Erectile dysfunction in patients with Peyronie's disease treated with different grafts: a systematic review.

Introduction: Peyronie's disease causes penile curvature and painful erections, potentially impairing quality of life; surgical grafts are employed to correct curvature and restore penetrative sexual function.

Objectives: This study aimed to summarize the evidence on perioperative and functional outcomes of surgical grafting procedures for Peyronie's disease.

Methods: A systematic review was conducted following the PRISMA guidelines. Databases including PubMed, EMBASE, Scopus, Google Scholar, and the Cochrane Library were searched up to April 1, 2023. Eligible studies included retrospective or prospective reports on patients aged 18 years or older treated with various graft materials, including vein, dermal, buccal mucosa, small intestinal submucosa, human cadaveric, and bovine pericardium. Quality was assessed using the JBI Critical Appraisal Checklist. Due to data heterogeneity and a lack of comparative studies, no quantitative synthesis was performed. The systematic review was registered on PROSPERO-CRD42024508997. The review focused on perioperative outcomes, erectile function changes, and complication rates associated with different graft materials.

Results: Out of 521 articles identified from 1933 to 2023, 71 studies involving 2692 patients met the inclusion criteria. Six studies were prospective, and the remainder were retrospective. Quality assessment revealed a high or severely high risk of bias across all included studies. Erectile function worsened in 0%-70% of patients, with complication rates ranging from 0% to 50%. No comparative studies among graft types were identified.

Conclusion: Various graft materials offer reliable perioperative and functional outcomes for Peyronie's disease; however, further comparative studies are essential.