The surgical treatment of Peyronie's disease: Replacement of plaque by free autograft of buccal mucosa

Objectives: The aim of this work was the evaluation of clinical results of the use of buccal mucosa for replacement of Peyronie's disease plaque. Patients and methods: Twenty-six patients with Peyronie's disease were under observation. All the patients underwent the following investigations before and periodically within 3 years after the treatment: International Index of Erectile Function (IIEF-5), manual examination of plaque, autophotography of erect penis, conventional and power color Doppler sonography of penis, Peno-Brachial Index (PBI) before and its increase (IPBI) after the intracavernous injection of papaverin, Peak Systolic Velocity (PSV), end diastolic velocity (EDV), Resistance Index (RI), Sexual Encounter Profile questions (SEP-2 and SEP-3), measurements of penile length and curvature angle in the phase of rigidity. After stabilization in plaque's development (mean time 2.0 +/- 0.1 years) the patients underwent a surgery by means of excision of plaque and its replacement by free autograft of buccal mucosa. Results: After the surgical treatment (with mean follow up observation of 3.2 +/- 0.1 years) in 24 patients out of 26 (92.3%) the complete straightening of penis occurred, in two (7.7%) cases a residual curvature (< 10 degrees) remained, in four patients (15.4%) the shortening of penis (by 1 cm) and in two patients (7.7%) a partial reduction of erectile power were observed. Conclusion: Buccal mucosa showed high properties of adaptation and revascularization, good anatomical and functional clinical results by replacement of indurative plaque, it kept a stable elasticity without shrinkage; the method is simple and can be recommended for wide use in clinics for surgical treatment of Peyronie's disease. (c) 2005 Elsevier B.V. All rights reserved.