Clinical Outcomes of Bovine Pericardial Tissue Patch Grafting for Surgical Correction of Peyronie’s Disease: A Prospective Single-Center Case Series

Clinical Outcomes of Bovine Pericardial Tissue Patch Grafting for Surgical Correction of Peyronie’s Disease: A Prospective Single-Center Case Series | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Clinical Outcomes of Bovine Pericardial Tissue Patch Grafting for Surgical Correction of Peyronie’s Disease: A Prospective Single-Center Case Series Pankaj Joshi, Pawan Kandhari, Meritxell Costa, Saurabh Thakkar, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7499415/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 21 Jan, 2026 Read the published version in Basic and Clinical Andrology → Version 1 posted 9 You are reading this latest preprint version Abstract Background Surgical correction of Peyronie's disease often requires grafting techniques to restore penile anatomy and function. The bovine pericardial patch is a promising biomaterial due to its strength, elasticity, and biocompatibility. This study evaluates the safety, handling, and clinical outcomes associated with its use. Methods A prospective, single-center clinical study enrolled six patients with Peyronie's disease requiring plaque incision and grafting. Data on surgical handling, postoperative outcomes, complications, and patient satisfaction were collected and analyzed descriptively. Results All surgeries were completed without intraoperative complications. Patch handling characteristics were rated as excellent. No adverse events, graft-related complications, or loss of penile function were observed. Patient satisfaction was rated as very high at follow-up. Conclusion Bovine pericardial tissue patch grafting demonstrated excellent safety, efficacy, and satisfaction rates for correction of Peyronie's disease deformities, supporting its wider clinical use. Peyronie's disease Bovine pericardium Graft Penile curvature Surgical outcomes Figures Figure 1 Introduction Peyronie's disease (PD) is a localized connective tissue disorder of the penile tunica albuginea, characterized by the development of fibrous plaques, which can lead to penile curvature, pain, and sexual dysfunction [ 1 ]. The prevalence of PD is estimated to range from 3–9% in the general male population, although it may be underreported due to patient reluctance [ 2 , 3 ]. Surgical correction remains the gold standard for patients with severe deformities, failed medical management, or significant functional impairment [ 4 ]. Several surgical techniques exist for PD, including plication, plaque incision/excision with grafting, and implantation of penile prostheses [ 5 ]. Grafting is preferred in patients with significant curvature (> 60 degrees) or complex deformities where plication would result in unacceptable penile shortening [ 6 ]. The ideal graft material must be durable, flexible, biocompatible, non-immunogenic, and easy to handle intraoperatively [ 7 ]. Bovine pericardium has emerged as an attractive graft material due to its favorable biomechanical properties, high tensile strength, pliability, and ease of integration into host tissues [ 8 , 9 ]. It has been widely used in cardiovascular and reconstructive surgeries, demonstrating excellent outcomes and minimal adverse events [ 10 , 11 ]. Its application in penile surgery, although less extensively studied, has shown promising results. The choice of graft material critically impacts long-term outcomes, including recurrence of curvature, erectile dysfunction, graft contracture, and patient satisfaction [ 12 ]. Previous studies have evaluated autologous, synthetic, and xenogeneic grafts, but consensus regarding the optimal material remains elusive [ 13 ]. Bovine pericardium offers potential advantages over synthetic and some autologous options, including reduced surgical time, absence of donor site morbidity, and superior handling characteristics [ 14 ]. However, comprehensive prospective data evaluating the use of bovine pericardial patches specifically for tunical grafting in PD patients remain limited. This study aims to systematically assess the clinical performance, safety, and surgeon-reported handling characteristics of a bovine pericardial tissue patch in patients undergoing surgical correction for Peyronie's disease. The primary outcomes included intraoperative and postoperative complication rates, postoperative penile function, and patient satisfaction. We hypothesized that the bovine pericardial patch would demonstrate excellent integration, low complication rates, and high satisfaction among both surgeons and patients. Materials and Methods Study Design and Population A prospective, single-center study was conducted enrolling six patients diagnosed with Peyronie's disease, who required surgical correction using plaque incision and grafting techniques. Inclusion criteria included men aged 18 years and above with disabling penile curvature secondary to PD and willingness to participate and provide informed consent. