Camarena-Reynoso HR, Leos-Acosta C, Shuck-Bello CE, Hernández-Castellanos VA, Cantellano-Orozco M, Morales-Montor JG, Pacheco-Gahbler Carlos, Calderón-Ferro Francisco, Sotomayor-De Zavaleta Mariano

Language: Spanish
References: 29
Page: 261-265
PDF size: 4551.95 Kb.

ABSTRACT

Background: Peyronie’s disease is an acquired condition characterized by the formation of fibrous plaques in the tunica albuginea of the penis. The majority of patients can be managed conservatively with oral or intralesional medication. Surgical options vary from tunica albuginea shortening contralateral to the curvature, to resection of the fibrous area with graft application. One alternative is the use of porcine small intestine submucosa.
Objective: To demonstrate porcine intestinal submucosal graft application in the treatment of Peyronie’s disease.
Clinical case: Patient is a 66-year-old man with 9-year disease onset presenting with cephalic penile curvature accompanied by pain during erection. Test with alprostadil showed penile curvature and 2 cm dorsal plaque. Patient was treated with vitamin E and colchicine for 6 months with no improvement. The decision was made to apply porcine intestinal submucosal graft.
Conclusions: Porcine intestinal submucosa application is a useful alternative in treating Peyronie’s disease. It provides length and flexibility while correcting penile curvature by generating healthy cell growth at the fibrosis site, converting it into functional tissue. It is easy to rehydrate and suture, it minimizes scar tissue formation, and it is infection-resistant.

REFERENCES

1. Gelbard MK, Dorey F, James K. The natural history of Peyronie´s disease. J Urol. 1990;144(6):1376-9.

2. Carson CC, Jordan GH, Gelbard MK. Peyronie’s disease: New concepts in etiology, diagnosis and treatment. Contemp Urol 1999;11:64-44.

3. Lindsay MB, Schain DM, Grambsch P. The incidence of Peyronie‘s disease in Rochester, Minnesota, 1950 through 1984. J Urol 1991;146(4):1007-9.

4. Nyberg Jr LM, Bias WB, Hochbert MC, Walsh PC. Identification of an inherited form of Peyronie’s disease with autosomal dominant inheritance and association with Dupuytren’s contracture and histocompatibility B7 cross-reacting antigens. J Urol 1982;128(1):48-51.

5. Ralph DJ, Schwartz G, Moore W. The genetic and bacteriological aspects of Peyronie’s disease. J Urol. 1997;157(1):291-4.

6. O’Brien K, Parker M, Guhring P. Analysis of the natural history of Peyronie’s disease J Sex Med 2004;1(suppl 1):50. abstract 69.

7. Lue T, El-Sakka A, Sotomayor M. Enfermedad de Peyronie. Atlas de Difunción Eréctil. 2da ed. Science Press Brasil – Latin America Ltda. 2003. 99-106.

8. Ralph DJ, Hughes T, Lees WR, Pryor JP. Preoperative assessment of Peyronie’s disease using color Doppler sonography. Br J Urol. 1992;69(6):629-32.

9. Jones WJ: Counseling men with sexual dysfunction. AUA Update Series 1997; XVI (lesson 23):178-184.

10. Akkus E, Carrier S, Rehman J. Is colchicine effective in Peyronie’s disease? A pilot study. Urology 1994;44(2):291-5.

11. Shah PJR, Green NA, Adib RS. A multicenter double blind controlled clinical trial of potassium paraaminobenzoate (Potaba) in Peyronie’s disease. Prog Reprod Biol Med. 1983;9:61-67.

12. Weidner W, Hauck EW, Schnitker J; Peyronie’s Disease Study Group of Andrological Group of German Urologists. Potassium paraaminobenzoate (POTABA) in the treatment of Peyronie’s disease: A prospective, placebo-controlled, randomized study. Eur Urol. 2005;47(4):530-5.

13. Pryor JP, Farrell CR. Controlled clinical trial of vitamin E in Peyronie’s disease. Prog Reprod Biol Med 1983;9:41-45.

14. Gelbard MK, James K, Riach P. Collagenase versus placebo in the treatment of Peyronie’s disease: A double blind study. J Urol 1993;149(1):56-8.

15. Rehman J, Bennet A, Melman A. Use of intralesional verapamil to dissolve Peyronie’s disease plaque: A long-term single-blind study. Urology 1998;51(4):620-6.

16. Levine LA, Goldman KE, Greenfield JM. Experience with intraplaque injection of verapamil for Peyronie’s disease. J Urol 2002;168(2):621-5.

17. Essed E, Schoeder FH. New surgical treatment for Peyronie´s disease. Urology 1985;25(6):582-7.

18. Devine Jr CJ, Horton CE. The surgical treatment of Peyronie’s disease with a dermal graft. J Urol 1974;111(1):44-9.

19. Ralph D, al-Akraa M, Pryor JP. The Nesbit operation for Peyronie’s disease: 16-year experience. J Urol 1995;154(4):1362-3.

20. Gholami SS, Lue TF. Correction of penile curvature using 16-dot technique: A review of 132 patients. J Urol 2002;167(5):2066-9.

21. Bokarica P, Parazajder J, Mazuran B, Gilja I. Selecting the appropriate procedure for Peyronie’s disease. Am J Urol Rep 2005;3:82-85.

22. Hellstrom WJ, Reddy S. Application of pericardial graft in the surgical management of Peyronie’s disease. J Urol 2000;163(5):1445-7.

23. Brannigan RE, Kim ED, Oyasu R, McVary KT. Comparison of tunica albuginea substitutes for the treatment of Peyronie’s disease. J Urol 1998;159(3):1064-8.

24. Lue TF, El-Sakka AI. Venous patch graft for Peyronie’s disease: Part I: Technique. J Urol 1998;160(6 Pt 1):2047-9.

25. Knoll LD. Use of porcine small intestinal submucosal graft in the surgical management of Peyronie’s disease. Urology 2001;57(4):753-7.

26. Badylak SF, Kokini K, Tullius B. Morphologic study of small intestinal submucosa as body wall repair device. J Surg Res 2002;103(2):190-202.

27. Hodde JP, Hilos MC. Bioactive FGF-2 in sterilized extracelular matrix. Wounds 2001; 13:195-201.

28. Badylak SF. Small intestinal submucosa (SIS): a biomaterial conducive to smart tissue remodeling. Tissue Engineering: Current Perspectives, Bell E (ed). Burkhauser Publishers, Cambridge, MA;1993,179-189.

29. Knoll LD. Use of porcine small intestinal submucosal graft in the surgical management of Peyronie’s disease: Review of 97 patients. J Urol 2003;169:275.