Mid-term outcomes of modified grid plaque incision and sealing with Collagen Fleece for treatment of Peyronie's disease

Abstract

Introduction & Objectives: Surgery is gold-standard for correction of Peyronie's curvature. Recently, there have been reports on partial plaque excision and grafting with collagen fleece technique regarding long term efficacy. However, there is still concern regarding regeneration of cavernosal defect, and consequently the restoration of erection function. This study was aimed to introduce a less invasive technique by multiple grid plaque incisions instead of plaque excisions to minimize complications.

Materials & Methods: From May 2018 and November 2020, 27 patients with stable Peyronie’s disease (PD) were included. Surgical technique was composed 3 major steps; 1) releasing and elevation of the neurovascular bundle or urethra, 2) multiple deep grid plaque incisions and 3) sealing with collagen fleece (TachoSil®) without suturing. We assessed the stretched penile length (SPL), totally straightness preoperatively and 24 weeks postoperatively. This study was approved by the Institutional Review Board of the Korea University Hospital.

Results: Mean patient age was 60.5 ± 6.4 years (range: 46–72). The mean curvature was 53.5 (40-80) degree, 5 with dorsal curvature, 3 with pure lateral curvature, 3 with ventral curvature, 6 with dorso-lateral curvature and 10 with ventro-lateral curvature. Mean operative time was 90.5 ± 24.6 minutes (60–140). Mean follow-up was 14.6 ± 5.7 months (6-23). All patients achieved totally straightness. Mean penile length of preoperative and postoperative 24 weeks were 10.6 ± 1.0cm (range: 9-12) and 11.7 ± 0.8cm (range: 10-12), respectively. None of patients had hematoma postoperatively and erectile function was preserved postoperatively 24 weeks.

Conclusions: Our mid-term outcome with this technical modification of various plaque incisions shows that one can achieve a sufficient surgical effect without making defect of carvernosum. However, long-term clinical outcomes are necessary to confirm these encouraging findings.