L D Knoll1. 1. Center for Urological Treatment, Nashville, Tennessee 37203, USA.
Abstract
OBJECTIVES: To report the use of a new acellular, xenographic porcine jejunal submucosal graft as a closure material for the tunica albuginea after plaque incision. METHODS: Twelve patients with at least a 12-month history of Peyronie's disease with a penile curvature of 70 degrees or greater were evaluated. Patient age ranged from 39 to 61 years (mean 50). Preoperatively, all underwent Doppler ultrasound after an intracavernous injection. Lyophilized (freeze-dried) small intestinal submucosa immersed in normal saline was used to graft the tunical deficit after the plaque incision using a subcoronal incisional approach. RESULTS: Surgical correction of the penile curvature was achieved in 11 of 12 patients. At a mean follow-up of 11 months (range 5 to 20), all patients were potent, with one requiring intracavernous injection therapy. One patient developed a 60 degrees curvature 6 months postoperatively and required reoperation. No reports of penile shortening, pain, infection, hematoma, bulging at the graft site, or evidence of a local immunogenic rejection reaction have been noted. CONCLUSIONS: At this early stage, acellular porcine jejunal submucosal grafts for coverage of cavernosal defects after Peyronie's plaque incision allow for satisfactory clinical results. The ease of surgical handling and placement and no associated comorbidities from harvesting techniques, coupled with no adverse reactions, make this material an anatomic and functional tunical substitute.
OBJECTIVES: To report the use of a new acellular, xenographic porcine jejunal submucosal graft as a closure material for the tunica albuginea after plaque incision. METHODS: Twelve patients with at least a 12-month history of Peyronie's disease with a penile curvature of 70 degrees or greater were evaluated. Patient age ranged from 39 to 61 years (mean 50). Preoperatively, all underwent Doppler ultrasound after an intracavernous injection. Lyophilized (freeze-dried) small intestinal submucosa immersed in normal saline was used to graft the tunical deficit after the plaque incision using a subcoronal incisional approach. RESULTS: Surgical correction of the penile curvature was achieved in 11 of 12 patients. At a mean follow-up of 11 months (range 5 to 20), all patients were potent, with one requiring intracavernous injection therapy. One patient developed a 60 degrees curvature 6 months postoperatively and required reoperation. No reports of penile shortening, pain, infection, hematoma, bulging at the graft site, or evidence of a local immunogenic rejection reaction have been noted. CONCLUSIONS: At this early stage, acellular porcine jejunal submucosal grafts for coverage of cavernosal defects after Peyronie's plaque incision allow for satisfactory clinical results. The ease of surgical handling and placement and no associated comorbidities from harvesting techniques, coupled with no adverse reactions, make this material an anatomic and functional tunical substitute.
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