A novel approach for the surgical management of Peyronie’s disease using an acellular, human dermis tissue graft: preliminary results

Abstract

To present for the first time, the use of an acellular, dermis tissue graft from serologically screened human donors (Εpiflex(®), Deutshes Institut für Zell- und Gewebeersatz) for covering cavernosal defects after plaque incision. Five patients with a mean age of 57.4 ± 2.1 years and an International Index of Erectile Function (IIEF-5) score >20, diagnosed with Peyronie's disease (PD) with disease duration and a stable penile deformity of at least 12 and 6 months, respectively, underwent reconstructive surgery. The curvature was dorsal in two, dorsal and left in two and dorsal and right in one patient. The patients were scheduled for follow-up at 1, 3 and 6 months. Placement of the Epiflex(®) graft (size 20 × 40 mm) was performed after appropriate spatulation and fixation with 4-0 Monocryl sutures in all patients. Two of the patients also underwent a small plication of the convex side in order to achieve 100% straightening during artificial erection. All patients had an uneventful course and resumed successful sexual activity 1 month later. No penile deformity, infection, antigenicity or de novo erectile dysfunction was observed during the follow-up period. This is the first study on the use of an acellular, human dermis tissue graft for the surgical management of PD. Despite our small number of patients, we now routinely use this type of graft, due to its superior biomechanical properties, excellent results and maximum safety. Larger patient series with longer follow-up periods are needed to verify our results.