Dermal graft surgery for Peyronie's disease: Long term results at a 15 years follow-up.

Objectives: To evaluate long-term outcomes of patients subjected to corporoplasty, plaque incision and excision, and autologous dermal grafting, with at least 15 years of follow-up. METHODS: The charts of consecutive patients with a penile curvature and a minimum of 15 years follow up were retrospectively reviewed. The patients underwent corporoplasty and penile straightening with autologous dermal grafting, harvested at the level of the anterior-superior iliac spine. At the time of the follow-up, a postoperative IIEF - 5 questionnaire was administered by telephonic interview, and patients were also asked to complete an 8 items self-evaluation questionnaire. After signing informed consent, the patients were invited to undergo dynamic and basal penile sonography, as well as injection of 10 mcg of PGE1 for dynamic evaluation of the graft.

Results: A total of 16 patients were identified. Penile shortening of up to 1.5 cm was reported in about 40% of cases and residual bending was reported by 4 of 16 patients. However, there was no impairment in penetration. On physical examination of the suture site, a small indurated nodule was palpable in two patients. Data regarding the dynamic sonography is available for the 5 patients who accepted to undergo the test. No sign of a fibrotic reaction or calcification was detected in the static phase. After injection of 10 mcg PGE-1, in comparison to the basal measurement, the dermal grafts showed compliant length adaptation. CONCLUSIONS: Dermal graft substitution surgery for Peyronie's disease allows to obtain good functional results with durable satisfaction of the patients on long term follow up.