Abstract
Report the results using porcine small intestinal submucosa (SIS) as a graft material in the surgical management of Peyronie's disease (PD). We performed a retrospective chart review of men with PD who underwent surgical correction of the curvature by plaque "H" incision and patch grafting with 4-ply SIS (Cook, Bloomington, IN) by a single surgeon at our institution. Degree and direction of curvature, sexual function, and co-morbidities were assessed pre- and postoperatively. Thirteen patients were identified. Mean age was 57 +/- 8, range 42-70 years. Median follow-up was 14 months, range 3-89 months. At presentation, all reported penile curvature. Also reported were difficulty with vaginal penetration (determined by question number 2 of the sexual encounter profile questionnaire - SEP2), palpable plaque, hourglass deformity, difficulty with firmness, and difficulty with sustaining erection (determined by SEP3) in 77%, 69%, 77%, 62%, and 46% of patients, respectively. Mean and median degrees of curvature of the primary deformity were 71 and 67.5 degrees, respectively. Three patients had secondary curves of less than 30 degrees in a different direction. Mean and median plaque size were 3.5 and 2.7 cm2, respectively. Seven patients had one graft and six patients had two grafts placed with a mean size of 15 +/- 0 cm2. For the patient with PD, SIS grafting can achieve a functionally straight erection with durable results yet with relatively high rates of erectile dysfunction. SIS is a viable graft material for use in the surgical treatment of PD.
Highlights
Peyronie’s disease (PD) is a condition of plaque formation in the tunica albuginea of the corpora cavernosa with resultant curvature of the penis [1]
The disease has two phases; an early acute phase associated with painful erections and progression of deformity, and a later chronic phase in which the pain ceases and the deformity is stabilized
We present our institution’s experience with small intestinal submucosa (SIS) grafts in 13 patients
Summary
Peyronie’s disease (PD) is a condition of plaque formation in the tunica albuginea of the corpora cavernosa with resultant curvature of the penis [1]. The disease has two phases; an early acute phase associated with painful erections and progression of deformity, and a later chronic phase in which the pain ceases and the deformity is stabilized. Conservative medical therapy is the initial treatment of choice for patients with acute phase disease. SIS for Patching in Treatment of Peyronie’s Disease injections and various forms of energy have been applied for the treatment of PD [2]. Few medical therapies have been proven effective in large scale trials. Surgical correction is the treatment of choice when the deformity precludes intercourse, but should not be considered until the disease has reached its stable, chronic phase
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