Editorial Comment on “A Comparative Study Between Two Different Grafts Used as Patches After Plaque Incision and Inflatable Penile Prosthesis Implantation for End-Stage Peyronie’s Disease”

Abstract

I read with interest the recent article in the Journal of Sexual Medicine comparing the clinical outcomes between fibrin-coated collagen fleece (TachoSil; Baxter Healthcare, Deerfield, IL, USA) and porcine small intestinal submucosa in patients who underwent inflatable penile prosthesis implantation for end-stage Peyronie’s disease (PD).1 In recognition of the oft-repeated phrase in surgery, “there are more ways than one to skin a cat,” numerous substitution graft materials have been used in Peyronie reconstructive surgery.2 TachoSil is a ready-to-use fibrin sealant agent composed of an equine collagen matrix coated with human fibrinogen and thrombin. It has been used in many surgical specialties to improve hemostasis, promote tissue sealing, and support sutures when standard surgical techniques are insufficient.3 A recent systematic review on TachoSil4 showed that it has a role as supportive treatment in surgery to improve and shorten operative time, with potentially lower postoperative complications and hospital costs. However, TachoSil can have problems with intraoperative handling, especially at surgical sites that are difficult to access, and can be associated with higher risks of viral infection or other transferable diseases and stimulate allergic reactions.5 In fact, the Food and Drug Administration has issued warnings that the use of TachoSil can induce thrombosis if applied intravascularly and can potentially transmit infectious agents or cause hypersensitivity or allergic or anaphylactoid reaction.6