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Buccal mucosa is a promising graft in Peyronie’s disease surgery. Our experience and a brief literature review on autologous grafting materials

Andrea Fabiani, Lucilla Servi, Fabrizio Fioretti, Valentina Maurelli, Flavia Tombolini, Alessandra Filosa, Alessandro Zucchi, Gianni Paulis, Gabriele Mammana
  • Andrea Fabiani
    Urologic Unit, Surgical Dpt, ASUR Marche Area Vasta 3, Macerata Civic Hospital, Italy | andreadoc1@libero.it
  • Lucilla Servi
    Urologic Unit, Surgical Dpt, ASUR Marche Area Vasta 3, Macerata Civic Hospital, Italy
  • Fabrizio Fioretti
    Urologic Unit, Surgical Dpt, ASUR Marche Area Vasta 3, Macerata Civic Hospital, Italy
  • Valentina Maurelli
    Urologic Unit, Surgical Dpt, ASUR Marche Area Vasta 3, Macerata Civic Hospital, Italy
  • Flavia Tombolini
    Urologic Clinic, Politechnic University of Marche Region, Ancona, Italy
  • Alessandra Filosa
    Pathologic Unit ASUR Marche Area Vasta 3, Macerata Civic Hospital, Italy
  • Alessandro Zucchi
    Urologic and Andrologic Clinic University of Perugia, Italy
  • Gianni Paulis
    Regina Apostolorum Hospital, Andrologic Center, Albano Laziale, Roma, Italy
  • Gabriele Mammana
    Urologic Unit, Surgical Dpt, ASUR Marche Area Vasta 3, Macerata Civic Hospital, Italy

Abstract

Aim: Peyronie’s Disease (PD) is an under reported acquired benign condition that, at the moment, is not curable with medical therapy. Surgery represent the gold standard of treatment. Surgical approaches are several and they consist in “plication techniques” or plaque incision/excision with grafting of resulting albuginea defect. Among grafting procedures, albuginea defect substitution with autologous materials demonstrated over the years not inferior results respect to heterologous grafts. Buccal mucosa graft (BMG) is not usually emphasized in many review articles and clinical series are yet limited. Methods: We present our experience with seventeen plaque incision procedures and BMG in surgical correction of complex penile curvatures due to PD performed in a period of 30 months. Our analyses was focused on buccal mucosa graft characteristics as major determinant of the surgical success. We also conducted a brief literature review on autologous grafting materials used in reconstructive penile surgery for PD. Results: Our cosmetics and functional results consists in a 100% of functional penile straightening with no relapses and 5,8% of de novo erectile dysfunction. Mean age was 56.4 years, mean follow-up of 22.5 (6-36) months. No complications graft related were observed. Operative time was 115.3 minutes in mean. Over 94% of patients referred they were “really much better” and “much better” satisfied based on PGI-I questionnaire administrated at the last follow- up visit. Conclusion: BMG is revealing as an optimal choice for reconstructive surgery in PD. Anatomical characteristics consisting in the great elasticity, the quick integration time and the easy harvesting technique lead to high cosmetics and functional success rate, without omitting economical and invasiveness aspects.

Keywords

Buccal mucosa; Graft; Peyronie disease; Autologous materials; Surgery

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Submitted: 2015-10-23 23:39:24
Published: 2016-07-04 15:13:24
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Copyright (c) 2016 Andrea Fabiani, Lucilla Servi, Fabrizio Fioretti, Valentina Maurelli, Flavia Tombolini, Alessandra Filosa, Alessandro Zucchi, Gianni Paulis, Gabriele Mammana

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