gms | German Medical Science

Introduction: Collagen fleece grafting (CFG) for Peyronie’s Disease (PD) is a recommended treatment option for severe curvature >60 degrees; however, inadequate evidence is available regarding 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°.

Material & methods: We performed a retrospective review of 89 patients undergoing surgical treatment for PD using partial plaque excision or incision and CFG. Patients were referred for surgery when the duration of PD ranged from 9–12 months and previous conservative therapies failed. Clinical parameters and complications were reviewed. Subgroup analysis was performed in patients with curvatures of >60° (n=54) and mild curvatures ≤60° (35).

Results: Median age was 59 (38–73) years, median curvature 70 (20–90)°. Curvature was dorsal, ventral, lateral, and complex in 66.3, 7.9, 15.7 and 10.1%. Partial plaque excision was performed in 87 (98%) patients. The mean surface area of grafting was 2.1 ± 1.9 cm2. The number of penile plaques was one in 63 and ≥2 in 26 patients (71 and 29%). There was no difference between the studied groups regarding operation time (86.3 vs. 94.4 min, p=0.13) and hospital stay (5 vs. 5 days, p=0.77). Neither glans necrosis nor glans hypoesthesia, ecchymosis, bleeding, hematoma, infection, penile shortening, residual curvature, revision surgery, or pain were significantly different between the two groups.

Conclusion: In patients with mild and severe PD deformities, early results and complications after partial plaque incision or excision and grafting with CFG are comparable.