TachoSil grafting to correct residual curvature during inflatable penile prosthesis implantation in patients with Peyronie’s disease”
International Journal of Impotence Research (2024)