Application of pericardial graft in the surgical management of Peyronie's disease

Purpose: We investigated the use of Tutoplast dagger cadaveric pericardium as an alternative material for grafting the tunica albuginea defect after P eyronie's plaque excision. Materials and Methods: A total of 11 patients with significant penile curva ture interfering with sexual intercourse were evaluated after at least 12 m onths of conservative therapy. Preoperative evaluation in all cases include d penile duplex Doppler ultrasound studies. Chemically processed and gamma irradiated pericardium was used to graft the cavernosal defect after surgic al excision of the penile plaque. In 3 patients se penile prosthesis was si multaneously placed secondary to documented erectile dysfunction at duplex Doppler ultrasound evaluation. Results: Penile curvature resolved in all patients, allowing for normal sex ual function after a mean followup of 14 months (range 9 to 19). No postope rative evidence of tissue rejection or infection was noted. In 1 patient ur ethro-corporal communication developed and a single penile cylinder was exp lanted. Another patient had a mild dorsal bulge at the site of graft placem ent when the prosthesis was fully inflated. Conclusions: Polymeric silicone material used to provide satisfactory resul ts in the surgical treatment of Peyronie's disease but it is no longer avai lable for biomedical use. We demonstrate the effective use of cadaveric per icardium as a graft material for cavernosal defects after Peyronie's plaque excision. Overall patient satisfaction, absence of a second surgical incis ion, relative low risk and ease of surgical placement make this material id eal for the surgical treatment of this disease process.