Comparison of Technical Success and Adverse Events of Plaque Incision and Grafting Methods in Patients with Peyronies disease: Tunica Vaginalis versus Buccal Mucosa

Ainayev Y. Zhanbyrbekuly U. Gaipov A. Suleiman M. Kissamedenov N. Zhaparov U. Urazova S. Rakhmetova N. Turebayev D. Keulimzhayev N. Zhankina R. Khairli G.
December 2022 Elsevier Inc.

Urology
2022 #170 226 - 233 pp.

Objective: To compare the clinical outcomes of Peyronies disease (PD) patients who were treated by plaque incision and grafting either with tunica vaginalis (TV) or buccal mucosa (BM) grafts. Methods: PD patients in BM (n=20) and TV group (n = 20) were recruited between 2013 and 2020. Erectile dysfunction was assessed by short form of International Index of Erectile Function Questionnaire (IIEF-5). Technical success was defined as residual curvature ≤15°. Penile Doppler ultrasound was performed at baseline evaluation, 3-, and 24 months. Peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistance index were measured in erect penis. Erect penile length and curvature angle were measured at baseline and at 3, 12, and 24 months. Results: Mean age of the groups was comparable (47.2 ± 10.8 years in TV vs 46.5 ± 9.9 years in BM groups). Baseline mean penile curvature was 48.0 ± 6.6° (TV) and 50.3±11.6° (BM) (P <.001). Mean residual curvature at 24-month visits was 12.4 ± 4.9° (TV) and 7.9 ± 3.7° (BM), not significantly different. Technical success rate was 90% for both groups at 24 months. Surgery significantly increased erect penile length in both groups. Mean preoperative IIEF-5 scores were 18.4 ± 2.5 and 17.5 ± 2.2 in TV and BM groups, respectively. In both groups, IIEF-5 scores significantly improved after surgery with no intergroup IIEF-5 difference (20.6 ± 2.6 in TV and 21.3 ± 2.2 in BM). Mean postoperative PSV significantly increased, EDV significantly decreased in both groups, however, there was no significant intergroup difference. Conclusion: Both grafting materials provided similar beneficial effects regarding technical success, erectile dysfunction, and penile length.

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Astana Medical University, Department of Urology and Andrology, Nur-Sultan, Kazakhstan
Nazarbayev University, School of Medicine, Department of Medicine, Nur-Sultan, Kazakhstan
JSC ‘National Center of Neurosurgery’, Department for Reception and Diagnosis, Nur-Sultan, Kazakhstan
Astana Medical University, Department of General Medical Practice No. 3, Nur-Sultan, Kazakhstan
Astana Medical University, Department of microbiology and virology named after Sh. I. Sarbasova, Nur-Sultan, Kazakhstan
Astana Medical University, Department of Surgery with an angiosurgery and plastic surgery course, Nur-Sultan, Kazakhstan

Astana Medical University
Nazarbayev University
JSC ‘National Center of Neurosurgery’
Astana Medical University
Astana Medical University
Astana Medical University

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