title: Bicentric prospective evaluation of corporoplasty with porcine small intestinal submucosa (SIS) in patients with severe Peyronie's disease.
abstract: BACKGROUND
  Advanced Peyronie's disease (PD) with severe penile deviation demands grafting procedures following plaque incision or partial plaque excision in order to avoid penile shortening and to improve quality of life of affected patients. Small intestinal submucosa (SIS) is an established xenograft. The objective of the present study was to validate external results in a bicentric prospective manner.
  
  
  METHODS
  Patient selection criteria, surgical technique and standards for pre- and postoperative care were defined. Consecutively, patients with severe penile deviation in stable disease and sufficient erectile function were included between 2007 and 2015. After plaque incision, grafting was performed using SIS in a standardized manner. The postoperative evaluation using a non-validated questionnaire included complications, correction of curvature, pre- and postoperative erectile function, change in penile length and general satisfaction with the procedure.
  
  
  RESULTS
  Forty-three patients underwent surgery between 2007 and 2015. The mean degree of preoperative curvature was 73.8° (range 60-90°). No intraoperative or major postoperative complications were reported. After a mean follow-up of 33.0 months (range 10-59), complete straightening of the penis was achieved in 74.4%. 88.4% of all patients were able to achieve satisfying sexual intercourse (67.4% unaided, 21.0% with assistance). The IIEF-5 score was improved in 69.8% (mean improvement 4.0 points). Overall 86.0% were satisfied with the surgical treatment.
  
  
  CONCLUSIONS
  Corporoplasty with SIS in patients with PD and severe penile curvature is a safe approach and shows good long-term results. A thorough patient selection and a standardized pre-, intra- and postoperative procedure are decisive for a satisfying outcome.
authors.affiliation: Department of Urology, Lueneburg Medical Center, Lueneburg, Germany.|Department of Urology, Menoufia University, Shebeen El-Kom, Egypt.
authors.forename: K
authors.initials: K
authors.lastname: Sayedahmed
authors.affiliation: Department of Urology, University of Regensburg, Caritas St. Josef Medical Center, Landshuter Str. 65, 93053, Regensburg, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Rosenhammer
authors.affiliation: Department of Urology, University of Regensburg, Caritas St. Josef Medical Center, Landshuter Str. 65, 93053, Regensburg, Germany.
authors.forename: P J
authors.initials: PJ
authors.lastname: Spachmann
authors.affiliation: Department of Urology, University of Regensburg, Caritas St. Josef Medical Center, Landshuter Str. 65, 93053, Regensburg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Burger
authors.affiliation: Department of Urology, Lueneburg Medical Center, Lueneburg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Aragona
authors.affiliation: Department of Urology, Lueneburg Medical Center, Lueneburg, Germany.
authors.forename: B T
authors.initials: BT
authors.lastname: Kaftan
authors.affiliation: Department of Urology, Lueneburg Medical Center, Lueneburg, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Olianas
authors.affiliation: Department of Urology, University of Regensburg, Caritas St. Josef Medical Center, Landshuter Str. 65, 93053, Regensburg, Germany. hans-martin.fritsche@ukr.de.
authors.forename: H M
authors.initials: HM
authors.lastname: Fritsche
mesh_terms: D000328:Adult; D000818:Animals; D004210:Dissection / Q000379:methods; D006801:Humans; D007421:Intestine, Small / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D018579:Patient Selection; D010410:Penile Erection; D010411:Penile Induration / Q000175:diagnosis / Q000601:surgery; D010413:Penis / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology; D011788:Quality of Life; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods; D011795:Surveys and Questionnaires; D013552:Swine; D016378:Tissue Transplantation / Q000379:methods*; D016896:Treatment Outcome; D013521:Urologic Surgical Procedures, Male / Q000009:adverse effects / Q000379:methods
keywords: Induratio penis plastica; Penile curvature; Peyronie’s disease; SIS; Small intestinal submucosa