Outcomes of surgical correction of Peyronie's disease with plaque excision and grafting: Comparison of testicular tunica vaginalis graft versus bovine pericardium graft

doi:10.1016/j.ajur.2023.03.005

Asian Journal of Urology, 2024, 11 (3): 497-503 doi: 10.1016/j.ajur.2023.03.005

Regular Papers: Original Articles

Outcomes of surgical correction of Peyronie's disease with plaque excision and grafting: Comparison of testicular tunica vaginalis graft versus bovine pericardium graft

Ali Eslahi^a,b,Faisal Ahmed^c,*(

),Mohammad Reza Askarpour^a,Hossein-Ali Nikbakht^d,Iman Shamohammadi^a,Payam Ghasemi^a,Hanieh Alimardani^a,Bahareh Ebrahimi^b

^aDepartment of Urology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
^bShiraz Geriatric Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
^cUrology Research Center, Al-Thora General Hospital, Department of Urology, School of Medicine, Ibb University of Medical Sciences, Ibb, Yemen
^dSocial Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran

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Abstract

Objective: Peyronie's disease (PD) is an abnormal wound healing in the penile tunica albuginea. After fibrotic plaque excision, different graft materials have been used to repair the defects, but the optimal graft remains unknown. This study aimed to compare the functional outcomes of testicular tunica vaginalis grafts and bovine pericardium grafts in patients with severe PD.

Methods: A retrospective comparative study was conducted on 33 PD patients undergoing partial plaque excision and grafting from September 2015 to May 2021. The patients were divided into two groups depending on the type of graft used. For 15 patients in Group B, testicular tunica vaginalis grafts were used to repair the defect, while for 18 patients in Group A, bovine pericardium grafts were used. Data of the patient's age, comorbidities, sexual function, penile curvature, postoperative complications, need for further treatment, change in penile length, and satisfaction were gathered and compared between the groups. Sexual function was evaluated using the 5-item version of the International Index of Erectile Function (IIEF-5), and a functional less than 20-degree penile curvature after surgery was considered a successful intervention.

Results: There was no difference in age, comorbidities, degree of curvature, perioperative IIEF-5, operative time, plaque size, or complication rates. After surgery, a statistically significant improvement in curvature degree (p<0.05) and satisfactory penile appearance (p<0.05) were seen in both groups without any superiority between the two groups (p=0.423 and p=0.840, respectively). With a 30-month follow-up, the IIEF-5 was consistent in both groups, with no statistical significance between the groups (p=0.492). The main change in penile length during the operation was increased and still positive in the last follow-up in both groups without statistical significance (p=0.255 and p=0.101, respectively).

Conclusion: Partial plaque excision and corporoplasty with both testicular tunica vaginalis or bovine pericardium grafts are equally effective in treating males with clinically significant PD.

Key words： Peyronie's disease Plaque excision Testicular tunica vaginalis graft Bovine pericardium graft

Received: 05 October 2022 Available online: 20 July 2024

Corresponding Authors: *E-mail address: fmaaa2006@yahoo.com (F. Ahmed).

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	Articles by authors
	Ali Eslahi
	Faisal Ahmed
	Mohammad Reza Askarpour
	Hossein-Ali Nikbakht
	Iman Shamohammadi
	Payam Ghasemi
	Hanieh Alimardani
	Bahareh Ebrahimi

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Cite this article:

Ali Eslahi,Faisal Ahmed,Mohammad Reza Askarpour, et al. Outcomes of surgical correction of Peyronie's disease with plaque excision and grafting: Comparison of testicular tunica vaginalis graft versus bovine pericardium graft[J]. Asian Journal of Urology, 2024, 11(3): 497-503.

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http://www.ajurology.com/EN/10.1016/j.ajur.2023.03.005 OR http://www.ajurology.com/EN/Y2024/V11/I3/497

Intraoperative photos of pericardium bovina grafting. (A) Degloving the penis and degree of curvature; (B) Peyronie's plaque removal and grafting over the corpora cavernosa (yellow arrow), and dissection of the neurovascular bundle from the tunica albuginea (green arrow); (C) Penile appearance after curvature correction.

Intraoperative photos of testicular tunica vaginalis grafting. (A) Degloving the penis and degree of curvature; (B) Testicular tunica vaginalis dissection; (C) Penile appearance after curvature correction after Peyronie plaque removal, grafting over the corpora cavernosa and fixation (yellow arrow), and dissection of the neurovascular bundle from the tunica albuginea (green arrow).

Demographic characteristics and operative findings of the patients.

Comparison of the international index of erectile function and degree of curvature between pericardium graft and tunica vaginalis graft.

Postoperative complications, follow-up duration, change in penile length, and satisfaction in both groups.

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