Buccal mucosa is a promising graft in Peyronie’s disease surgery. Our experience and a brief literature review on autologous grafting materials

Fabiani, Andrea; Servi, Lucilla; Fioretti, Fabrizio; Maurelli, Valentina; Tombolini, Flavia; Filosa, Alessandra; Zucchi, Alessandro; Paulis, Gianni; Mammana, Gabriele

doi:10.4081/aiua.2016.2.115

Cited by 12 publications

(11 citation statements)

References 46 publications

(44 reference statements)

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“…Results are somewhat worse, in patients with Peyronie's disease, mainly due to the shortening resulting from this technique in a patient whose penis is already shortened by the disease itself. However, in face of the effectiveness of patch or prosthesis implantation techniques for curved penis correction in selected cases [20][21][22][23] , we oppose the results of our experience through the Nesbit corpora-plasty, carried out under local anesthesia following the protocol of fast-track surgery, which we believe is a reproducible technique regardless of population type, which does not require an exhaustive selection of patients in terms of their physical state. This technique allows for improvement of health resources performance and in turn, reduces the derived morbidity of the surgical and anesthetic act.…”

Section: Discussionmentioning

confidence: 51%

“…Although the cost of the intervention with outpatient treatment is similar to the process with hospital admission, savings are mainly in hospitality sector and health personnel. In addition, the hospital also benefits from an increase in the number of available beds, since, according to our own experience and that of other authors reviewed, the average hospital stay of patients operated by Nesbit technique with hospital admission varies between 1 and 3 days [19][20][21][22][23][24][25][26][27][28][29][30][31][32] .…”

Section: Discussionmentioning

confidence: 99%

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'Fast-Track' Protocol for Penile Curvature Treatment

Verdejo¹,

Navalon-Monllor²,

Monzo-Cataluna³

et al. 2017

J Anesth Surg

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Objectives: To describe a multimodal recovery protocol (fast-track surgery) for surgical treatment of penile curvature, as developed by the urology department at the General University Hospital of Valencia over the course of the last 10 years. Our aim was to demonstrate that the use of this protocol improves cost-effectiveness of the procedure, when compared to the classical procedure which requires hospital admission and general or spinal anesthesia. Material and Methods: We compared two groups of patients. The first group underwent strict ambulatory corporoplasty under our multimodal recovery protocol in an out-patient setting, with data collected prospectively. The second group of patients underwent curved penis surgery following the classical procedure before the multimodal recovery protocol was implemented, data was collected retrospectively. We evaluated the inclusion criteria and hospital discharge, as well as obtained results and degree of satisfaction through elaboration of a questionnaire. Results: Results obtained with fast-track protocol were comparable to those of conventional surgery, providing a null incidence of complications except for the inevitable shortening of the penis, clearly independent of the outpatient procedure regimen. The satisfaction degree with the received treatment was found to be over 95%. Conclusions: Virtually all patients affected by penile curvature could are suitable candidates for a fast-track surgery program, with the consequent improvement in cost-effectiveness of the procedure and no reduction of the quality of care received or patient satisfaction.

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Section: Discussionmentioning

confidence: 51%

Section: Discussionmentioning

confidence: 99%

'Fast-Track' Protocol for Penile Curvature Treatment

Verdejo¹,

Navalon-Monllor²,

Monzo-Cataluna³

et al. 2017

J Anesth Surg

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show abstract

“…Despite the recent raising of not surgical treatment of Peyronie’s disease, such as collagenase clostridium injections, 2,15,16 surgical intervention with PEG remains the mainstay for patients with severe penile curvature or hourglass deformations 3 . Various type of grafts have been used for this kind of surgery: autologous grafts, such as veins, 17 albuginea, 6 or buccal mucosa 5 which are affected by the need of an additional incision (and possible complications) in order to retrieve the graft, 10,12 and xenografts, such as porcine small intestine submucosa, 8 bovine pericardium, 11 and hemostatic grafts, 9 which have the advantage of being “off‐the‐shelf” products that do not need surgical retrieval and can be directly sewn into albugineal defects 3,12 . However, there is still no clear evidence about which graft is the optimal choice in case of PEG.…”

