Corporoplasty using bovine pericardium graft in Peyronie’s disease

32nd Annual EAU Congress, 24-28 March 2017, London, United Kingdom

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Corporoplasty using bovine pericardium graft in Peyronie’s disease Eur Urol Suppl 2017; 16(3);e2153

Ruiz-Hernandez M.1, Fraile-Poblador A.2, Donis-Canet F.1, Martínez-Salamanca J.I.3, Martínez-Arcos L.M.1, Sanz-Mayayo E.1, Rodríguez-Patrón R.1, Burgos-Revilla F.J.1 1

Hospital Universitario Ramón y Cajal, Dept. of Urology, Madrid, Spain, 2Hospital Universitario Ramón y Cajal and Centro de Urología Médico-Quirúrgico CUMQ-LYX, Dept. of Urology, Madrid, Spain, 3Centro de Urología Médico-Quirúrgico CUMQ-LYX, , Madrid, Spain INTRODUCTION & OBJECTIVES: Corporoplasty using bovine pericardium graft is indicated in patients with severe Peyronie’s disease or short penis. In this video, we perform this technique in a patient with a penile length of 11 cm and a dorsal curvature of 60º. We also show the results of this technique obtained in our centre. MATERIAL & METHODS: The surgical technique starts with a subcoronal incision and penis degloving. Next, the neurovascular bundle is dissected from the tunica albuginea. Then, an erection is induced by saline injection into the corpora cavernosa. H-shaped incisions are made at the point of maximum curvature, following Egydio’s technique. The pericardium graft selected is 10% bigger than the corpora cavernosa defect. After the graft is fixed, another erection is provoked to check if the curvature has been corrected. We reviewed 14 patients who underwent this technique, under one single surgeon, in our centre. Short and long term complications, as well as functional results were analysed, using pre and post-surgery IIEF-5 questionnaire and a phone survey where we included a satisfaction rate from 1 to 10 using the visual analogic scale (VAS) and the question “Would you undergo the same operation again?” RESULTS: Mean age was 52.7 years and mean follow up was 22.4 months. 14.3% had prior Peyronie's surgery, 64.3% were smokers or former smokers, 28.6% cardiopathy, 21.4% diabetes mellitus, 21.4% hypertension and one patient was hypogonadic. Mean curvature was 79.6º.

Correction degree

VAS satisfaction (median) ¿Would you undergo same operation again?

Eur Urol Suppl 2017; 16(3);e2153

- Complete (64.3%) - < 20º (21.4%) - Opposite side (14.3%) 7.5 Yes (85.7%)

32nd Annual EAU Congress, 24-28 March 2017, London, United Kingdom

V88

Corporoplasty using bovine pericardium graft in Peyronie’s disease Eur Urol Suppl 2017; 16(3);e2154

Glans hypoesthesia

Early= 63.6% >3 months= 21.4% Erectile dysfunction moderate to severe (IIEF-5≤ Previous ED= 7,1 11) Post surgery (>3 months) - without IPDE-5= 21.4% - with IPDE-5 = 14.3% Median shortening (patient reported) 2,5 cm (0-6 cm) <1 = 21.4% 1-3= 57,2% >3 = 2,4%

Palpation of irregularities Pain with erection Anorgasmia Clavien IIIa complications

64.3% 7.1% 7.1% 14.3%

CONCLUSIONS: Corporoplasty with bovine pericardium graft is a safe and effective option in severe Peyronie's disease, although it is not exempt from complications. Glans hypoesthesia and penis shortening are common complications, and erectile function can be impaired.

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