Peyronie's disease: excision of the plaque and grafting with tunica vaginalis.

In patients with refractory Peyronie's disease, satisfactory sexual rehabilitation with correction of chordee and amelioration of local pain and tenderness can be achieved with wide excision of the plaque, followed by grafting with the tunica vaginalis from the testes. However, one must be extremely careful in assessing and selecting patients for surgery, and at least six months of observation must be allowed. The surgical outcome is most gratifying in patients with "mature" or well-demarcated plaques with progressive chordee. Finally, strict adherence to surgical principles to prevent graft contracture or to minimize its effects is urged.