Polyglycolic Acid Polymer Versus Porcine Small Intestine Submucosa Graft After Plaque Incision in Peyronie's Disease: A Comparative Study.

BACKGROUND

Peyronie's disease (PD) with severe penile curvature often requires surgical correction through plaque incision and grafting (PIG).

OBJECTIVES

To compare surgical outcomes between polyglycolic acid polymer grafts and porcine small intestinal submucosa (SIS) grafts in patients undergoing PIG for PD.

MATERIALS AND

METHODS

This retrospective cohort study included patients with PD who underwent PIG using either Gore Bio-A (BioA group, n = 20) or SIS grafts (Cook Biotech, West Lafayette, IN, USA; SIS group, n = 21). The primary outcome was the incidence of postoperative erectile dysfunction (ED). Secondary outcomes included the degree of penile curvature correction, sensory disturbances, patient satisfaction, and surgical complications.

RESULTS

The median age was 61 years in the BioA group and 57 years in the SIS group (p = 0.381). The BioA group exhibited a significantly higher rate of refractory ED compared to the SIS group (p = 0.006). No significant differences were observed between groups in terms of penile straightening, sensory alterations, postoperative complications, or the need for penile prosthesis implantation. Patient satisfaction was significantly higher in the SIS group (p = 0.015).

DISCUSSION: This study is the first to directly compare Gore Bio-A and SIS grafts in PIG surgery for PD. Despite similar safety profiles and high curvature correction rates in both groups, erectile function outcomes were significantly better in the SIS group. Patient-reported satisfaction also favored SIS. Although associated with higher rates of ED, Gore Bio-A may still represent a viable option in selected cases, particularly when PIG is performed in conjunction with penile prosthesis implantation. Limitations include the retrospective, non-randomized design, and small sample size.

CONCLUSION

In this cohort, the SIS graft was associated with better postoperative outcomes than the BioA graft, with lower rates of refractory ED and higher patient satisfaction following PIG for PD.