Use of a Non–cross-linked Xenograft (Xenform) in Surgical Treatment of Peyronie’s Disease
Objective
To evaluate the effectiveness in Peyronie's disease surgical treatment using Xenform, a non–cross-linked graft derived from dermal bovine tissue, to close the defect obtained after plaque incision, without penile prosthesis implant. A further objective is to evaluate the satisfaction of patients. (1)
Materials and Methods
We treated with plaque incision 28 patients with a stable penile curvature ≥60° hindering penetration and with erectile function conserved. International Index of Erectile Function-15 and a not-validated questionnaire constituted of 7 questions about their satisfaction were administered after 1 year of follow-up. Furthermore, specific questions were relative about penile straightening, penile postoperative length, glandular sensitivity, and feeling palpability. (2)
Results
Sixteen patients were seen after at least 1 year of follow-up. Curvature improvement was obtained in all cases, with the complete straightening in 75%; we did not observe any retraction of the graft and any recurrence on the curvature.
Significant reduced glans sensibility and erectile dysfunction were the more frequent postoperative complications, resulting in 43.8% and 25%, respectively. All patients are satisfied with the straightening. Only 2 patients are dissatisfied about the overall result. (3-4)
Discussions
Graft is resulted compatible with albugineal features, like thickness, consistency, and elasticity; it is waterproof, allowing the visualization of complete correction of the curvature after the suture. No severe complications were observed except 1 hematoma requiring surgical revision.
Conclusion
Plaque incision corporoplasty with Xenform graft is an effective and safe surgical treatment. Xenform is a secure and a reliable albugineal substitute, comparable to other heterologous graft. We have not observed any retraction. Patient's satisfaction is linked to the treatment result and to sexual life.
Reference
1 Egydio PH, Lucon AM, Arap S. Treatment of Peyronie’s disease by incomplete circumferential incision of the tunica albuginea and placque with bovine pericardium graft. Urology 2002; 59(4): 570-4
2. Austoni E, Colombo F, Mantovani F. Radical surgery and conservation of erection in Peyronie’s disease. Arch Ital Urol Androl 1995; 67(5): 359-64
3. Carson CC, Levine L. Outcomes of surgical treatment of Peyronie’s disease. BJU Int. 2014; 113(5): 704-13
4. Levine LA, Burnett AL. Standard operating procedures for Peyronie’s disease. J Sex Med 2013; 10(1): 230-44.