Comparison of technical success and adverse events of plaque incision and grafting methods in patients with Peyronie's disease: Tunica vaginalis versus buccal mucosa.

To compare the clinical outcomes of Peyronie's disease (PD) patients who were treated by plaque incision and grafting either with tunica vaginalis (TV) or buccal mucosa (BM) grafts.

PD patients in BM (n=20) and TV group (n=20) were recruited between 2013 and 2020. Erectile dysfunction was assessed by short form of International Index of Erectile Function Questionnaire (IIEF-5). Technical success was defined as residual curvature ≤15°. Penile Doppler ultrasound was performed at baseline evaluation, 3-, and 24 months. Peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistance index were measured in erect penis. Erect penile length and curvature angle were measured at baseline and at 3, 12, and 24 months.

Mean age of the groups was comparable (47.2±10.8 years in TV vs 46.5±9.9 years in BM groups). Baseline mean penile curvature was 48.0±6.6° (TV) and 50.3±11.6° (BM) (p<0.001). Mean residual curvature at 24-months visits was 12.4±4.9° (TV) and 7.9±3.7° (BM), not significantly different. Technical success rate was 90% for both groups at 24 months. Surgery significantly increased erect penile length in both groups. Mean preoperative IIEF-5 scores were 18.4±2.5 and 17.5±2.2 in TV and BM groups, respectively. In both groups, IIEF-5 scores significantly improved after surgery with no intergroup IIEF-5 difference (20.6±2.6 in TV and 21.3±2.2 in BM). Mean postoperative PSV significantly increased, EDV significantly decreased in both groups, however, there was no significant intergroup difference.

Both grafting materials provided similar beneficial effects regarding technical success, erectile dysfunction, and penile length.

Urology. 2022 Sep 14 [Epub ahead of print]

Yernur Ainayev, Ulanbek Zhanbyrbekuly, Abduzhappar Gaipov, Makhmud Suleiman, Nurlan Kissamedenov, Ulan Zhaparov, Saltanat Urazova, Nurila Rakhmetova, Dulat Turebayev, Nurbol Keulimzhayev, Rano Zhankina, Gafur Khairli

Astana Medical University, Department of Urology and Andrology, Nur-Sultan, Kazakhstan., Nazarbayev University, School of Medicine, Department of Medicine, Nur-Sultan, Kazakhstan., Astana Medical University, Department of Urology and Andrology, Nur-Sultan, Kazakhstan.. Electronic address: ., JSC 'National Center of Neurosurgery', Department for Reception and Diagnosis, Nur-Sultan, Kazakhstan., Astana Medical University, Department of General Medical Practice No. 3, Nur-Sultan, Kazakhstan., Astana Medical University, Department of microbiology and virology named after Sh. I. Sarbasova, Nur-Sultan, Kazakhstan., Astana Medical University, Department of Surgery with an angiosurgery and plastic surgery course, Nur-Sultan, Kazakhstan.

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