Extratunical grafting for minimally invasive management of complex Peyronie's disease deformities.

Background: Penile deformities due to Peyronie's Disease (PD) often significantly impair men's sexual health and quality of life.

Aim: In this article we discuss the extratunical graft (ETG) procedure as a management strategy for PD patients with hourglass or indent penile deformities.

Methods: We compiled descriptions of surgical techniques and performed a review of the literature regarding ETG for PD.

Outcomes: The ETG procedure appears to have promising results in the management of indent/hourglass deformity of PD.

Results: The findings of this review of the literature demonstrate that ETG is a safe and effective reconstructive technique for penile deformity with minimal side effects.

Clinical implications: We recommend utilizing ETG with or without plication for PD patients with indent or hourglass deformities.

Strengths and limitations: Strengths of ETG are the improvement in patients with tunical indents and hourglass deformities secondary to PD. Additionally, patients who underwent ETG maintained sexual function given no significant change in penile length and intact erectile function. Limitations, however, are that the procedure is relatively new, and data are limited to small cohorts.

Conclusion: The ETG procedure is a safe and effective for management of complex PD in the short- and intermediate-term follow-up cohort.