Novel approaches and new grafting materials in Peyronie's disease reconstructive surgery

The aim of this study is to review the current literature that reports outcomes of Peyronie's disease (PD) grafting surgery, with a special focus on novel approaches and grafting materials. For this purpose, a literature review was performed through PubMed between 2014 and 2019 regarding grafting techniques in PD reconstructive surgery. Keywords used for the search were: Peyronie's disease, penile curvature, surgical therapy, surgical outcomes, grafting techniques, grafts, and graft materials. Outcomes discussed in this review include post-operative penile straightening rates, penile shortening, erectile function, sensation at the glans penis, and patient satisfaction rates. There are several techniques and grafts available that can be used to close the tunical defect after partial plaque excision or plaque incision. Autologous and non-autologous grafts have been investigated for this purpose. Currently, non-autologous off-the-shelf grafts are being used predominantly because of some advantages that include: no harvesting from the patient's body, ready availability, decreased operative times, easy handling, and reduced morbidity. Patients scheduled for grafting surgery do need to have sufficient and documented erectile rigidity preoperatively. Moreover, realistic expectations should be set before surgery. By meeting these requirements, patients can expect good and satisfactory surgical outcomes. The most important predictors of success in PD grafting surgery still remain surgeon experience and careful patient selection.