Medium-term follow-up of plaque incision and porcine small intestinal submucosal grafting for Peyronie's disease.
The best surgical option for the management of severe cases of Peyronie's disease is currently a matter of debate. To determine medium-term outcomes and complications after treatment of severe Peyronie's disease by porcine small intestinal submucosa (SIS) grafts, we retrospectively reviewed 33 consecutive plaque incisions followed by 4-ply SIS grafting in 28 patients (2002-2009). Postoperative complications, penile length preservation, de novo ED, penile curvature correction and curvature recurrence rates were recorded. Median patient age was 54 years (38-69 years). Median preoperative curvature was 90° (30-90°) (stable for at least 6 months). Six patients (21%) had preoperative ED. There were few postoperative complications (no cases of infection, haematoma (n=2), penile hypoesthesia (n=1), patch rejection and migration (n=1)). Subjective penile shortening and de novo ED were observed in 7 (25%) and 3 (11%) patients, respectively. The success rate for the procedure (straight penis or curvature ≤20° and ability to have intercourse) was 67% (22/33). Four patients achieved curvature correction after a repeat procedure with a new SIS graft. Eleven patients experienced recurrence within 3 months of surgery. After a median follow-up of 9 months (3-94), 22 patients (79%) had a satisfactory curvature correction.
Department of Urology and Andrology, Robert Debré Academic Hospital, Avenue du Général Koenig, Reims, France. fstaerman@chu-reims.fr
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F
Staerman
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Pierrevelcin
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T
Ripert
J
J
Menard
D000328:Adult; D000368:Aged; D000818:Animals; D007172:Erectile Dysfunction; D005500:Follow-Up Studies; D006801:Humans; D007413:Intestinal Mucosa / Q000637:transplantation*; D007421:Intestine, Small; D008297:Male; D008875:Middle Aged; D010411:Penile Induration / Q000473:pathology / Q000601:surgery*; D010413:Penis / Q000473:pathology / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology; D012008:Recurrence; D012189:Retrospective Studies; D013552:Swine; D014183:Transplantation, Heterologous; D013521:Urologic Surgical Procedures, Male / Q000379:methods*