Bicentric prospective evaluation of corporoplasty with porcine small intestinal submucosa (SIS) in patients with severe Peyronie’s disease

• Published in: World journal of urology Vol. 35; no. 7; pp. 1119 - 1124
• Main Authors: Sayedahmed, K., Rosenhammer, B., Spachmann, P. J., Burger, M., Aragona, M., Kaftan, B. T., Olianas, R., Fritsche, H. M.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.07.2017; Springer Nature B.V
• Subjects: Adult; Animals; Connective tissue diseases; Dissection - methods; Humans; Intestine; Intestine, Small - transplantation; Male; Medicine; Medicine & Public Health; Middle Aged; Nephrology; Oncology; Original Article; Patient Satisfaction; Patient Selection; Patients; Penile Erection; Penile Induration - diagnosis; Penile Induration - surgery; Penis; Penis - pathology; Penis - physiopathology; Penis - surgery; Postoperative Complications - diagnosis; Postoperative Complications - etiology; Quality of Life; Reconstructive Surgical Procedures - adverse effects; Reconstructive Surgical Procedures - methods; Sexual intercourse; Surgery; Surveys and Questionnaires; Swine; Tissue Transplantation - methods; Treatment Outcome; Urologic Surgical Procedures, Male - adverse effects; Urologic Surgical Procedures, Male - methods; Urology; Xenografts; Penile curvature; Peyronie’s disease; SIS; Small intestinal submucosa; Induratio penis plastica
• ISSN: 0724-4983; 1433-8726
• DOI: 10.1007/s00345-016-1973-5

Introduction Advanced Peyronie’s disease (PD) with severe penile deviation demands grafting procedures following plaque incision or partial plaque excision in order to avoid penile shortening and to improve quality of life of affected patients. Small intestinal submucosa (SIS) is an established xenograft. The objective of the present study was to validate external results in a bicentric prospective manner. Methods Patient selection criteria, surgical technique and standards for pre- and postoperative care were defined. Consecutively, patients with severe penile deviation in stable disease and sufficient erectile function were included between 2007 and 2015. After plaque incision, grafting was performed using SIS in a standardized manner. The postoperative evaluation using a non-validated questionnaire included complications, correction of curvature, pre- and postoperative erectile function, change in penile length and general satisfaction with the procedure. Results Forty-three patients underwent surgery between 2007 and 2015. The mean degree of preoperative curvature was 73.8° (range 60–90°). No intraoperative or major postoperative complications were reported. After a mean follow-up of 33.0 months (range 10–59), complete straightening of the penis was achieved in 74.4%. 88.4% of all patients were able to achieve satisfying sexual intercourse (67.4% unaided, 21.0% with assistance). The IIEF-5 score was improved in 69.8% (mean improvement 4.0 points). Overall 86.0% were satisfied with the surgical treatment. Conclusion Corporoplasty with SIS in patients with PD and severe penile curvature is a safe approach and shows good long-term results. A thorough patient selection and a standardized pre-, intra- and postoperative procedure are decisive for a satisfying outcome.