Autologous dermal tissue grafting for Peyronie’s Disease with large tunica albuginea defects
Nagao, K1; Iwai, H1; Tai, T1; Ozaki, Y1; Tanaka, N1; Kobayashi, H1; Nakajima, K1
1: Toho University, Japan
Objective: We performed 218 surgical operations for treatment of Peyronie’s disease. Calcification of the tunica albuginea, marked curvature, and extensive lateral plaques resulted in large defects that required dermal grafting. This study evaluated the effectiveness and safety of dermal grafting for treatment of Peyronie’s disease.
Methods: We analyzed data from 643 cases of Peyronie’s disease. Average patient age was 51.5 years. The chief complaints included curvature, palpable fibrosis, pain, and erectile function. Drug therapy resulted in improvement in 328 (51%) cases. After conservative treatment for 1 year, patients underwent plication or grafting. In addition, two methods were used for saphenous vein grafting: vein grafting after plaque excision and vein grafting after hourglass-shaped incision. Dermal grafting was performed for large or lateral defects.
Results: In total, 129 patients underwent saphenous vein grafting, 16 underwent dermal grafting, and 73 underwent plication. Evaluation of patients who underwent dermal grafting showed graft hardening and slight graft shrinkage in only one patient, during the second postoperative month. However, graft quality improved during the 6 months after surgery. Among patients who received large dermal grafts, all grafts were of sufficient size at 1 postoperative year.
Conclusion: Dermal grafts are useful for treatment of lateral penile defects and large defects caused by calcification of the tunica. Although the grafted dermis decreases in size during the 2 months after surgery, it returns to its original size within 6 to 12 months postoperatively.
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