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Comparing Outcomes of Grafts Used in Peyronie’s Disease Surgery: a Systematic Review

  • Male Sexual Dysfunction and Disorder (N Thirumavalavan, Section Editors)
  • Published:
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Abstract

Purpose of Review

Peyronie’s disease (PD) is a scarring condition of the tunica albuginea. Various graft materials are used to fill defects following plaque incision (PIG) or partial excision (PEG), but the optimal graft material remains unknown. This systematic review compares outcomes of different grafts, performed with or without concurrent penile prosthesis implantation (PPI).

Recent Findings

Studies reported quantitative curvature assessment, with adequate follow-up to assess straightening, change in penile length, postoperative erectile dysfunction (ED), and patient satisfaction. From a total of 41 study arms, 1732 patients underwent PEG/PIG without and 302 with PPI. For PIG/PEG without PPI, the most frequently used grafts are cadaveric human pericardium (38.3%), autologous saphenous vein (21.2%), and porcine small intestinal submucosa (13.5%) with reported mean preoperative curvature of 69.3° and curvature recurrence ≥ 30° in 6.6%, 5.4%, and 15.4%, respectively. Grafts used most commonly with PPI include hemostatic patches (36.4%), bovine pericardium (34.8%), with similar mean preoperative curvature of 70.0° (p < 0.01). Satisfaction rates for PIG/PEG without PPI ranged from 70 to 100% with lowest satisfaction rates associated with dermis (70%) and human pericardium (73.4%). In the prosthesis cohort, satisfaction rates exceeded 88% with all grafts.

Summary

Human pericardium seems to be the most commonly used graft when PPI is not indicated, with low rates of curvature recurrence, an acceptable rate of ED and satisfaction. Hemostatic patches are the most favorable graft choice with concurrent PPI. In general, the PD treatment literature is limited to low evidence grade retrospective studies, and further prospective investigation is warranted.

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Authors and Affiliations

  1. Division of Urology, Rush University Medical Center, Chicago, IL, USA

    Petar Bajic, Channa A. Amarasekera & Laurence A. Levine

  2. Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, 9500 Euclid Ave, Q10-1, Cleveland, OH, 44195, USA

    Petar Bajic

  3. Department of Urology, Northwestern University, Chicago, IL, USA

    Aisha L. Siebert & Channa A. Amarasekera

  4. Galter Health Science Library, Northwestern University, Chicago, IL, USA

    Corinne H. Miller

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  1. Petar Bajic
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  2. Aisha L. Siebert
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Correspondence to Petar Bajic.

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LAL is a consultant for Absorption Pharmaceuticals, Boston Scientific, Coloplast, and Gesiva Medical.

The remaining authors have no conflicts of interest.

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Bajic, P., Siebert, A.L., Amarasekera, C.A. et al. Comparing Outcomes of Grafts Used in Peyronie’s Disease Surgery: a Systematic Review. Curr Sex Health Rep 12, 236–243 (2020). https://doi.org/10.1007/s11930-020-00283-3

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