Grafting Area Reduction in Peyronie's Disease Surgery: Comparative Assessment Between Double Y Vs iGrafter APP Using...

Area of Science:

• Urology
• Sexual Medicine
• Surgical Innovation

Background:

• Plaque incision and graft (PIG) techniques for severe Peyronie's disease (PD) can lead to erectile dysfunction (ED).
• Graft size is a key factor contributing to post-PIG ED.
• The iGrafter software aims to minimize grafting area using a mathematical algorithm.

Purpose of the Study:

• To compare the Double-Y (DY) and iGrafter PIG techniques.
• Evaluation focused on total grafting area, variability in graft calculation, and operative time.
• Assessing the impact of iGrafter on potential ED risk reduction.

Main Methods:

• Six sexual medicine urologists performed both DY and iGrafter techniques twice on 3D-printed penile models.
• Standardized 60° uniplanar dorsal curvature models were used for simulation.
• Graft areas and operative times were meticulously recorded for analysis.

Main Results:

• iGrafter resulted in a significantly smaller grafting area (11.6 cm²) compared to DY (23.3 cm²), a 50.2% reduction.
• The iGrafter technique showed less variation in graft area across surgeons (CV 10.56% vs 23.28%).
• Total operative time was longer for iGrafter (49.4 min) versus DY (40.7 min).

Conclusions:

• The iGrafter technique substantially reduces graft area in PIG surgery for PD.
• This smaller graft size holds potential for mitigating post-operative erectile dysfunction.
• While iGrafter may increase operative time, its graft area reduction offers significant clinical benefits.