Surgical treatment of Peyronie’s disease by plaque incision and buccal mucosa graft: a systematic review and meta-analysis

Peyronie's disease (PD) is a debilitating condition affecting the sexual and psychological health of millions of men and their partners around the world. Plaque incision (PI) surgery with buccal mucosa graft (BMG) is a promising option for patients with PD. This systematic review aims to comprehensively assess the efficacy of PI with BMG in the management of PD. PubMed, Scopus, Web of Science, Embase, CENTRAL, and Clinicaltrials.gov were systematically searched for possible keywords to include full-text studies and abstracts. After full-text screening and extraction, the quality of included studies was assessed using the National Institutes of Health (NIH) study quality assessment tools. Open Meta-Analyst software was used with a random effect model for all analyses. Seventeen reports were included in the current systematic review, including nine full-text reports and eight abstracts. Meta-analysis of the included data revealed that PI with BMG showed a success rate of 98.6%, a satisfaction rate of 92.1%, and a very low de novo erectile dysfunction rate of 1.7%, with a penile shortening rate of 1.1%. The International Index of Erectile Dysfunction and the length of the affected side significantly increased by 1.69 points and 1.99 cm, respectively. Head-to-head analysis showed comparable outcomes between BMG and other grafting methods. PI with BMG seems to be an effective treatment for PD with comparable potential to other grafting methods. Further randomized clinical trials are needed to evaluate the efficacy of PI with BMG in comparison to other grafting techniques.