Section: Discussionmentioning

confidence: 99%

“…3 This kind of surgery aims at straightening by recovering penile length through incision/excision on the "short" side of the curvature, with a higher risk of post-operative erectile dysfunction (ED) compared to penile shortening techniques. 4 Over the past decades, various type of grafts, both allografts [5][6][7] and xenografts, [8][9][10][11] have been used to cover albugineal defects after plaque excision 3,12 but none of these proved superior compared to others, in terms of surgical and functional outcomes. 3,12 The aim of our study was to compare two different types of xenograft, porcine dermal matrix and bovine pericardium matrix, used to cover albugineal defects in PEG for PD, by assessing functional outcomes and patient's satisfaction after surgery.…”

Section: Introductionmentioning

confidence: 99%

Long‐term outcomes after plaque incision and grafting for Peyronie’s disease: comparison of porcine dermal and bovine pericardium grafts

Fiorillo¹,

Droghetti²,

Palmisano³

et al. 2020

Andrology

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Background Plaque incision and grafting (PEG) is one of the mainstays in surgical therapy for severe penile curvature in Peyronie’s disease (PD). Different kinds of grafts are available for covering albugineal defects during PEG, both allografts and xenografts. However, to date, none of these proved superior to others. Objectives To compare two different types of xenograft, porcine dermal matrix and bovine pericardium matrix in PEG for PD. Materials and methods From 2010 to 2019, 63 patients with PD underwent PEG, using porcine dermal (n = 25; Group 1) and bovine pericardium (n = 38; Group 2) grafts. Long‐term outcomes were evaluated through multi‐disciplinary questionnaires administration by phone interview. The following items were considered: correction of penile bending, quality of erection, intercourse ability, penile shortening, and sensitiveness. Overall satisfaction and impact of surgery on sexual activity and quality of life were also investigated. Results Plaque median (IQR) size was 29 (22‐33) mm and was smaller in Group 1 (27.5 vs. 31 mm; P = .03). Complete follow‐up data were available for 53 patients (84%). Considering post‐operative outcomes, no differences were found when considering ED rates, penile shortening, sensitiveness, complications, and penile straightening (all P > .1). Patients in Group 2 were more likely to have palpable penile nodules at follow‐up (20.6 vs. 0%; P = .03). However, patient’s post‐operative sexual life satisfaction was consistent between the two groups, with just 1 (5.3) and 8 (23.5) patients in Group 1 and 2 respectively referring a worsening in sexual life satisfaction (P = 0.2). At follow‐up, 84.9% of patients that would still undergo surgery for PD, with no statistical difference between the two groups (P = .4). Conclusions Corporoplasty with PEG is an effective treatment for men with PD. Porcine dermal and bovine pericardium xenografts seem to have similar long‐term outcomes.

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“…The mixed results of plaque incision/excision and grafting have provoked a drive towards optimizing possible approaches. Recent authors have sought to improve patient outcomes and satisfaction with multiple incisions in lieu of large grafts ( 60 ) and novel graft materials such as autologous lingual mucosa grafts, requiring 130 minutes of operating time ( 69 ), SIS grafts at 165 minutes ( 70 ), and buccal mucosa grafts at 115 minutes ( 71 ). One group presented the results of plaque excision and tunical re-approximation without graft, describing good results on short-term follow-up ( 72 ).…”

Section: Surgical Managementmentioning

confidence: 99%

Contemporary surgical and non-surgical management of Peyronie’s disease

Wayne

Cordon

2018

Transl. Androl. Urol.

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Numerous treatments have been proposed for Peyronie’s disease (PD). As the evidence base has expanded, the field of operative and non-operative options for patients has narrowed. Collagenase clostridium hystolyticum (CCH) injection now comprises the medical option, and surgical possibilities entail penile plication, plaque incision/excision and grafting, and prosthesis implantation. Still, questions abound regarding the optimal approach and indication for each of these treatments. We conducted a review of literature exploring the contemporary management of PD with a particular focus on work since the last American Urologic Association’s (AUA) guidelines update for PD. Recent results and discussion indicate trends toward minimal invasiveness, toward a more holistic approach to the PD patient, and away from algorithmic management, galvanized, in part, by data challenging long-held beliefs.

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Buccal mucosa is a promising graft in Peyronie’s disease surgery. Our experience and a brief literature review on autologous grafting materials

Abstract: SummaryNo conflict of interest declared.

Cited by 12 publications

References 46 publications

'Fast-Track' Protocol for Penile Curvature Treatment

'Fast-Track' Protocol for Penile Curvature Treatment

Long‐term outcomes after plaque incision and grafting for Peyronie’s disease: comparison of porcine dermal and bovine pericardium grafts

Contemporary surgical and non-surgical management of Peyronie’s disease

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