To compare outcomes between hemostatic patches (HP) versus pericardium allografts (PA) for complex Peyronie's disease with erectile dysfunction managed with inflatable penile prosthesis (IPP) and plaque incision and grafting (PIG).
We reviewed all men who underwent IPP with PIG for PD at our institution (4/2010-9/2018). PIG was performed via relaxing tunical incisions during IPP implantation following manual modeling if there was persistent curve >30° and/or significant narrowing. Tunical defects >2 cm were grafted. PA (Coloplast, Minneapolis, MN) or HP consisting of either Evarrest, Nu-Knit (Ethicon Inc., Somerville, NJ), or TachoSil (Baxter Int., Deerfield, IL) were used.
HP was placed in 18 men (n = 10 Evarrest, n = 6 Nu-Knit, and n = 2 TachoSil), 15 had PA. There was no difference in mean age, preoperative curvature (HP:75° vs PA:78°), or grafted area (HP:11.9 cm2 vs PA:10.9 cm2) between HP and PA cohorts. Mean operative time was shorter for HP (122 vs 166 minutes, P = .01). Median follow-up: 6.6 months (range: 2-27 months) for HP and 34.6 months (range: 13-103 months) for PA. Residual curvature >20° was present following HP in 16.7% (n = 3) and PA in 13.3% (n = 2; P = 1.0). There were no complications attributable to HP/PA material and no IPP herniation through the tunical defect. Postoperatively, 94.4% (n = 17) of HP and 93.3% (n = 14) of PA patients were engaged in penetrative intercourse (P = 1.0).
HP are effective materials to cover the tunical defect over an IPP following plaque incision for PD. HP outcomes are similar to PA, while operative time is shorter for HP.
Urology. 2019 Mar 23 [Epub ahead of print]
M Ryan Farrell, George A Abdelsayed, Matthew J Ziegelmann, Laurence A Levine
Division of Urology, Rush University Medical Center, Chicago, IL., Division of Urology, Rush University Medical Center, Chicago, IL. Electronic address: .