Use of small intestinal submucosa graft for the surgical management of Peyronie's disease.
OBJECTIVE
We report on the long-term followup of porcine small intestinal submucosal graft as a closure material for the tunica albuginea after plaque incision.


METHODS
A total of 162 patients with at least a 12-month history of Peyronie's disease with penile curvature of 60 degrees or more were evaluated. Patient age ranged from 33 to 69 years (mean 52). Preoperatively all patients underwent intracavernous injection and photographic documentation of curvature. Surgisis ES, derived from porcine small intestine, was immersed in normal saline and was used to graft the tunical deficit after plaque incision using a subcoronal incisional approach.


RESULTS
Surgical correction of penile curvature was achieved in 148 of 162 patients (91%). At a mean followup of 38 months (range 6 to 96) 79% of the patients were fully potent with 21% requiring assistance. No reports of intraoperative penile shortening, long-term pain, infection, bulging at the graft site or evidence of a local immunogenic rejection reaction have been noted.


CONCLUSIONS
Surgisis grafts for the coverage of cavernous defects after Peyronie's plaque incision allow for satisfactory clinical results in long-term followup. The ease of surgical handling and placement, no associated comorbidities from harvesting techniques, and no adverse reactions make this material an anatomical and functional tunical substitute.
Knoll
L Dean
LD
Center for Urological Treatment and Research, Nashville, Tennessee 37203, USA. dknoll23@yahoo.com
D000328:Adult; D000368:Aged; D000818:Animals; D005500:Follow-Up Studies; D006801:Humans; D007413:Intestinal Mucosa / Q000637:transplantation*; D007421:Intestine, Small; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010411:Penile Induration / Q000175:diagnosis / Q000601:surgery*; D011183:Postoperative Complications / Q000503:physiopathology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013552:Swine; D016378:Tissue Transplantation / Q000379:methods; D020858:Tissue and Organ Harvesting; D016896:Treatment Outcome; D013521:Urologic Surgical Procedures, Male / Q000379:methods*