Collagen Fleece Grafting for Surgical Treatment of Patients with Mild to Severe Peyronie’s Curvatures

Background Collagen Fleece Grafting (CFG) for Peyronie’s Disease (PD) is a recommended treatment option for severe curvature > 60 degrees. However, little is known about its utility in mild curvatures. A subgroup of patients with a significant risk of penile shortening or symptomatic plaques might benefit from the approach in mild curvatures < 60°. We aimed to analyze the treatment indications, surgical technique, and early postoperative results of CGF in this scenario. We performed a retrospective review of patients undergoing surgical treatment for PD using partial plaque excision or incision and CFG. Patients were referred for surgery when the duration of PD was at least 9 months and previous conservative therapies had failed. Clinical parameters and complications were reviewed. Subgroup analysis was performed in patients with curvatures of > 60° and mild curvatures ≤ 60. Results A total of 89 patients were identified. Median (range) age was 59 (38–73) years, and median (range) curvature was 70 (20–90)°. Curvature was dorsal in 66% of cases, ventral in 8%, lateral in 16%, and complex in 10% of cases. Partial plaque excision was performed in 87 (98%) patients. The mean (SD) surface area of grafting was 2.1 (1.9) cm ² . The number of penile plaques was only one in 63 (71%) patients and 2 or more in 26 (29%) patients. There was no difference between the two groups (Curvature ≤ 60 vs. >60) regarding mean operation time (86.3 vs. 94.4 min, p = 0.13) or mean hospital stay (5 vs. 5 days, p = 0.77). There was no significant difference between the two groups regarding the incidence of post-operative glans necrosis nor glans hypoesthesia, ecchymosis, bleeding, hematoma, infection, residual curvature, revision surgery, or pain. Conclusions In patients with mild and severe PD deformities, early post-operative outcomes and complications after partial plaque incision or excision and grafting with CFG seemed similar. The technique may be safely applied in select patients with mild penile curvature.