Plaque incision and buccal mucosa graft hits high success rate in Peyronie’s disease

Corporoplasty with plaque incision and buccal mucosa graft achieved strong structural and functional outcomes with high patient satisfaction among individuals with stable-phase Peyronie's disease, according to a prospective study published in the Journal of Sexual Medicine.1

Buccal mucosa grafting had a 95% success rate at 3 months post-procedure and 90% at 24-months’ follow-up. No significant penile shortening occurred.

At the baseline preoperative evaluation, the mean International Index of Erectile Function Questionnaire (IIEF-5) score was 17.5 ± 2.2. At 3-months’ follow-up, the median IIEF-5 score was 20.1 ± 2.2, and at 24-months’ follow-up, the median IIEF-5 score was 21.3 ± 2.2 (P <.0001). No de novo erectile dysfunction occurred, and no serious complications occurred during or following the surgical procedure.

Overall, 22 patients enrolled in the study between September 2013 and May 2020. The single-site study was conducted at the Department of Urology and Andrology, Astana Medical University, Kazakhstan. Of the 22 patients, 20 completed the study, with 2 patients lost to follow-up. At baseline, all patients reported that they were unable to have painless and satisfactory intercourse for a minimum time period of the previous 12 months. All patients had previously received unsuccessful medical/conservative treatments for Peyronie’s disease.

The median patient age was 46.5 years, the median duration of Peyronie's disease was 17 months (range 12-36 months), and the median preoperative curvature was 45° (range, 40°-90°). The of the curvature was dorsal (n = 9), ventral (n = 2), lateral (n = 4), dorsolateral (n = 3), ventrolateral (n = 2).

The median plaque length was 21.8 mm, the median operative time was 145.75 minutes, and the median lengthy of postoperative hospital stay was 8 days (range, 7-18).

After patients received treatment with plaque incision and buccal mucosa grafting, penile length and residual curvature were measured at the 3- and 24-month follow-up sessions. Penile Doppler ultrasound and completion of IIEF5 questionnaires also occurred at these visits. At the 24-month session the investigators assessed the satisfaction of the patient and their sexual partner.

“Our study contributes to the current state of knowledge regarding the safety and efficacy of buccal mucosa grafting in Peyronie's disease. Our study confirmed the results of the previous studies and showed that corporoplasty with buccal mucosa led to excellent structural, functional, and patient satisfaction results,” the investigators wrote in their conclusion.

“We think, based on our and previous studies’ results, that plaque incision and buccal mucosa grafting seems as an effective and safe correction procedure in patients with Peyronie's disease, which is worthy of further research. The success of this surgical approach in terms of erectile dysfunction should be further evaluated with dedicated questionnaires validated for use in patients with Peyronie’s disease,” the investigators added.

Reference

1. Ainayev Y, Zhanbyrbekuly U, Gaipov A, et al. Surgical reconstruction of penile curvature due to Peyronie’s disease by plaque incision and buccal mucosa graft [published online ahead of print June 17, 2021]. J Sex Med. doi: 10.1016/j.jsxm.2021.04.009