scholarly journals Buccal mucosa is a promising graft in Peyronie’s disease surgery. Our experience and a brief literature review on autologous grafting materials

2016 ◽  
Vol 88 (2) ◽  
pp. 115 ◽  
Author(s):  
Andrea Fabiani ◽  
Lucilla Servi ◽  
Fabrizio Fioretti ◽  
Valentina Maurelli ◽  
Flavia Tombolini ◽  
...  
Keyword(s):  
Literature Review ◽  
Buccal Mucosa ◽  
Peyronie’S Disease ◽  
Benign Condition ◽  
Buccal Mucosa Graft ◽  
Harvesting Technique ◽  
Clinical Series ◽  
Peyronie's Disease ◽  
Grafting Materials

Aim: Peyronie’s Disease (PD) is an under reported acquired benign condition that, at the moment, is not curable with medical therapy. Surgery represent the gold standard of treatment. Surgical approaches are several and they consist in “plication techniques” or plaque incision/excision with grafting of resulting albuginea defect. Among grafting procedures, albuginea defect substitution with autologous materials demonstrated over the years not inferior results respect to heterologous grafts. Buccal mucosa graft (BMG) is not usually emphasized in many review articles and clinical series are yet limited. Methods: We present our experience with seventeen plaque incision procedures and BMG in surgical correction of complex penile curvatures due to PD performed in a period of 30 months. Our analyses was focused on buccal mucosa graft characteristics as major determinant of the surgical success. We also conducted a brief literature review on autologous grafting materials used in reconstructive penile surgery for PD. Results: Our cosmetics and functional results consists in a 100% of functional penile straightening with no relapses and 5,8% of de novo erectile dysfunction. Mean age was 56.4 years, mean follow-up of 22.5 (6-36) months. No complications graft related were observed. Operative time was 115.3 minutes in mean. Over 94% of patients referred they were “really much better” and “much better” satisfied based on PGI-I questionnaire administrated at the last follow- up visit. Conclusion: BMG is revealing as an optimal choice for reconstructive surgery in PD. Anatomical characteristics consisting in the great elasticity, the quick integration time and the easy harvesting technique lead to high cosmetics and functional success rate, without omitting economical and invasiveness aspects.

Surgical Reconstruction of Penile Curvature due to Peyronie's Disease by Plaque Incision and Buccal Mucosa Graft

2021 ◽  
Author(s):  
Yernur Ainayev ◽  
Ulanbek Zhanbyrbekuly ◽  
Abduzhappar Gaipov ◽  
Makhmud Suleiman ◽  
Kainar Kadyrzhanuly ◽  
...  
Keyword(s):  
Buccal Mucosa ◽  
Peyronie’S Disease ◽  
Surgical Reconstruction ◽  
Penile Curvature ◽  
Buccal Mucosa Graft ◽  
Peyronie's Disease

scholarly journals Buccal mucosa graft in surgical management of Peyronie’s disease: Ultrasound features and clinical outcomes

2021 ◽  
Vol 93 (1) ◽  
pp. 107-110
Author(s):  
Andrea Fabiani ◽  
Fabrizio Fioretti ◽  
Maria Pia Pavia ◽  
Luca Lepri ◽  
Emanuele Principi ◽  
...  
Keyword(s):  
Surgical Management ◽  
Buccal Mucosa ◽  
De Novo ◽  
Surgical Complication ◽  
Peyronie’S Disease ◽  
Penile Curvature ◽  
Ultrasound Evaluation ◽  
Dynamic Ultrasound ◽  
Peyronie's Disease

