Department of Surgery, Division of Urology, Washington University School of Medicine, St. Louis, Missouri, USA.

Report the results using porcine small intestinal submucosa (SIS) as a graft material in the surgical management of Peyronie's disease (PD).

We performed a retrospective chart review of men with PD who underwent surgical correction of the curvature by plaque "H" incision and patch grafting with 4-ply SIS (Cook, Bloomington, IN) by a single surgeon at our institution. Degree and direction of curvature, sexual function, and co-morbidities were assessed pre- and postoperatively.

Thirteen patients were identified. Mean age was 57 +/- 8, range 42-70 years. Median follow-up was 14 months, range 3-89 months. At presentation, all reported penile curvature. Also reported were difficulty with vaginal penetration (determined by question number 2 of the sexual encounter profile questionnaire - SEP2), palpable plaque, hourglass deformity, difficulty with firmness, and difficulty with sustaining erection (determined by SEP3) in 77%, 69%, 77%, 62%, and 46% of patients, respectively. Mean and median degrees of curvature of the primary deformity were 71 and 67.5 degrees, respectively. Three patients had secondary curves of less than 30 degrees in a different direction. Mean and median plaque size were 3.5 and 2.7 cm2, respectively. Seven patients had one graft and six patients had two grafts placed with a mean size of 15 +/- 0 cm2.

For the patient with PD, SIS grafting can achieve a functionally straight erection with durable results yet with relatively high rates of erectile dysfunction. SIS is a viable graft material for use in the surgical treatment of PD.

Written by
Lee EW, Shindel AW, Brandes SB.

Reference
Int Braz J Urol. 2008 Mar-Apr;34(2):191-7.

PubMed Abstract
PMID:18462517

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