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Current Sexual Health Reports
Published in: Current Sexual Health Reports 4/2020

01-12-2020 | Erectile Dysfunction | Male Sexual Dysfunction and Disorder (N Thirumavalavan, Section Editors)

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

Authors: Petar Bajic, Aisha L. Siebert, Channa A. Amarasekera, Corinne H. Miller, Laurence A. Levine

Published in: Current Sexual Health Reports | Issue 4/2020

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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.
Appendix
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Metadata
Title
Comparing Outcomes of Grafts Used in Peyronie’s Disease Surgery: a Systematic Review
Authors
Petar Bajic
Aisha L. Siebert
Channa A. Amarasekera
Corinne H. Miller
Laurence A. Levine
Publication date
01-12-2020
Publisher
Springer US
Published in
Current Sexual Health Reports / Issue 4/2020
Print ISSN: 1548-3584
Electronic ISSN: 1548-3592
DOI
https://doi.org/10.1007/s11930-020-00283-3

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