332 Autologous Dermal Tissue Grafting for Peyronie's Disease with Large Tunica Albuginea Defects

Abstract

We performed 188 surgical operations for treatment of Peyronie's disease. Calcification of the tunica albuginea, marked curvature, and extensive lateral plaques resulted in large defects that required dermal grafting. This study evaluated the effectiveness and safety of dermal grafting for treatment of Peyronie's disease. We analyzed data from 555 cases of Peyronie's disease. Average patient age was 51.4 years. The chief complaints included curvature, palpable fibrosis, pain, and erectile function. Drug therapy resulted in improvement in 283 (51%) cases. After conservative treatment for 1 year, patients underwent plication or grafting. In addition, two methods were used for saphenous vein grafting: vein grafting after plaque excision and vein grafting after hourglass-shaped incision. Dermal grafting was performed for large or lateral defects. In total, 113 patients underwent saphenous vein grafting, 11 underwent dermal grafting, and 64 underwent plication. Evaluation of patients who underwent dermal grafting showed graft hardening and slight graft shrinkage in only one patient, during the second postoperative month. However, graft quality improved during the 6 months after surgery. Among patients who received large dermal grafts, all grafts were of sufficient size at 1 postoperative year.