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Comment on “Long-term outcome after grafting with small intestinal submucosa and collagen fleece in patients with Peyronie’s disease: a matched pair analysis”

International Journal of Impotence Research volume 31, pages 302–303 (2019)Cite this article

To the Editor: In this paper, Rosenhammer et al. [1] presents their long-term data from a matched cohort analysis examining two different graft materials (small intestinal submucosa [SIS] and self-adhesive collagen fleece [CF]) following plaque incision/partial excision for Peyronie’s disease (PD). The senior author, G. Hatzichristodoulou, was the first to report data using CF as a sealant following plaque incision/excision with excellent efficacy and safety for both dorsal and ventral curvatures [2, 3]. The main advantage of this technique is that it eliminates the need for lengthy suturing of the graft to ensure water-tight closure, thus shortening length of surgery.

In this study, 43 patients who underwent SIS were retrospectively matched with 43 patients who underwent CF grafting using the degree of preoperative penile curvature as the primary matching factor. Median preoperative curvature was quite severe (80 degrees) and similar between both groups. Overall, both procedures offered excellent overall outcomes with minimal complications and need for reintervention. When analyzing PD surgical data, it is crucial to assess the most relevant patient, physician, and health-care outcomes. These include correcting penile curvature, preserving penile length, maintaining erectile function, avoiding complications, decreasing the need for secondary interventions, avoiding unnecessary expenses (technique or time related), and ensuring patient satisfaction (https://www.auanet.org/guidelines/male-sexual-dysfunction-peyronies-disease-(2015)). Unlike many other PD intervention studies, the authors here were diligent in reporting most outcomes related to all these parameters. Their data demonstrated that, while both interventions were similar in most regards, the use of CF portended significantly shorter surgery and better preservation of penile length.

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References

  1. Rosenhammer B, et al., Long-term outcome after grafting with small intestinal submucosa and collagen fleece in patients with Peyronie’s disease: a matched pair analysis. Int J Impot Res 2018 (this issue).

  2. Hatzichristodoulou G, Gschwend JE, Lahme S. Surgical therapy of Peyronie’s disease by partial plaque excision and grafting with collagen fleece: feasibility study of a new technique. Int J Impot Res. 2013;25:183–7.

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  3. Hatzichristodoulou G. Introducing the ventral sealing technique using collagen fleece for surgical therapy of patients with ventral Peyronie’s curvature: initial experience. Int J Impot Res 2018. https://doi.org/10.1038/s41443-018-0044-4.

    Article  CAS  Google Scholar 

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  1. Department of Urology, University of California Irvine, CA, USA

    Faysal A. Yafi

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  1. Faysal A. Yafi
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Correspondence to Faysal A. Yafi.

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Yafi, F.A. Comment on “Long-term outcome after grafting with small intestinal submucosa and collagen fleece in patients with Peyronie’s disease: a matched pair analysis”. Int J Impot Res 31, 302–303 (2019). https://doi.org/10.1038/s41443-018-0091-x

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