title: The surgical treatment of Peyronie's disease: replacement of plaque by free autograft of buccal mucosa.
abstract: OBJECTIVE
  The aim of this work was the evaluation of clinical results of the use of buccal mucosa for replacement of Peyronie's disease plaque.
  
  
  METHODS
  Twenty-six patients with Peyronie's disease were under observation. All the patients underwent the following investigations before and periodically within 3 years after the treatment: International Index of Erectile Function (IIEF-5), manual examination of plaque, autophotography of erect penis, conventional and power color Doppler sonography of penis, Peno-Brachial Index (PBI) before and its increase (IPBI) after the intracavernous injection of papaverin, Peak Systolic Velocity (PSV), end diastolic velocity (EDV), Resistance Index (RI), Sexual Encounter Profile questions (SEP-2 and SEP-3), measurements of penile length and curvature angle in the phase of rigidity. After stabilization in plaque's development (mean time 2.0+/-0.1 years) the patients underwent a surgery by means of excision of plaque and its replacement by free autograft of buccal mucosa.
  
  
  RESULTS
  After the surgical treatment (with mean follow up observation of 3.2+/-0.1 years) in 24 patients out of 26 (92.3%) the complete straightening of penis occurred, in two (7.7%) cases a residual curvature (<10 degrees) remained, in four patients (15.4%) the shortening of penis (by 1cm) and in two patients (7.7%) a partial reduction of erectile power were observed.
  
  
  CONCLUSIONS
  Buccal mucosa showed high properties of adaptation and revascularization, good anatomical and functional clinical results by replacement of indurative plaque, it kept a stable elasticity without shrinkage; the method is simple and can be recommended for wide use in clinics for surgical treatment of Peyronie's disease.
authors.affiliation: Department of Urology at State Medical Academy, I. Chavchavadze Ave. 33, 380079 Tbilisi, Georgia, Georgia. iva_shioshvili@yahoo.com
authors.forename: Tamaz J
authors.initials: TJ
authors.lastname: Shioshvili
authors.forename: Alexander P
authors.initials: AP
authors.lastname: Kakonashvili
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000637:transplantation*; D010208:Papaverine / Q000008:administration & dosage; D010410:Penile Erection / Q000502:physiology; D010411:Penile Induration / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color; D013521:Urologic Surgical Procedures, Male / Q000379:methods*; D014665:Vasodilator Agents / Q000008:administration & dosage
chemical_list: D014665:Vasodilator Agents; D010208:Papaverine