Small intestinal submucosa graft in the treatment of Peyronie’s disease: Long term patient-reported outcomes and satisfaction

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

374

Small intestinal submucosa graft in the treatment of Peyronie's disease: Long term patient-reported outcomes and satisfaction Eur Urol Suppl 2017; 16(3);e660

Ribeiro Morgado L.A.1, Ribeiro Morgado M.2, Pacheco-Figueiredo L.1, Tomada N.1, Cruz F.1 1

Centro Hospitalar São João, Dept. of Urology, Porto, Portugal, 2Faculdade de Medicina da Universidade do Porto, Dept. of Renal, Infectious and Urologic Diseases, Porto, Portugal INTRODUCTION & OBJECTIVES: Peyronie’s Disease (PD) is an acquired connective tissue disorder characterized by the formation of dense fibrous collagen plaques in the tunica albuginea that leads to penile deformity and sexual dysfunction. Four-layered porcine small intestinal submucosa (SIS) graft (SURGISIS®, Cook Medical) is used as a tunica albuginea replacement after plaque incision for the surgical correction of severe penile curvature (>60º) in patients with intact erectile function or erectile dysfunction (ED) responsive to pharmacotherapy. The surgery aspires to correct penile curvature and recover patient’s ability to perform satisfactory sexual intercourse. However, complications such as ED, penile gland sensory loss, penile shortening, curvature recurrence and palpation of knots may emerge. This study endeavors to evaluate long-term patient-reported outcomes and satisfaction after penile lengthening surgery with plaque incision and SIS grafting for PD. Our primary objective is to assess treatment success, complications and overall patient satisfaction focusing on the patient perspective. MATERIAL & METHODS: A retrospective review of 33 patients with PD who underwent surgical correction of penile curvature by plaque incision and grafting with SIS for severe penile curvature at our institution was undertaken after local ethical committee approval. Patient-reported long-term satisfaction and ED were accessed through validated questionnaires. Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) and brief International Index of Erectile Function (IIEF5) were used. An EDITS score of 50 or more was considered as the cut-off for satisfaction and a IIEF-5 score of 21 or less was regarded as diagnostic of ED. Residual penile curvature was evaluated through patient’s report and selfphotography of the erect penis. A 30º or more residual or de novo curvature was considered as significant. RESULTS: The mean patient age at follow-up was 59.73 (±6.43) years and mean follow-up time was 43.41 (±12.94) months. Preoperative ED responsive to pharmacotherapy was present in 17.6% (n=6) patients. A median EDITS score of 75 (60 - 90) and a 90.9% (n=30) satisfaction rate were noted. Moderate-to-severe ED was found in 23.3% (n=7) of patients with a median 21 (17 - 23) IIEF-5 score. Nonetheless 75% (n=12) were responsive to pharmacotherapy. A significant residual or de novo curvature was found in 6.06% (n=2) patients. Almost all patients would repeat (90.9%, n=30) as well as recommend (93.9%, n=2) plaque incision with SIS grafting if clinical circumstances were the same. CONCLUSIONS: Plaque incision and four-layered porcine small intestinal submucosal grafting for severe penile curvature achieves long-term curvature correction with an acceptable possibility of complications and high patient-reported overall satisfaction. Even though ED may happen it is often

Eur Urol Suppl 2017; 16(3);e660

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

374

Small intestinal submucosa graft in the treatment of Peyronie's disease: Long term patient-reported outcomes and satisfaction Eur Urol Suppl 2017; 16(3);e661

manageable with pharmacotherapy.

Eur Urol Suppl 2017; 16(3);e661 Powered by TCPDF (www.tcpdf.org)