Efficacy of H-shaped incision with bovine pericardial graft in Peyronie’s disease: a 1-year follow-up using penile Doppler ultrasonography

We present our experience with the use of an H-shaped incision and a bovine pericardial graft in patients with Peyronie’s disease (PD). In this retrospective study, 21 male patients with PD who underwent an H-shaped incision and received a bovine pericardial graft were included and followed for at least 1 year. The degree of penile curvature in all subjects was >60°. Patients had no erectile dysfunction prior to surgery. Outcomes assessed were resistive index (RI) in penile Doppler ultrasonography, improvements in curvature, erection hardness score, and postoperative patient satisfaction. The median age of the 21 patients was 58 (55, 63) years and the median duration of PD was 7 (6, 12) months. As the efficacy variable, there was no statistically significant change in the RI of the corpus cavernosum at 1 year post-surgery. The degree of penile curvature in the erectile state was remarkably decreased from 70 (60, 90) degree to 5 (5, 15) degree (P < 0.001). There was no significant change in the erection hardness score before and after surgery. Patient satisfaction evaluated via a Likert-type scale at 1 year after surgery was 4 (4, 5). In multiple linear regression analysis, patient satisfaction was correlated with the intraoperative defect size created by H-shaped incision (P = 0.009) and inversely related with the residual curvature (P < 0.001). The results from the subjective symptom score and the objective penile Doppler ultrasonography suggest that the H-shaped incision and the subsequent graft with the bovine pericardium is safe and effective in patients with PD. It is necessary to minimize the remnant curvature during graft surgery, because postoperative patient satisfaction was closely correlated with postoperative residual curvature.