Penile lengthening with porcine small intestinal submucosa grafting in Peyronie's disease treatment: long‐term surgical outcomes, patients’ satisfaction and dissatisfaction predictors

Morgado, Afonso; Morgado, M. Ribeiro; Tomada, Nuno

doi:10.1111/andr.12522

Cited by 18 publications

(35 citation statements)

References 29 publications

(50 reference statements)

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“…Kovac et al and Chung et al included 36 and 46 patients, respectively, who were recruited over a time period of six years and also received dermal and synthetic grafts [12] or dermal and cadaveric pericardial grafts [13], which may render comparison of results difficult. Morgado et al focused on patient satisfaction with sex life after surgery [16]. Other studies reported less subjective penile shortening in 5–71% of patients [12,13,14,15,16], compared to almost 97% of patients in the present study.…”

Section: Discussioncontrasting

confidence: 42%

“…Previously, others have reported inconsistent findings on patient satisfaction with surgical outcome following SIS grafting. Some studies found high satisfaction rates of 82–89% [13,14,15,16], while Chung et al reported that more than 65% of patients were not satisfied with surgical outcome [12]. Variable findings among studies regarding patient satisfaction with surgical outcome may be due to differences in patient characteristics, follow-up, study design, and methods.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, xenogenic small intestinal submucosa (SIS) represents one of the most commonly used and widely established grafts for penile surgery in PD patients [5,7]. To date, there have been few published studies on SIS grafting for PD, and these studies have primarily focused on surgical outcome and complications [8,9,10,11], whereas patient reported treatment satisfaction has been considered in the minority of studies [12,13,14,15,16]. In addition, patient self-perceptions and attitudes of sexuality following SIS grafting have not been investigated so far.…”

Section: Introductionmentioning

confidence: 99%

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Negative Self-Perception and Self-Attitude of Sexuality Is a Risk Factor for Patient Dissatisfaction Following Penile Surgery with Small Intestinal Submucosa Grafting for the Treatment of Severe Peyronie’s Disease

Soave

Dahlem

Vetterlein

et al. 2019

JCM

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Objective: To assess patient satisfaction with surgical outcome, body related self-perceptions, self-attitudes of sexuality, and health related quality of life after penile surgery with small intestinal submucosa (SIS) grafting for the treatment of severe Peyronie’s disease (PD). Material and methods: This retrospective study included 82 patients, who were treated with SIS grafting for severe PD between 2009 and 2013 at the University Medical Center Hamburg-Eppendorf. Patients were asked to complete standardized questionnaires including the International Index of Erectile Function Erectile Function domain (IIEF-EF), Short-Form (SF)-8 Health Survey, and Frankfurt Body Concept Scale-Sexuality (FKKS-SEX). Results: Follow-up was available in 58 (69.9%) patients. SIS grafting resulted in subjective straightening of the penis in 53 (91.3%) patients. After a mean follow-up of 28.9 ± 16.5 months, 24 (41.4%) patients were satisfied or very satisfied with surgical outcome. Postoperatively, the mean FKKS-SEX was 23.5 ± 5.9. In total, 36 (62.1%), 18 (31%), and four (6.9%) patients had FKKS-SEX scores corresponding to positive, neutral, and negative self-perception and self-attitude of sexuality, respectively. The mean postoperative SF-8 was 15.2 ± 6.4. Compared to the mean for German controls, patients achieved lower mean scores in the domains social functioning (50.4 ± 7.1), mental health (49.5 ± 9.2), and emotional roles (48.5 ± 6.8). Subjective shortening of the penis (Odds ratio (OR): 2.0), negative body related self-perceptions, and self-attitudes of sexuality (OR: 3.6) as well as IIEF-EF score (OR: 0.9) were risk factors for patient dissatisfaction (p-values ≤ 0.02). Conclusion: A relevant number of patients is not satisfied with surgical outcome after SIS grafting for the treatment of severe PD. Subjective shortening of the penis, negative body related self-perceptions, and self-attitudes of sexuality as well as IIEF-EF score were risk factors for patient dissatisfaction.

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Section: Discussioncontrasting

confidence: 42%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Negative Self-Perception and Self-Attitude of Sexuality Is a Risk Factor for Patient Dissatisfaction Following Penile Surgery with Small Intestinal Submucosa Grafting for the Treatment of Severe Peyronie’s Disease

Soave

Dahlem

Vetterlein

et al. 2019

JCM

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“…Human Penile Tissue Collection and Processing. Samples of CC of penis were obtained from organ donors during organ harvesting for transplant program or, alternatively, from patients submitted to programmed surgeries for correction of penile deviation or implantation of penile prosthesis [37] after informed consent. Patient's age was comprised between 43 and 63 years.…”

Section: Methodsmentioning

confidence: 99%

Cumulative Effect of Cardiovascular Risk Factors on Regulation of AMPK/SIRT1-PGC-1α-SIRT3 Pathway in the Human Erectile Tissue

