title: Graft materials in Peyronie's disease surgery: a comprehensive review.
abstract: OBJECTIVE
  To discuss the currently used graft materials in Peyronie's surgery.
  
  
  METHODS
  A MEDLINE search was conducted till the end of September 2006 on the surgical treatment of Peyronie's disease, and all aspects of the graft materials used for Peyronie's surgery were examined.
  
  
  RESULTS
  Currently available interposing graft materials may be classified in three categories: autologous tissues, extracellular matrix (ECM) tissues, and synthetic materials. Each grafting material in these categories has its own advantages and drawbacks in terms of tissue properties, antigenicity, availability, and cost-effectiveness. Saphenous vein grafts are the most widely used among autologous grafts, with acceptable functional outcomes in the long term. Other graft materials include tunica vaginalis, fascia lata, rectus fascia, and buccal mucosa, with variable results. Despite numerous advantages in terms of tissue compatibility, the major drawback of autologous grafts is tissue harvesting that to morbidities and longer operative durations. For this reason, the use of readily available ECM tissues as the products of tissue engineering is recommended by some authors. Among ECM grafts, cadaveric and bovine pericardia have satisfactory mid-term outcomes. However, longer follow-ups with an adequate number of patients are lacking. On the other hand, recent evidence suggests that small intestinal submucosa may be associated with high rate of operative failure and complications. Generally, synthetic materials are no longer used in grafting procedures in Peyronie's surgery because of their antigenicity and inappropriate functional properties. For prosthesis surgery, pericardia as well as autologous rectus fascia grafts are probably the most suitable graft materials because of their suitable tissue characteristics that satisfy the mechanical demands of the prosthesis.
  
  
  CONCLUSIONS
  Saphenous vein grafting from autologous tissues and pericardium from ECM tissues have satisfactory results. However, further research and clinical studies are needed in order to determine the optimal graft material.
authors.affiliation: University of Istanbul, Istanbul Faculty of Medicine, Department of Urology, Section of Andrology, Istanbul, Turkey. Electronic address: kadiogluates@ttnet.net.tr.
authors.forename: Ates
authors.initials: A
authors.lastname: Kadioglu
authors.affiliation: University of Istanbul, Istanbul Faculty of Medicine, Department of Urology, Section of Andrology, Istanbul, Turkey.
authors.forename: Oner
authors.initials: O
authors.lastname: Sanli
authors.affiliation: University of Istanbul, Istanbul Faculty of Medicine, Department of Urology, Section of Andrology, Istanbul, Turkey.
authors.forename: Tolga
authors.initials: T
authors.lastname: Akman
authors.affiliation: University of Istanbul, Istanbul Faculty of Medicine, Department of Urology, Section of Andrology, Istanbul, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ersay
authors.affiliation: University of Istanbul, Istanbul Faculty of Medicine, Department of Urology, Section of Andrology, Istanbul, Turkey.
authors.forename: Selcuk
authors.initials: S
authors.lastname: Guven
authors.affiliation: University of Istanbul, Istanbul Faculty of Medicine, Department of Urology, Section of Andrology, Istanbul, Turkey.
authors.forename: Firdovsi
authors.initials: F
authors.lastname: Mammadov
mesh_terms: D001672:Biocompatible Materials / Q000627:therapeutic use; D005109:Extracellular Matrix / Q000637:transplantation*; D006801:Humans; D008297:Male; D009092:Mucous Membrane / Q000637:transplantation*; D010411:Penile Induration / Q000601:surgery*; D010496:Pericardium / Q000637:transplantation*; D016038:Skin Transplantation / Q000379:methods*; D013524:Surgical Flaps; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D013521:Urologic Surgical Procedures, Male / Q000379:methods; D014680:Veins / Q000637:transplantation
chemical_list: D001672:Biocompatible Materials