title: Use of autologous grafts in the treatment of acquired penile curvature: An experience of 33 cases.
abstract: OBJECTIVE
  The objective was to compare the use of autologous dermal and temporalis fascia grafts in the treatment of acquired penile curvatures.
  
  
  METHODS
  It was a prospective observational study of 33 cases, conducted in Sher-i-Kashmir Institute of Medical Sciences, Srinagar from March 2007 to September 2013. All the patients had stable Peyronies disease (PD). Dorsal, dorsolateral and vental curvatures with good preoperative erections were included. PD index with visual analog scales for curvature was used preoperatively. An informed written consent was taken from all the patients with main emphasis on erectile dysfunction.
  
  
  RESULTS
  After an average follow up of 2 years, complete straightening of penis was observed in all patients with satisfactory sexual intercourse in 30 patients (90%). Three patients (10%) required frequent use of type 5 phosphodiesterase inhibitors for adequate erections. Overall 91% of patients and partners were satisfied with the procedure and cosmetically donor site was better in temporalis fascia graft site. No rejection of any graft was noted and glans hypoesthesia was noticed in 4 patients (12%). None of the patients required penile prosthesis. Total operative time for harvesting and application of the graft was more in dermal grafts (>3 hrs) than for temporalis fascia graft (2 hrs).
  
  
  CONCLUSIONS
  Tunical lengthening procedures by autologous free grafts represents a safe and reproducible technique. A good preoperative erectile function is required for tunical lengthening procedure. Temporalis fascia graft is thin, tough membrane and effective graft for PD with good cosmetic and functional results.
authors.affiliation: Department of Urology, Sher-i-Kashmir Institute of Medical Sciences, and GMC, Srinagar, Jammu and Kashmir, India.
authors.forename: Abdul Rouf
authors.initials: AR
authors.lastname: Khawaja
authors.affiliation: Department of Urology, Sher-i-Kashmir Institute of Medical Sciences, and GMC, Srinagar, Jammu and Kashmir, India.
authors.forename: Tanveer Iqbal
authors.initials: TI
authors.lastname: Dar
authors.affiliation: Department of Urology, Sher-i-Kashmir Institute of Medical Sciences, and GMC, Srinagar, Jammu and Kashmir, India.
authors.forename: Suhael
authors.initials: S
authors.lastname: Zahur
authors.affiliation: Department of Urology, Sher-i-Kashmir Institute of Medical Sciences, and GMC, Srinagar, Jammu and Kashmir, India.
authors.forename: Sheikh
authors.initials: S
authors.lastname: Tariq
authors.affiliation: Department of Urology, Sher-i-Kashmir Institute of Medical Sciences, and GMC, Srinagar, Jammu and Kashmir, India.
authors.forename: Arf
authors.initials: A
authors.lastname: Hamid
authors.affiliation: Department of Plastic Surgery, Sher-i-Kashmir Institute of Medical Sciences, and GMC, Srinagar, Jammu and Kashmir, India.
authors.forename: M S
authors.initials: MS
authors.lastname: Wani
authors.affiliation: Department of Urology, Sher-i-Kashmir Institute of Medical Sciences, and GMC, Srinagar, Jammu and Kashmir, India.
authors.forename: B S
authors.initials: BS
authors.lastname: Wazir
authors.affiliation: Department of Urology, Sher-i-Kashmir Institute of Medical Sciences, and GMC, Srinagar, Jammu and Kashmir, India.
authors.forename: Arsheed
authors.initials: A
authors.lastname: Iqbal
keywords: Acquired penile; autologous grafts; curvature