Long-term outcomes after plaque incision and grafting for Peyronie's disease: comparison of porcine dermal and bovine pericardium grafts.

Plaque incision and grafting (PEG) is one of the mainstays in surgical therapy for severe penile curvature in Peyronie's disease (PD). Different kinds of grafts are available for covering albugineal defects during PEG, both allografts and xenografts. However, to date none of these proved superior to others.

To compare two different types of xenograft, porcine dermal matrix and bovine pericardium matrix in PEG for PD.

From 2010 to 2019, 63 patients with PD underwent PEG, using porcine dermal (n= 25; Group 1) and bovine pericardium (n=38; Group 2) grafts. Long-term outcomes were evaluated through multi-disciplinary questionnaires administration by phone interview. The following items were considered: correction of penile bending, quality of erection, intercourse ability, penile shortening and sensitiveness. Overall satisfaction and impact of surgery on sexual activity and quality of life was also investigated.

Plaque median (IQR) size was 29 (22-33) mm, and was smaller in Group 1(27.5 vs. 31 mm; p = 0.03). Complete follow up data were available for 53 patients (84%). Considering postoperative outcomes, no differences were found when considering ED rates, penile shortening, sensitiveness, complications and penile streightening (all p>0.1). Patients in Group 2 were more likely to have palpable penile nodules at follow-up(20.6 vs. 0%; p=0.03). However, patient's postoperative sexual life satisfaction was consistent between the two groups, with just 1 (5.3) and 8 (23.5) patients in Group 1 and 2 respectively refferring a worsening in sexual life satisfaction (p=0.2). At follow up, 84.9% of patients that would still undergo surgery for PD, with no statistical difference between the two groups (p=0.4) CONCLUSIONS: Corporoplasty with PEG is an effective treatment for men with PD. Porcine dermal and bovine pericardium xenografts seem to have similar long-term outcomes.

Andrology. 2020 Sep 27 [Epub ahead of print]

Alessandro Fiorillo, Matteo Droghetti, Franco Palmisano, Lorenzo Bianchi, Pietro Piazza, Paolo Sadini, Martina Masetti, Enrico Molinaroli, Giorgio Gentile, Valerio Vagnoni, Alessandro Franceschelli, Fulvio Colombo

Department of Andrology, S, Orsola University Hospital, Bologna, Italy., Department of Urology, S, Orsola University Hospital, Bologna, Italy.