Pereira

Gouveia

Tomada

et al. 2020

Oxidative Medicine and Cellular Longevity

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Cardiovascular disease risk factors (CVDRF), especially diabetes mellitus (DM), disrupt oxidative stress response. This condition underlies endothelial dysfunction, early manifested in men as erectile dysfunction. The current study is aimed at elucidating the impact of CVDRF in the oxidation responsive AMPK/SIRT1-PGC-1α-SIRT3 pathway and related miRNAs in the human corpus cavernosum. Human penile tissue fragments from individuals submitted to programmed urological surgeries (n=27), aged 43-63 years, were clustered depending on the presence of CVDRF; the control group included samples from patients without CVDRF, and groups A and B included samples from patients with DM and additional CVDRF, totalizing ≤2 CVDRF (group A) and ≥3 CVDRF (group B). Dual-immunolabelling of SIRT3, SOD2, or GPX1 with α-actin in tissue sections was carried out. The assessment of expression levels of NOX1, phospho-AMPKα, total AMPKα, SIRT1, PGC-1α, SIRT3, SOD2, and GPX1 was performed by western blotting and of miR-200a, miR-34a, miR-421, and miR-206 by real-time PCR. Phospho-AMPKα and SIRT3 expression was found significantly increased in group B relative to other groups, suggesting a marked influence of CVDRF, additional to DM, in the regulation of these enzymes. NOX1 was also increased in group B relative to controls. Only an increasing tendency was observed in the phospho-AMPKα/total AMPKα ratio, SIRT1, and PGC-1α expression in groups A and B when compared with controls. Concerning antioxidant enzymes, GPX1 expression was found incremented in group A, but SOD2 expression was decreased in groups A and B, comparative with controls. Group B presented significantly diminished levels of miR-421 and miR-200a, but only a decreasing trend on miR-34 and miR-206 expression was observed. Taken together, our findings demonstrated that besides DM, additional CVDRF presented a cumulative effect in the cellular response to oxidative unbalance, contributing to AMPK/SIRT1-PGC-1α-SIRT3 pathway activation. SOD2, a major mitochondrial antioxidant defence, did not follow the same variation.

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“…The tunical defect area (TDA) positively correlated to the development of postoperative ED with the highest predictability in defects ≥ 21.9 cm 2 , supporting TDA as a potential predictor of postoperative ED development. In conclusion, the investigators regarded SIS grafting as a successful approach in terms of patient satisfaction, provided all risks and potential complications were adequately disclosed preoperatively 47 …”

Section: Postoperative Considerations: (Surgical Outcomes/patient Rehmentioning

confidence: 99%

A decade of grafting techniques as a sole treatment for Peyronie’s disease

2020

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Background Peyronie's disease (PD) can be a cosmetically and functionally devastating condition. Surgical approaches have been proposed in the chronic stages of PD as plication or plaque incision/excision with grafting to preserve penile size in complex cases. Although several surgeons nowadays are inclined toward the utilization of non‐autologous grafts owing to the ease of their preparation and availability, synthetic graft procedures still await more technical improvements and supporting evidence before their consideration for standard care. Objectives In this review, our goal is to facilitate an insight into the most promising grafting materials used for the management of PD and techniques associated. Materials and methods A PubMed review was conducted for all the studies on our topic within the past ten years (January 2009 until December 2019). The outcome parameters we documented and compared comprised of operative time, follow‐up time, postoperative penile cosmesis and function, and, finally, overall patient satisfaction related to each technique. Results Our search yielded 23 English‐written original study articles in addition to a single case report on the various grafting techniques utilized as the sole treatment for PD, each demonstrating different outcomes and points of comparison. Conclusion A successful grafting procedure for PD requires an appropriately tailored surgical modality and an experienced surgeon. Nevertheless, proper preoperative patient counseling on all aspects of his condition and opted treatment modality while setting clear and realistic expectations remains key for overall patient satisfaction.

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Penile lengthening with porcine small intestinal submucosa grafting in Peyronie's disease treatment: long‐term surgical outcomes, patients’ satisfaction and dissatisfaction predictors

Cited by 18 publications

References 29 publications

Negative Self-Perception and Self-Attitude of Sexuality Is a Risk Factor for Patient Dissatisfaction Following Penile Surgery with Small Intestinal Submucosa Grafting for the Treatment of Severe Peyronie’s Disease

Negative Self-Perception and Self-Attitude of Sexuality Is a Risk Factor for Patient Dissatisfaction Following Penile Surgery with Small Intestinal Submucosa Grafting for the Treatment of Severe Peyronie’s Disease

Cumulative Effect of Cardiovascular Risk Factors on Regulation of AMPK/SIRT1-PGC-1α-SIRT3 Pathway in the Human Erectile Tissue

A decade of grafting techniques as a sole treatment for Peyronie’s disease

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