Hand surgeons for Dupuytren’s contractures have been successfully using an open percutaneous needle fasciotomy procedure instead of an open procedure. Why can’t this closed percutaneous technique be a procedure used by urologists for Peyronie’s patients?

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This is a good question and in fact Dr. Levine has had direct contact with the physician in Florida who has championed this approach. Unfortunately the situation is different in Peyronie’s disease in that with Dupuytren’s the scar tissue attaches to the underlying tissue causing the tethered finger which can not fully extend. By using the percutaneous technique the attachment can be severed, thereby correcting the finger deformity. Unfortunately, there is no such attachment of the plaque to underlying tissues which when released would correct the deformity. Current surgical technique for PD uses a variety of plication procedures or making releasing incisions through the scar, but this leaves a defect/gap in the tunica albuginea which needs to be filled with a graft. Dr. Gerald Brock in London, Ontario has used a trans-tunical subtotal incision of the plaque but typically a plication procedure is necessary as well to get complete correction of deformity.