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

  • Andrea Fabiani | andreadoc1@libero.it Urologic Unit, Surgical Dpt, ASUR Marche Area Vasta 3, Macerata Civic Hospital, Italy.
  • 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.

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Published
2016-07-04
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Section
Original Papers - Andrology
Keywords:
Buccal mucosa, Graft, Peyronie disease, Autologous materials, Surgery
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How to Cite
Fabiani, A., Servi, L., Fioretti, F., Maurelli, V., Tombolini, F., Filosa, A., Zucchi, A., Paulis, G., & Mammana, G. (2016). Buccal mucosa is a promising graft in Peyronie’s disease surgery. Our experience and a brief literature review on autologous grafting materials. Archivio Italiano Di Urologia E Andrologia, 88(2), 115-121. https://doi.org/10.4081/aiua.2016.2.115

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