Lingual Mucosal Graft in Treatment of Peyronie Disease

Salem, Emad A.; Elkady, Ehab; Sakr, Ahmed; Maarouf, Aref; Bendary, Lotfy; Khalil, Samah R.; Shahin, Ashraf; Kamel, H.

doi:10.1016/j.urology.2014.07.042

Cited by 23 publications

(20 citation statements)

References 16 publications

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“…After plaque incision or partial plaque excision, the resultant tunica albuginea defect must be closed in order to restore the integrity of the tunica and the penis. There are several grafting materials for this purpose ( Table 2 ) ( 5 , 14 , 17 , 19 , 22 - 33 ). Synthetic grafting materials like polytetrafluoroethylene (Gore-Tex ® /Teflon ® , Gore Inc., Flagstaff, AZ, USA) or polyethylene terephthalate (Dacron ® , DuPont, Wilmington, DE, USA) were previously used in the surgical treatment of PD.…”

Section: Available Grafting Materialsmentioning

confidence: 99%

“…The use of autologous grafts necessitates a second incision for harvesting, which, in turn, leads to greater morbidity and prolonged operative time. Complications associated with harvesting of the autologous material include wound healing disorders, infection, scarring, swelling, pain, numbness, and possible lymphedema ( 30 , 33 ). For this reason, there is a growing interest among urologists to use non-autologous “off-the-shelf” grafts (tissue-engineered materials) like pericardium, small intestinal submucosa (SIS), or collagen fleece ( 5 , 14 ).…”

Section: Available Grafting Materialsmentioning

confidence: 99%

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Grafting techniques for Peyronie’s disease

Hatzichristodoulou

2016

Transl. Androl. Urol.

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Peyronie’s disease (PD) is a benign fibrotic condition of the penile tunica albuginea. PD can be associated with penile pain, curvature, shortening, and erectile dysfunction (ED). The predominant and most bothersome symptom in affected patients is penile curvature, which can lead to inability to have sexual intercourse. In such cases, surgical correction of the curvature may be required. Plication techniques to correct curvature can cause penile shortening and therefore are generally reserved for curvatures <60°. Penile prosthesis implantation with simultaneous correction of curvature by various means is recommended in PD patients with ED not responding to medical therapy. Grafting techniques are the preferred surgical treatment in patients with penile curvatures >60°, short penis, or hourglass deformity. Patients scheduled for grafting surgery are required to have satisfactory erectile rigidity preoperatively. There are various grafting materials that can be used for closure of the tunica albuginea defect following plaque incision/excision. Both autologous and non-autologous grafts have been used for PD reconstructive surgery, and each graft has its advantages and disadvantages. Novel grafting materials are presented and discussed in this review. A major advantage of the available “off-the-shelf” grafts is that there is no harvesting from a donor site and, thus, morbidity is reduced, and operative times are minimized. Further investigations in regard to tissue-engineered grafts to improve surgical handling and postoperative outcomes are ongoing. Surgeon experience, careful patient selection, patient preference and type of penile deformity affect the choice of graft. This review summarizes the literature within the past 5 years regarding grafting techniques in PD. Surgical outcomes and limitations of grafting techniques are reported. A major objective of this review is dedicated to preoperative considerations and indications for grafting procedures, with the aim to improve surgical outcomes and increase patient satisfaction. Proper postoperative management of patients after incision/excision and grafting is important to avoid early and long-term complications and unwanted outcomes. This review provides an overview of recent advances and recommendations in regard to rehabilitation strategies after grafting procedures. Adequate preoperative patient counseling, careful patient selection, appropriate indications, and postoperative management is key to optimal surgical outcomes with high satisfaction rates after grafting techniques in PD surgery.

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Section: Available Grafting Materialsmentioning

confidence: 99%

Section: Available Grafting Materialsmentioning

confidence: 99%

Grafting techniques for Peyronie’s disease

Hatzichristodoulou

2016

Transl. Androl. Urol.

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“…The mixed results of plaque incision/excision and grafting have provoked a drive towards optimizing possible approaches. Recent authors have sought to improve patient outcomes and satisfaction with multiple incisions in lieu of large grafts ( 60 ) and novel graft materials such as autologous lingual mucosa grafts, requiring 130 minutes of operating time ( 69 ), SIS grafts at 165 minutes ( 70 ), and buccal mucosa grafts at 115 minutes ( 71 ). One group presented the results of plaque excision and tunical re-approximation without graft, describing good results on short-term follow-up ( 72 ).…”

Section: Surgical Managementmentioning

confidence: 99%

Contemporary surgical and non-surgical management of Peyronie’s disease

Wayne

Cordon

2018

Transl. Androl. Urol.

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Numerous treatments have been proposed for Peyronie’s disease (PD). As the evidence base has expanded, the field of operative and non-operative options for patients has narrowed. Collagenase clostridium hystolyticum (CCH) injection now comprises the medical option, and surgical possibilities entail penile plication, plaque incision/excision and grafting, and prosthesis implantation. Still, questions abound regarding the optimal approach and indication for each of these treatments. We conducted a review of literature exploring the contemporary management of PD with a particular focus on work since the last American Urologic Association’s (AUA) guidelines update for PD. Recent results and discussion indicate trends toward minimal invasiveness, toward a more holistic approach to the PD patient, and away from algorithmic management, galvanized, in part, by data challenging long-held beliefs.

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“…[ 34 ] Surgery is safe in appropriately selected patients, with efficacy rates approaching 100% in some series. [ 108 109 ] However, there remains considerable interest in identifying effective nonoperative treatments for PD, as these would limit adverse events associated with surgery and may allow treatment during the active phase of disease, potentially modifying and attenuating the overall disease course. To develop such treatments, however, a comprehensive molecular understanding of PD pathogenesis and its natural history is required.…”

Section: Etiology Patient Assessment and Treatment: What We Know Somentioning

confidence: 99%

Peyronie's disease: What's around the bend?

Bilgutay

Pastuszak

2016

Indian J Urol

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Introduction:Peyronie's disease (PD) is a fibrotic diathesis of the tunica albuginea that results in penile plaque formation and penile deformity, negatively affecting sexual and psychosocial function of both patients and their partners. In this review, we discuss the PD literature and PD treatment options, with special emphasis on potential future therapies.Methods:The PD literature was reviewed, and articles of interest were identified using keyword search in PubMed. Articles evaluating investigational and novel PD treatments were emphasized.Results:Existing PD treatment modalities are diverse and include oral, topical, intralesional, mechanical, and surgical therapies. Surgical treatment has high success rates and is indicated in men with significant, stable deformity. The United States Food and Drug Administration-approved intralesional collagenase Clostridium histolyticum injection therapy is a minimally invasive option with demonstrated efficacy in PD. Other nonsurgical therapies have been reported, including Botox and stem cell therapy, but these currently have little or equivocal evidence to support their efficacy.Conclusions:Further research is essential to develop novel, safe, and effective minimally invasive PD treatment options. This work is ongoing, with the promise of specific, targeted, and highly effective therapies on the horizon.

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Lingual Mucosal Graft in Treatment of Peyronie Disease

Cited by 23 publications

References 16 publications

Grafting techniques for Peyronie’s disease

Grafting techniques for Peyronie’s disease

Contemporary surgical and non-surgical management of Peyronie’s disease

Peyronie's disease: What's around the bend?

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