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Objective To explore the surgical techniques and experiences in the treatment of Peyronie's disease using electric rotary grinding of tunica albuginea plaques followed by graft repair with tunica vaginalis or bovine pericardium under a microscope. Methods A retrospective cohort study was performed on 21 patients with severe penile curvature due to Peyronie's disease admitted in our department from January 2021 and May 2023. All of them underwent microscopic electric rotary grinding of tunica albuginea plaques followed by graft repair surgery. Short-term and mid-term outcomes were observed. Results For the 21 enrolled patients, 12 (57.1%) underwent repair using unilateral tunica vaginalis, 3 (14.3%) underwent repair using bilateral tunica vaginalis, and 6 (28.6%) underwent repair using bovine pericardium. The operation time was 170~385 (average 272±69) min, and the average postoperative follow-up duration was 3~24 (average 12.1±7.2) months. Seventeen patients (81.0%) had their penis fully extended, while 4 patients (19.0%) had slight dorsal curvature, which was less than 10°. All patients were satisfied with the shape of their penis during erection. The change in penile length was +(1.1±0.5) cm, and 9 patients (42.9%) reported early postoperative penile head numbness, which spontaneously resolved after an average duration of 3.2±1.9 months. All patients were able to successfully engage in sexual activity, with an average penile erection hardness score of 3.8. The overall satisfaction rate was 90.5% postoperatively. Conclusion Meticulous dissection of Buck's fascia under a microscope is advantageous in reliably preserving dorsal neurovascular structures. Application of an electric grinding drill for plaque ablation allows for more precise release of the tunica. Graft repair of tunica albuginea defects with testicular tunica vaginalis or bovine pericardium for Peyronie's disease yields overall favorable clinical outcomes and obtains high satisfaction. It is worthy of promotion in clinical practice.

Introduction: To evaluate the potential predictive value of the Mayo Adhesive Probability (MAP) score combined with the RENAL score for intraoperative outcomes in retroperitoneal laparoscopic nephron-sparing surgery (NSS) in an Eastern Asian population. Methods: An initial of 388 patients undergoing retroperitoneal laparoscopic NSS were identified. MAP and RENAL scores were calculated according to CT and a logistic regression model was adopted as a combination of the RENAL score and the MAP score. Results: A total of 293 patients were included. The overall intraoperative complication rate was 7.5% (21 cases). The MAP score was found to correlate with operation time (OT; r = 0.169), estimated blood loss (EBL; r = 0.318), and intraoperative complications (r = 0.242). The RENAL score was correlated with warm is-chemia time (r = 0.503), OT (r = 0.334), intraoperative complications (r = 0.178), and EBL (r = 0.218). The MAP score and the RENAL score were reliable predictors of overall intraoperative complications, with areas under the curve (AUC) of 0.728 and 0.759, respectively. After combination of these 2 scores, the AUC of overall intra-operative complications was improved with statistical significance (AUC = 0.847, combination vs. RENAL score: p = 0.044 < 0.05; combination vs. MAP score: p = 0.005 < 0.05). Conclusion: The MAP score is an important predictor of EBL, OT, and intraoperative complications in retroperitoneal laparoscopic NSS and its combination with the RENAL score showed a superior predictive value compared to a single score in overall intraoperative complications. The MAP score might be considered in preoperative radiologic aspects as regularly as the RENAL score. [ABSTRACT FROM AUTHOR]