MP36-09 EXPERIENCE WITH EXTRATUNICAL GRAFTING (ETG) FOR CORRECTION OF INDENTATION DEFORMITY WITHOUT BUCKLING IN MEN WITH PEYRONIE’S DISEASE

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP36-09 EXPERIENCE WITH EXTRATUNICAL GRAFTING (ETG) FOR CORRECTION OF INDENTATION DEFORMITY WITHOUT BUCKLING IN MEN WITH PEYRONIE’S DISEASE Jose Quesada-Olarte, Spencer Mosack, Daniel Roadman, and Laurence Levine Jose Quesada-OlarteJose Quesada-Olarte More articles by this author , Spencer MosackSpencer Mosack More articles by this author , Daniel RoadmanDaniel Roadman More articles by this author , and Laurence LevineLaurence Levine More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003270.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Peyronie's Disease (PD) can be surgically challenging, especially in men with indentation deformity. Extratunical grafting (ETG) is a relatively new surgical option that be employed to treat corporal indentation in those without buckling or hinge effect. Objective: To report our experience with the ETG procedure, including different grafts or graft location (under or over Buck’s fascia) pre and post-operative patient characteristics, and patient satisfaction. METHODS: We performed a retrospective chart review of patients following ETG, collecting data including baseline demographics, prior treatments, pre-operative deformity, erectile function, type of graft, grafting location (under or over Buck’s), patient satisfaction, and clinical outcomes at our tertiary-care referral center. RESULTS: From December 2018 to July 2022, 33 patients presenting with PD underwent an ETG and TAP and/or PEG (partial plaque excision and grafting) for indentation deformity with a mean follow-up of 14.6 months. Overall, patient satisfaction, specifically for the correction of indentation was 94%. Grafting location under or over Buck's fascia showed no statistical difference in patient satisfaction with penile appearance (54.5% and 72.7%, respectively, p>=0.05). Patients undergoing ETG, with PEG had significantly lower satisfaction with their erect appearance than TAP and ETG (0% and 71.4%, respectively, p=0.003). Several different grafts were used, there was no difference in satisfaction between the grafts used. Palpable graft was reported in 30 patients (91%), but only two were bothered by the graft (6%). Statistical analysis showed no difference in patient satisfaction according to the size of the graft or degree of curve correction. CONCLUSIONS: ETG has emerged as a less invasive and less risky surgical option than PEG to correct indentation deformities which are not associated with buckling or axial instability. Our initial results demonstrate a high rate of satisfaction with correction of indentation, but multiple factors contributed to lower overall satisfaction with appearance of the penis including loss of length (9%), residual curvature (6%), sensory changes (9%), and erectile dysfunction (15.1%). Further studies are needed to determine the optimum approach. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e482 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jose Quesada-Olarte More articles by this author Spencer Mosack More articles by this author Daniel Roadman More articles by this author Laurence Levine More articles by this author Expand All Advertisement PDF downloadLoading ...