Plaque incision or excision and grafting of collagen TachoSil improves the outcomes of patients with Peyronie’s disease

This study investigated the effectiveness and safety of plaque incision/excision and or grafting (PIG/PEG) with collagen TachoSil to treat erectile dysfunction in patients with Peyronie's disease (PD). Researchers suggested that PIG/PEG is a good and safe procedure to treat these patients.

PD consists of developing scar tissue (plaque) inside the penis. This can result in a bent, rather than straight, erect penis. This disorder can be painful and can cause erectile dysfunction. The standard treatment for this disorder is penis lengthening methods. This treatment consists of the incision (a cut made on the skin) or excision (cutting tissue/plaque out). After excision, the plaque is replaced by a graft (transplant of living tissue). This method is associated with a significant risk of erectile dysfunction (up to 50%) and penis hypesthesia (reduced sensitivity and pain; up to 52%).

More recently, a graft made of collagen has been considered for grafting procedures for PD. Collagen is a body protein present in several body parts and gives structure to skin and muscles. Prior studies showed the effectiveness and safety of collagen as well as its ease of use which results in a reduction of operation time. However, the effectiveness of this method in PIG/PEG is still not clear.

This study included information about 52 patients with PD. All participants underwent PIG/PEG with collagen (TachoSil). The main outcome measured was penile bend correction, penile shortening, and erectile function, and hardness.

PIG was the preferred method (80.8%). Penile bend correction was achieved in 92.3% and no significant penis shortening was recorded. However, penis shortening was reported by 83.3% of patients at 6 months. However, when measured by medical professionals, no difference in curve and length was seen.

No significant difference was found in erection function and hardness at 3 or at 6 months. However, 16.7% of men had a worse erectile function and 14.3% required treatment with medication 6 months after surgery. 78.5% of men were satisfied with treatment after 6 months.

The most common complications after surgery were swelling and a collection of blood (40.4%). Wound infection was the second most common (3.8%) complication. At 6 months, 35.7% of patients reported penile hypoesthesia.

This study concluded that PIG/PEG with collagen improves the outcomes of patients with PD, with manageable side effects.

This study included a limited number of participants and a short follow-up period. Longer studies with bigger populations are necessary.