Collagen Fleece Grafting for Surgical Treatment of Patients with Mild to Severe Peyronie’s Curvatures

Author:

Garaz Radion1,Amend Bastian1,Stenzl Arnulf1,Bedke Jens2,Hennenlotter Jörg1,Rausch Steffen1

Affiliation:

1. Eberhard Karls University of Tübingen

2. Stuttgart Hospital

Abstract

Abstract

Background Collagen Fleece Grafting (CFG) for Peyronie’s Disease (PD) is a recommended treatment option for severe curvature > 60 degrees. However, little is known about its utility in mild curvatures. A subgroup of patients with a significant risk of penile shortening or symptomatic plaques might benefit from the approach in mild curvatures < 60°. We aimed to analyze the treatment indications, surgical technique, and early postoperative results of CGF in this scenario. We performed a retrospective review of patients undergoing surgical treatment for PD using partial plaque excision or incision and CFG. Patients were referred for surgery when the duration of PD was at least 9 months and previous conservative therapies had failed. Clinical parameters and complications were reviewed. Subgroup analysis was performed in patients with curvatures of > 60° and mild curvatures ≤ 60. Results A total of 89 patients were identified. Median (range) age was 59 (38–73) years, and median (range) curvature was 70 (20–90)°. Curvature was dorsal in 66% of cases, ventral in 8%, lateral in 16%, and complex in 10% of cases. Partial plaque excision was performed in 87 (98%) patients. The mean (SD) surface area of grafting was 2.1 (1.9) cm2. The number of penile plaques was only one in 63 (71%) patients and 2 or more in 26 (29%) patients. There was no difference between the two groups (Curvature ≤ 60 vs. >60) regarding mean operation time (86.3 vs. 94.4 min, p = 0.13) or mean hospital stay (5 vs. 5 days, p = 0.77). There was no significant difference between the two groups regarding the incidence of post-operative glans necrosis nor glans hypoesthesia, ecchymosis, bleeding, hematoma, infection, residual curvature, revision surgery, or pain. Conclusions In patients with mild and severe PD deformities, early post-operative outcomes and complications after partial plaque incision or excision and grafting with CFG seemed similar. The technique may be safely applied in select patients with mild penile curvature.

Publisher

Springer Science and Business Media LLC

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