Medium-long-term outcomes of saphenous vein graft in Peyronie surgery: Is there a need for new graft material?

Aim: We present our results of tunical incision and saphenous graft surgery for men with short penis and who cannot have sexual relations due to curvature linked to chronic Peyronie plaques.

Introduction: Peyronie disease is a chronic process where fibrotic plaques form in the tunica albuginea. The plaques cause pain in the acute period and cause the penis to bend after inflammation ends. Surgical procedures are required for curvature>30°. Saphenous vein graft (SVG) replacement is an alternative method for tunical plaque incision defect.

Material-method: The outcomes for 71 patients with TI+SVG surgery were retrospectively assessed. Plaque features (curvature angle, location, direction of curve and tunical defect diameter), operative and postoperative properties (surgery duration, recurrent curvature, penis shortening, glans hypoesthesia, satisfaction score, follow-up duration), preoperative-postoperative penis length and IIEF-5 score differences were assessed.

Results: Mean age was 61.12±7.9 (45-75) years, mean curvature angle was 62.0±14.7 (50-90), location was mid-penile for 46 (65%), with angulation direction toward the dorsal for 37 (52%), and the defect area after tunical incision was 15.5±3.9 (10-23) cm. With mean follow-up duration of 37±9.4 months, 9 patients had re-curvature (13.2%), 8 had short penis (11.3%) and 7 had ED identified (9.4%). Total penis straightening was present for 86.8%, with patient satisfaction score of 21.1±4.4 (8-25).

Conclusion: The TI+SVG method is an effective method for Peyronie surgery in the medium-long term.