L Dean Knoll1. 1. Center for Urological Treatment and Research, Nashville, Tennessee 37203, USA. dknoll23@yahoo.com
Abstract
PURPOSE: We report on the long-term followup of porcine small intestinal submucosal graft as a closure material for the tunica albuginea after plaque incision. MATERIALS AND METHODS: A total of 162 patients with at least a 12-month history of Peyronie's disease with penile curvature of 60 degrees or more were evaluated. Patient age ranged from 33 to 69 years (mean 52). Preoperatively all patients underwent intracavernous injection and photographic documentation of curvature. Surgisis ES, derived from porcine small intestine, was immersed in normal saline and was used to graft the tunical deficit after plaque incision using a subcoronal incisional approach. RESULTS: Surgical correction of penile curvature was achieved in 148 of 162 patients (91%). At a mean followup of 38 months (range 6 to 96) 79% of the patients were fully potent with 21% requiring assistance. No reports of intraoperative penile shortening, long-term pain, infection, bulging at the graft site or evidence of a local immunogenic rejection reaction have been noted. CONCLUSIONS: Surgisis grafts for the coverage of cavernous defects after Peyronie's plaque incision allow for satisfactory clinical results in long-term followup. The ease of surgical handling and placement, no associated comorbidities from harvesting techniques, and no adverse reactions make this material an anatomical and functional tunical substitute.
PURPOSE: We report on the long-term followup of porcine small intestinal submucosal graft as a closure material for the tunica albuginea after plaque incision. MATERIALS AND METHODS: A total of 162 patients with at least a 12-month history of Peyronie's disease with penile curvature of 60 degrees or more were evaluated. Patient age ranged from 33 to 69 years (mean 52). Preoperatively all patients underwent intracavernous injection and photographic documentation of curvature. Surgisis ES, derived from porcine small intestine, was immersed in normal saline and was used to graft the tunical deficit after plaque incision using a subcoronal incisional approach. RESULTS: Surgical correction of penile curvature was achieved in 148 of 162 patients (91%). At a mean followup of 38 months (range 6 to 96) 79% of the patients were fully potent with 21% requiring assistance. No reports of intraoperative penile shortening, long-term pain, infection, bulging at the graft site or evidence of a local immunogenic rejection reaction have been noted. CONCLUSIONS: Surgisis grafts for the coverage of cavernous defects after Peyronie's plaque incision allow for satisfactory clinical results in long-term followup. The ease of surgical handling and placement, no associated comorbidities from harvesting techniques, and no adverse reactions make this material an anatomical and functional tunical substitute.
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