Introduction: Plaque incision and grafting represent the best surgical approach to the Peyronie’s Disease (PD). The grafting procedures must be restricted to patients with normal preoperative status, excessive curvature and/or deformities. However, the ideal graft has not been identified yet. Buccal mucosa grafts (BMG) provided excellent short-term results, ensuring the fast return of spontaneous erections and preventing shrinkage, which is the main cause of graft failure. Another fearsome surgical complication is de novo erectile dysfunction (ED). We report our results with BMG focusing on the analysis of ultrasonographic and clinical data demonstrating buccal mucosa as determinant factor that allow to avoid complications. Materials and methods: From 2013 to 2019 we performed at our Urology Unit 27 corporoplasties with BMG to correct complex penile curvature due to PD. Clinical, post-surgical and ultrasound follow up data were evaluated. All patients were no responders to medical treatment or previous surgical procedures. The evaluation period was 72 months. Data regarding pre-operative work-up, including IIEF (IIEF-5) questionnaire administration, detailed clinical history and penile dynamic ultrasound (PGE1-induced erection) were collected. The time of spontaneous erection resumption was recorded for each patient. To improve blood supply to the graft, a low-dose PDE5-i was prescribed for all patients for a period of two months, starting immediately after discharge. Check-ups were scheduled every 3 months, starting from 1 month after surgery. In each visit, patients underwent a penile ultrasound evaluation of graft features. After 6 and 12 months, all patients underwent a penile dynamic ultrasound for Erection Hardness Score determination, then standard ultrasound and clinical evaluation yearly. Our analyses were focused on BMG as a major determinant of the surgical success. Results: Mean age of 27 patients was 57 years (42-71) with a maximum follow up time of 72 months and minimum of 3. Site of penile curvature was dorsal in 18 (67%) patients, ventral in 2 (7%), complex in 7 (26%). The degree of the curvature was < 60° in 11 (41%) patients, > 60° in 16 (59%). Straightening of penis was reached in 100% of cases. Penile shortening resulted in 7.4% (2/27). De novo ED appeared in 2/27 cases with a post-operative rate of PDE5i users increasing from 12 to 14 patients (45% vs 52%). Ultrasound aspects of BMG, recorded at every follow up visit, results in a hypoechoic plaque with an iperechoic rim that become isoechoic over the time in all cases. No case of scars or seroma was registered. Small intra-graft cystic lesions were highlighted in 3 cases (11%).Conclusions: BMG may represent a good choice in grafts procedures for PD surgical management. The functional results obtained by BMG procedures were related to the good anatomical characteristics of the patch and were highlighted in our series by use of penile ultrasound, during the follow up period.

scholarly journals Urethroplasty with dorsal buccal mucosa graft. Is it still the method of choice in long term urethral stenosis?

2017 ◽  
Vol 89 (1) ◽  
pp. 42 ◽  
Author(s):  
Carlo Pavone ◽  
Dario Fontana ◽  
Ninfa Giacalone ◽  
Nino Dispensa ◽  
Marco Vella ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Buccal Mucosa ◽  
Maximum Flow ◽  
Screening Tests ◽  
Life Questionnaire ◽  
Urethral Stenosis ◽  
Buccal Mucosa Graft

The aim of our work was to evaluate the long-term changes in symptoms (median 42 months) and to analyze data for any negative predictive factors for the application of the procedure, in patients who underwent to urethroplasty with dorsal buccal mucosa graft. During the period from 2010 to 2015 27 patients were examined. Than they underwent urethroplasty using dorsal buccal mucosa graft (graft of 4 x 2.5 cm). The evaluation of symptoms has been addressed through the application of the IPSS Quality of Life Questionnaire (International Prostatic Symptoms Score) and the evaluation of urinary flow has been carried out by a comparative analysis between the pre- and post-operative uroflowmetry. As our study has shown, data obtained by the screening tests in the post-operative follow-up indicate that there is an increase in the maximum flow of urine until 1 month after surgery. The results in the long-term follow-up are different because they show a partial reduction of the maximum flow although it is maintained around an average value of 23 ml/s being still higher than the maximum flow in the pre-operative period. According to our results it follows that there is a low failure rate of the procedure after a median of 42 months. Only in patients with urethral stenosis longer than 2 cm, a lower long term success is achieved. From what we could observe, this length of the stenosis seems to be the only negative predictive factor for long-term maintenance of a good Quality of Life in patients undergoing the procedure. The results obtained from our study confirm literature data according to which, the gold standard for 2-cm long bulbar urethral stricture whose lumen is well preserved with circumferential spongiofibrosis limited to 1-2 mm is the dorsal graft urethroplasty with buccal mucosa that in our study showed success rates higher of 80% after a median follow up of 42 months and a percentage of relapse-free patients of 82.1% ( median 3.5 years).

Buccal mucosa transplant – the concept of «ideal graft» in surgical management of peyronie’s disease

Urologiia ◽  
2017 ◽  
Vol 4_2017 ◽  
pp. 68-72
Author(s):  
S.V. Kotov Kotov ◽  
A.G. Yusufov Yusufov ◽  
M.K. Semenov Semenov ◽  
◽  
◽  
...  
Keyword(s):  
Surgical Management ◽  
Buccal Mucosa ◽  
Peyronie’S Disease ◽  
Peyronie's Disease
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