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Abstract

Volume 26, Issue 3 (May 2024) 26, 250–259; 10.4103/aja202358

Grafts in Peyronie’s surgery without the use of prostheses: a systematic review and meta-analysis

Anastasios Natsos1, Vasileios Tatanis1, Stavros Kontogiannis1, Sharon Waisbrod2, Kristiana Gkeka1, Mohamed Obaidad1, Angelis Peteinaris1, Konstantinos Pagonis1, Costas Papadopoulos3, Panagiotis Kallidonis1, Evangelos Liatsikos1,4, Petros Drettas1

1Department of Urology, University of Patras, Patras 26500, Greece; 2Uroclinic, Pfaeffikon 8808, Switzerland; 3Department of Medical Physics, University of Patras, Patras 26500, Greece; 4Department of Urology, Medical University of Vienna, Vienna 1090, Austria.

Correspondence: Anastasios Natsos

Received: 19 July 2023; Accepted: 07 October 2023; published online: 09 January 2024

Abstract

Peyronie’s disease (PD) is characterized by abnormal penile curvature, and various surgical methods have been developed using different graft materials. However, there is currently no universal agreement on which type of graft is the best. The objective of this review was to evaluate the available literature and identify the most effective graft material for penile curvature correction in PD. A literature search was conducted using electronic databases, including PubMed, Scopus, and the Cochrane Library. The patients, intervention, comparison, and outcome (PICO) approach was used to define the eligibility of studies. Two authors independently selected studies, evaluated them, and extracted data. Random-effect models using the DerSimonian–Laird method were used. Most studies were single-arm studies and had a high risk of bias. Buccal mucosa grafts (BMG) were found to result in the highest penile straightening rates and were associated with the least de novo erectile dysfunction. TachoSil grafts demonstrated a high success rate in straightening despite a higher mean preoperative curvature, while Tutoplast grafts had a higher incidence of postoperative erectile dysfunction. BMG had the highest percentage of postoperative penile straightening. Overall, the TachoSil graft showed the best performance when preoperative curvature is taken into account. Based on the available literature, BMG appear to be the most effective for penile curvature correction in PD, but this is offset by the requirement for low preoperative curvature. The TachoSil graft shows the best overall performance when preoperative curvature is considered. Comparative randomized clinical trials are
still needed to determine graft superiority.

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Asian Journal of Andrology CN 31-1795/R ISSN 1008-682X  Copyright © 2023  Shanghai Materia Medica, Chinese Academy of Sciences.  All rights reserved.