Long-term follow-up of penile curvature correction utilizing autologous albugineal crural graft

Ros, Carlos Teodósio Da; Graziottin, Túlio M.; Ribeiro, Eduardo Pontual; Averbeck, Márcio Augusto

doi:10.1590/s1677-55382012000200013

Cited by 23 publications

(11 citation statements)

References 17 publications

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“…Not all of the studies reviewed collected such data, although there appears to be more of a trend towards its collection, especially in more recent studies. Among these are studies that directly measure satisfaction via a categorical question (yes/no) (Da Ros et al ., ) or via a Likert‐type scale (Taylor & Levine, ). Others do so indirectly, by asking patients if they would undergo the same procedure again (Otero et al ., ).…”

Section: Discussionmentioning

confidence: 99%

Grafts for Peyronie's disease: a comprehensive review

et al. 2017

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The difficulty implicit in combining all the characteristics that an ideal patch to treat Peyronie's disease with a lengthening procedure should have, together with the challenges of comparing results from different series, means that the ideal patch has yet to be determined. Our objective with this review was to determine whether any given patch type is preferable to the others based on the evaluation of the results of published studies. A systematic search of the literature was conducted from PubMed until December 2016. Articles reporting basic research, animal research, reviews or meta-analyses and studies in children were eliminated. Series with patients undergoing some kind of other surgical intervention were only included if results were reported separately. Case reports and series of five patients were excluded. Five variables were selected to evaluate the results: number of patients, follow-up period, straightening rate, shortening rate and post-operative ED rate. For this purpose, 69 papers were included for review, and the outcomes of the use of autologous dermis, tunica vaginalis, dura mater, fascia, saphenous vein, tunica albuginea, buccal mucosa, porcine intestinal submucosa, pericardium, TachoSil and synthetic materials were presented and analysed separately. The different series published are extremely variable and heterogeneous in terms of the number of patients included, patient selection, follow-up periods, and in the measurement and interpretation of the outcomes analysed. Given these facts, it is not possible to draw any definitive conclusion, homogeneous, prospective studies using validated tools are required to determine which the ideal graft is.

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Section: Discussionmentioning

confidence: 99%

Grafts for Peyronie's disease: a comprehensive review

et al. 2017

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“…Table 3 summarizes the plaque incision or partial plaque excision and grafting for PD literature published since 2010 ( 14 , 15 , 21 , 32 , 33 , 36 - 38 ).…”

Section: Surgical Outcomesmentioning

confidence: 99%

“…In a study by Da Ros et al ., the authors describe long-term results after grafting with an autologous tunical albugineal crural graft ( 38 ). The authors included 33 patients with PD.…”

Section: Surgical Outcomesmentioning

confidence: 99%

“…Loose or compressive dressing around the penis is recommended for at least 24 h to avoid hematoma formation ( 14 , 15 , 20 , 36 ). Patients should refrain from sexual intercourse and sexual activities for 4–6 weeks postoperatively ( 21 , 30 , 38 ). Despite limited data, postoperative rehabilitation is recommended in order to reduce the risk of postoperative ED, enhance recovery of erectile function, reduce the risk of penile length loss after surgery, and optimize straightening of the penis ( 1 , 5 , 7 , 30 ).…”

Section: Postoperative Managementmentioning

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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“…A aplicação da túnica albugínea autóloga na correção de alterações penianas vem sendo descrita com sucesso (Schwarzer et al, 2003;Da Ros et al, 2012). Gadja et al(2006) utilizaram retalhos de túnica albugínea na reconstrução do ureter de cães e observaram bons resultados na substituição de parte do órgão.…”

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