Objectives: To report the results from a prospective multicentric study of patients with Peyronie's disease ( PD ) treated with the ‘sliding’ technique ( ST ). Patients and Methods: From June 2010 to January 2014, 28 consecutive patients affected by stable PD with severe penile shortening and end‐stage erectile dysfunction ( ED ) were enrolled in three European PD tertiary referral centres. The validated International Index of Erectile Function ( IIEF ) questionnaire, the Sexual Encounter Profile ( SEP ) Questions 2 and 3, and the Peyronie's disease questionnaire ( PDQ ) were completed preoperatively by all patients. At the follow‐up visits (at 3, 6 and 12 months), the IIEF , the SEP Questions 2 and 3, the PDQ , and the Erectile Dysfunction Inventory of Treatment Satisfaction ( EDITS ) were completed. The outcome analysis was focused on penile length restoration, and intra‐ and postoperative complications classified according the Clavien–Dindo Classification. Results: The mean (range) follow‐up was 37 (9–60) months. A malleable penile prosthesis ( PP ) was implanted in seven patients, while an inflatable three‐pieces PP was placed in the remainder. In the case of inflatable PP implantation, porcine small intestinal submucosa and acellular porcine dermal matrix were used to cover the tunical defects. While in patients undergoing malleable PP implantation, collagen‐fibrin sponge was used. The mean operative time was 145 min in the inflatable PP group and 115 min in the malleable PP group. There were no intraoperative complications. Postoperative complications included profuse bleeding requiring a blood transfusion in one patient (3.5%) on anticoagulation therapy for a mechanical heart valve (Grade II ) and PP infection requiring the removal of the device (7%) (Grade III ). There were no late recurrences of the shaft deformation. The postoperative functional data showed a progressive improvement in the score of all questionnaires, peaking at 12 months postoperatively. The mean (range) penile lengthening was 3.2 (2.5–4) cm and no patient reported recurrence of the curvature. Conclusions: The present series suggests that, in the hands of experienced high‐volume surgeons, penile length restoration with the use of the ST represents an effective option for end‐stage PD associated with ED and severe shortening of the shaft. Larger series and longer follow‐up will be required to fully establish the efficacy of this procedure.

Oncotarget | https://doi.org/10.18632/oncotarget.11883 Rossana Critelli, Francesca Fasanelli, Marco Oderda, Silvia Polidoro, Manuela Bianca Assumma, Clara Viberti, Mirko Preto, Paolo Gontero, Giuseppina... Detection of multiple mutations in urinary exfoliated cells from male bladder cancer patients at diagnosis and during follow-up

Background: Although many grafts have been used for plaque incision with grafting (PIG) and penile prosthesis (PP) implantation, there is no evidence that favors 1 specific graft over another. Aim: To compare fibrin-coated collagen fleece (TachoSil; Baxter International, Deerfield, IL, USA) with porcine small intestinal submucosa (SIS; Cook Biotech, West Lafayette, IN, USA) as grafts. Methods: From January 2007 to January 2015, 60 non-randomized consecutive patients affected by end-stage Peyronie disease underwent PIG and PP implantation (AMS 700CX; Boston Scientific, Marlborough, MA, USA). All patients underwent preoperative penile dynamic duplex ultrasound. All procedures were performed by the same surgeon. Patients were divided in 2 different groups according to the graft used to cover the albuginea defect. SIS was used for grafting in 34 patients (group A) and TachoSil was used in 26 patients (group B). Outcomes: Overall hospital stay, operative time, 5-point Likert hematoma scale, visual analog scale, incidence of postoperative complications, and PP mechanical failure were selected as outcome measures. Functional outcomes were assessed through validated questionnaires (International Index of Erectile Function, Erectile Dysfunction Inventory of Treatment Satisfaction, and Sexual Encounter Profile questions 2 and 3) preoperatively and 3, 6, and 12 months postoperatively. Results: The patients' median age was 63 years. No statistically significant differences were detected between groups for age and type and degree of curvature (median = 65°). Average follow-up was 35 months. No major intraoperative complications were reported. The average operative time was 145 minutes for group A and 120 minutes for group B. No statistically significant differences between groups were detected for postoperative complications. Only 3 patients developed a major postoperative complication requiring a 2nd surgical intervention: 1 patient in group A for mechanic failure and 1 patient in group A and 1 in group B for inflatable PP infection. Multivariate statistical analysis showed no significant difference for all variables analyzed between the 2 groups, except for operative time, which was significantly shorter for group B. Clinical Implications: TachoSil could represent a valuable option for grafting, considering its advantages in operative time and cost compared with SIS. Strengths and Limitations: Long-term follow-up represents a strength factor. Main limitations are the non-randomized nature of the study and the small number of patients. Conclusions: TachoSil seems to represent an effective solution for grafting after PIG and PP implantation. However, additional studies are warranted to confirm our results.