title: Buccal mucosa is a promising graft in Peyronie's disease surgery. Our experience and a brief literature review on autologous grafting materials.
abstract: OBJECTIVE
  Peyronie's Disease (PD) is an under reported acquired benign condition that, at the moment, is not curable with medical therapy. Surgery represent the gold standard of treatment. Surgical approaches are several and they consist in "plication techniques" or plaque incision/excision with grafting of resulting albuginea defect. Among grafting procedures, albuginea defect substitution with autologous materials demonstrated over the years not inferior results respect to heterologous grafts. Buccal mucosa graft (BMG) is not usually emphasized in many review articles and clinical series are yet limited.
  
  
  METHODS
  We present our experience with seventeen plaque incision procedures and BMG in surgical correction of complex penile curvatures due to PD performed in a period of 30 months. Our analyses was focused on buccal mucosa graft characteristics as major determinant of the surgical success. We also conducted a brief literature review on autologous grafting materials used in reconstructive penile surgery for PD.
  
  
  RESULTS
  Our cosmetics and functional results consists in a 100% of functional penile straightening with no relapses and 5,8% of de novo erectile dysfunction. Mean age was 56.4 years, mean follow-up of 22.5 (6-36) months. No complications graft related were observed. Operative time was 115.3 minutes in mean. Over 94% of patients referred they were "really much better" and "much better" satisfied based on PGI-I questionnaire administrated at the last follow- up visit.
  
  
  CONCLUSIONS
  BMG is revealing as an optimal choice for reconstructive surgery in PD. Anatomical characteristics consisting in the great elasticity, the quick integration time and the easy harvesting technique lead to high cosmetics and functional success rate, without omitting economical and invasiveness aspects.
authors.affiliation: Urologic Unit, Surgical Dpt, ASUR Marche Area Vasta 3, Macerata Civic Hospital. andreadoc1@libero.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Fabiani
authors.forename: Lucilla
authors.initials: L
authors.lastname: Servi
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Fioretti
authors.forename: Valentina
authors.initials: V
authors.lastname: Maurelli
authors.forename: Flavia
authors.initials: F
authors.lastname: Tombolini
authors.forename: Alessandra
authors.initials: A
authors.lastname: Filosa
authors.forename: Alessandro
authors.initials: A
authors.lastname: Zucchi
authors.forename: Gianni
authors.initials: G
authors.lastname: Paulis
authors.forename: Gabriele
authors.initials: G
authors.lastname: Mammana
mesh_terms: D000359:Aftercare; D000368:Aged; D007172:Erectile Dysfunction / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000637:transplantation*; D017060:Patient Satisfaction; D010411:Penile Induration / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D011795:Surveys and Questionnaires; D014182:Transplantation, Autologous; D016896:Treatment Outcome