Leriche technique to brake Peyronies plaques

[Sad]

Hi. I've have Peyronies and I've heard there's a new procedure used in Europe called the Leriche technique. Has this been successful? And if so can someone tell me of a urologist that would perform it on me? Thanks.

[ComeBacKid]

We heard good things about it, but I don't think I've ever talked to anyone on this forum or off of it who had the technique done. After initial good reports in studies from europe, we heard nothing about it.  No credible usa peyronies doc does it that i'm aware of or advocates it.  To me, just using common sense I think it was overhyped reports from some unkown doctor in europe.  If it really worked as well as what the reports said, it would of surely caught on in the USA.  Along with pdlabs it remains to me one of the biggest mysteries and flukes of everything i've seen since having this disease for a decade.

Comebackid

[gallicdenis]

This was posted on the Pubs.gov website of the NIH.

"[Leriche technique for the treatment of La Peyronie's disease]

Khouaja K, Delmas V, Boccon-Gibod L.

Clinique Urologique, Hôpital Bichat, Paris. karimkhouaja@yahoo.fr

OBJECTIVE: The treatment of La Peyronie's disease comprises medical treatment during the inflammatory acute phase and surgical treatment at the stage of stabilization of the lesions. This technical report describes the Leriche technique for the treatment of the stable phase of La Peyronie's disease. OPERATIVE TECHNIQUE: Patients are operated on an outpatient basis under local anaesthesia, after localization of the plaque by intraoperative ultrasound of the penis with erection induced by physiological saline. A percutaneous tear of the plaque is performed with an 18 gauge needle. MATERIALS AND METHODS: Ten patients with a mean age of 58 years (range: 32-82 years) were operated for La Peyronie's disease between January 2002 and January 2004. They all presented with painless penile curvature on erection, but severe discomfort or impossibility of sexual intercourse. The patients were reviewed at 1 and to 3 months. The results were assessed in terms of the degree of penile straightening and resumption of sexual activity. RESULTS: Three patients obtained complete cure. Two patients gained sufficient penile straightening to allow sexual intercourse and recovery was insufficient to allow sexual intercourse for 3 patients, but the result was improved after a second or even a third attempt. The last 2 patients were classified as treatment failures and were treated by penile prosthesis in one case and by the Nesbit technique in the other case. The results observed at 1 month persisted at 3 months. CONCLUSION: The Leriche technique for the treatment of La Peyronie's disease is a simple, minimally invasive technique with satisfactory results. It does not compromise a subsequent procedure and does not present any short-term or long-term complications."

[LWillisjr]

I have seen this "study" before. It is the only one I am aware of out of this clinic in Paris. It isseveral years old and I have not heard of any other clinic perofmring this technique. And certainly a study with only 8-10 patients does not have much statistical bearing. I would think that if this technique is growing in popularity that we would see more positive information on it.

[Luciano]

Well the study about Leriche technique is published also on this board. (complete study)
https://www.peyroniesforum.net/index.php/topic,119.0.html
(it says lariche in the title, supposed to be leriche)
If you read it carefully, there are 2 comments (at the bottom) , 1 by leriche himself saying that the authors of the study had better results than he ever had using it himself... (he had only 30% satisfaction, as to the guys in the study they had 70%)
(He says that because of the bad results he had, he modified it. He now cuts the plaque with a lancet through the skin)

And, more interesting the comment by another uro who tried it:

Commentary by Pierre Bondil, Urologie, Chambery.

The laceration of the plaque with a needle is a new therapy which has the advantage of simplicity, low cost, and a reduced morbidity. I have used it systematically for 4 years but uniquely intraoperatively, which allows one to reduce the plicatures in the albuginea. Laceration allows a gain of 1 and sometimes 2 cm in length, and to reduce the plaque. Nevertheless, the precise technique of laceration needs to be improved. The first which I did resulted in a doubling of the volume of the plaque, which led me to be more prudent, and to look to improve the technique with 2 precautions: a controlled technique for laceration and prevention of a recurrence or post-operative fibrous aggravation by an accompanying corticoid injection, the prescription of tadalafil each evening in the absence of spontaneous erections, and recommendations for repetitive extensions of the cavernous tissue by traction on the glans for 2 weeks. Actually, on an erect penis, I avoid making an extensive laceration, but uniquely longitudinal and transverse grooves if the plaque is extensive and a prudent section of the plaque's fibrous attachments.

So it seems it is not quite as successful as the study wants to show us. And even the inventor as well as uros that used it have modified it and are not using it anymore. The one uro that used it, only used it during plication operations so he would have less plications.

AND the uro that tried it for the first time doubled the volume of the plaque of his patient....  . I wouldn't want to be the first guy if an uro was going to try it out.

Bottom line: IMO its nothing special, just another trial and error.
Luc

[carldeboard]

don't know for sure. Just read the report here and on wikipedia. sounds like it works to me. An implant cost 25,000 dollars. the leriche maybe a 1000 what
urologist would give up 25000 for 1000.

[MattFoley]

As far as I know, the leriche technique had been abandoned because no other doctor could replicate the original results. Is anyone doing it?

[james1947]

I made a serious search on the web.
It really seams that no one using the Leriche technique today.

James

[Whyisthishappening]

[Leriche technique for the treatment of La Peyronie's disease].
https://www.ncbi.nlm.nih.gov/pubmed/15776920
A percutaneous tear of the plaque is performed with an 18 gauge needle

[hope794]

Great infos! Thanks!!! Please, keep us updated..

[james1947]

The conclusion from the article from September 2004:

The Leriche technique for the treatment of La Peyronie's disease is a simple, minimally invasive technique with satisfactory results. It does not compromise a subsequent procedure and does not present any short-term or long-term complications.

My question is why the Leriche technique didn't come the the mainstream Peyronies treatment after 15 years.
An example from 2018:
https://www.auajournals.org/doi/full/10.1016/j.juro.2018.02.2189

James

[TonySa]

Sounds similar to the scratch technique, often combined w other procedures.