Plaque Incision and Grafting (Lue procedure) for Peyronie's disease is sometimes indicated where the penile curvature exceeds 60 degrees, and erectile function remains healthy. Penile length and any shortening already taken place due to the Peyronie's are also taken into consideration.
The procedure involves degloving (pulling back) the penile shaft skin, and then approaching the scarred area and cutting into it ('Incision'). Once the incision is made and the penis pulled straight, a graft is stitched into the defect created ('Grafting'), to restore and lengthen the concave side of the penis to match the longer, convex side. The result is tested with a test-erection during the operation, and any further corrections made.
The graft material used can vary, but at LMC we currently use Bovine pericardial patch SJM- a widely used graft with minimal reported problems.
The surgery takes around 2 to 3 hours, and usually requires an overnight stay.. There is a dressing and bandage applied for a few days along with a catheter (to drain the bladder), after which it can be removed. Patients are advised to avoid intercourse for a month after surgery, and warned that there is a 20-30% risk of worsened erectile function in the medium-term, which may require pharmacological asssitance (eg with Viagra). The overall complication rate of this operation is is fairly high at 20-30% over 5 years (worldwide data), and it is only generally performed when none of the other options (conservative management, Nesbit procedure or penile prosthesis) are suitable.
Lue procedure (Plaque Incision & Grafting)