Small Intestinal Submucosa Grafting for Peyronie's Disease: Outcomes and Patient Satisfaction

To evaluate surgical outcomes and complications and assess overall patient satisfaction after small intestinal submucosa (SIS) grafting for PD.

Twenty-eight patients were treated with tunical incision and grafting with SIS. Mean age was 58 years (range:43-71). A preoperative protocol was applied to all patients. Patients were also evaluated at follow-up clinic visits. The International Index of Erectile Function (IIEF-5), a modified Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire, postoperative self-reports and clinical characteristics were used to measure outcomes.

Hypertension, hypercholesterolemia and type 2 diabetes were reported in 53,6%, 46,4% and 28,6%, respectively. Previous penile trauma was reported by 10,7%. The mean operative time was 151 ± 23 minutes. Average follow-up was 18 months (range: 3-36). The only surgical complication was 1 case of infected hematoma treated with surgical drainage. Self-reported complete resolution of curvature was 82,1%. Subjective perception of penile shortening was reported by 71,4% of patients. However, only four patients objectively showed post-operative penile shortening. Erectile function was completely preserved in 64,2%. Four patients complained of ED despite medication, even though no objective vascular etiology was shown on post-operative penile doppler ultrasound. Overall, 82,2% of patients reported high levels of satisfaction.

Surgical treatment of PD using SIS grafting is a safe option, with low rate of major complications. It has good surgical outcomes and high patient satisfaction rates.

Urology. 2016 Nov 04 [Epub ahead of print]

Pedro Valente, Carolina Gomes, Nuno Tomada

Centro Hospitalar de São João, Department of Renal, Urological and Infeccious Diseases, Porto, Portugal; Centro Hospitalar do Tâmega e Sousa, Department of Urology, Penafiel, Portugal. Electronic address: ., Faculty of Medicine, University of Porto, Porto, Portugal., Centro Hospitalar de São João, Department of Renal, Urological and Infeccious Diseases, Porto, Portugal; Faculty of Medicine, University of Porto, Porto, Portugal.