Editorial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Urol. Mar 24, 2015; 4(1): 1-4
Published online Mar 24, 2015. doi: 10.5410/wjcu.v4.i1.1
Reconstructive surgery in Peyronie’s disease: What’s new?
Elisabetta Costantini, Alessandro Zucchi
Elisabetta Costantini, Alessandro Zucchi, Urology and Andrology Department, University of Perugia, 06123 Perugia, Italy
Author contributions: Both authors contributed to this manuscript.
Conflict-of-interest: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Alessandro Zucchi, MD, Associate Professor, Urologist, Urology and Andrology Department, University of Perugia, S. Andrea delle Fratte, 06123 Perugia, Italy. zucchi.urologia@gmail.com
Telephone: +39-33-87728183 Fax: +39-7-55784416
Received: December 28, 2014
Peer-review started: December 29, 2014
First decision: January 8, 2015
Revised: February 2, 2015
Accepted: February 10, 2015
Article in press: February 12, 2015
Published online: March 24, 2015
Processing time: 86 Days and 15.8 Hours
Abstract

Surgical treatment of Peyronie’s disease (PD) is still a challenge and a gold standard approach does not exist; however the main goal is to straight penile shaft, and to restore penetrative and coital capacity. The less invasive approach aims to correct curvature without intervening directly on the fibrous plaque while the more complex “corporoplasty” applies specific geometric criteria and uses different autologous and heterologous grafts. Each approach has its pros and cons and decision-making should be tailored to the individual patient’s expectations. Other surgical options include different use of patches to cover the tunica albuginea defect, with the choice depending on the surgeon’s personal experience. Despite the wide range of autologous (buccal mucosa, vein, dermis, etc.) and heterologous grafts (bovine pericardium, swine intestinal submucosa, porcine dermis, etc.) none currently represents the real “gold standard” because the data are extremely variable and frequently not representative. Several factors seem to favor buccal mucosa grafts over inert biocompatible materials: as vital tissue, buccal mucosa tends to heal rapidly, immediately integrating with the surrounding albuginea tissue. This translates into a more rapid resumption of spontaneous erections (after 3/4 d) and sexual activity and into a reduced risk of curvature relapse and erectile dysfunction after surgery. Another advantage of the buccal mucosa graft is its low cost. In conclusion, despite the recent development of some exciting new surgical techniques we are still unable to deliver a definitive take-home message about reconstructive surgery in PD because the majority of the studies reported insufficient data. However, since it is clear that major outcomes, besides the cosmetic result, are the patient’s and partner’s satisfaction and the economic impact of each technique, we recommend they be included among the outcome assessment parameters in further studies

Keywords: Reconstructive urology; Peyronie’s disease; Corporoplasty

Core tip: Surgical treatment of Peyronie’s disease is still a challenge and a “gold standard” approach does not exist. This paper tries to review the main surgical techniques making an assessment of functional and aesthetical results, underling costs and benefits.