Vein grafting of tunical incisions in the treatment of Peyronie's disease.

The effectiveness of vein grafting of tunical incisions of Peyronie's plaques in straightening the penis, with preservation of normal erectile function is evaluated. Eighteen patients with Peyronie's disease were surgically treated with a vein patch graft technique to correct their penile curvature. Transverse relaxing incisions were made on the tunica albuginea where a curvature was identified by an artificial erection. A vein graft from the saphenous vein was sewn into the defect created by relaxing incisions. If there was evidence of a residual curvature after the vein grafts were sewn in, a plication of the contralateral surface of the tunica albuginea was performed. The saphenous vein grafting alone was sufficient to straighten the penis 90 to 100% in 50% of patients. Of twelve patients who were potent preoperatively, one required postoperatively an occasional intracorporeal injection to maintain erection. Two of the impotent men regained their potency postoperatively. None of the patients lost sensation in the glans or shaft of the penis. Penile shortening was reported in three patients. No decrease in the penis rigidity was noted. Patients were discharged within 5 days of the procedure. There were no immediate complications. Fifteen of our sixteen followed patients resumed intercourse in eight weeks. We found that plaque incision in the venous grafting is much easier than the other incisional and excisional procedures described in the literature, and may lead to successful correction of penile deformity without compromising potency, penile length and sensitivity.

Brachytelephalangy with mental retardation, peculiar face and short stature in two sibs. A new MCA/MR syndrome?

A new MCA/MR syndrome?: Two sibs are described who shares as clinical features microcephaly, short stature, deep set eyes, thick eyebrow, straight long nose with prominent bridge, septum extending below alae nasi, short philtrum, small mouth, high palate, prominent everted lower lip, and brachytelephalangy. To the best of our knowledge, this association has not been reported before.