Comparison of Technical Success and Adverse Events of Plaque Incision and Grafting Methods in Patients with Peyronie's disease: Tunica Vaginalis versus Buccal Mucosa.

OBJECTIVE: To compare the clinical outcomes of Peyronie's disease (PD) patients who were treated by plaque incision and grafting either with tunica vaginalis (TV) or buccal mucosa (BM) grafts. METHODS: PD patients in BM (n=20) and TV group (n = 20) were recruited between 2013 and 2020. Erectile dysfunction was assessed by short form of International Index of Erectile Function Questionnaire (IIEF-5). Technical success was defined as residual curvature ≤15°. Penile Doppler ultrasound was performed at baseline evaluation, 3-, and 24 months. Peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistance index were measured in erect penis. Erect penile length and curvature angle were measured at baseline and at 3, 12, and 24 months. RESULTS: Mean age of the groups was comparable (47.2 ± 10.8 years in TV vs 46.5 ± 9.9 years in BM groups). Baseline mean penile curvature was 48.0 ± 6.6° (TV) and 50.3±11.6° (BM) (P <.001). Mean residual curvature at 24-month visits was 12.4 ± 4.9° (TV) and 7.9 ± 3.7° (BM), not significantly different. Technical success rate was 90% for both groups at 24 months. Surgery significantly increased erect penile length in both groups. Mean preoperative IIEF-5 scores were 18.4 ± 2.5 and 17.5 ± 2.2 in TV and BM groups, respectively. In both groups, IIEF-5 scores significantly improved after surgery with no intergroup IIEF-5 difference (20.6 ± 2.6 in TV and 21.3 ± 2.2 in BM). Mean postoperative PSV significantly increased, EDV significantly decreased in both groups, however, there was no significant intergroup difference. CONCLUSION: Both grafting materials provided similar beneficial effects regarding technical success, erectile dysfunction, and penile length.

Autologous testicular tunica vaginalis graft in Peyronie's disease: a prospective evaluation.

BACKGROUND: Peyronie's disease (PD) is a two-phase progressive condition characterized by inelastic plaques in the tunica albuginea of the penis, leading to curvature of the penis. Men with PD also suffer from psychological distress, and sexual life and overall quality of life. Although the preferred surgical treatment modality in Peyronie's disease is plaque incision and grafting, there is lack of studies assessing the erectile function and penile vasculature after the treatment. OBJECTIVES: We aimed to evaluate the efficiency and safety of plaque incision and tunica vaginalis of testis grafting in PD. METHODS: This was a prospective analysis. Erectile dysfunction was assessed via International Index of Erectile Function Questionnaire (IIEF-5). Penile Doppler ultrasound was performed to assess peak systolic velocity (PSV) and end-diastolic velocity (EDV). Postoperative follow-ups were scheduled at 3, 12, and 24 months. RESULTS: Twenty patients (mean age 47.2 ± 10.8 years) were included. The mean preoperative penile curvature was 48 ± 6.6°. The technical success rate was 100% at 3 months and 90% at 24 months. At follow-up visits, mean erect penile length was no different from the baseline. The baseline mean IIEF-5 score was 18.4 ± 2.5. The mean IIEF-5 score was 20.6 ± 2.6 at 24-month visit (p < 0.0001). Mean PSV significantly increased, while EDV significantly reduced after surgery. There were no serious complications related to surgery. CONCLUSIONS: We conclude that surgical reconstruction of penile curvature with tunica vaginalis grafting was a safe and effective procedure in PD.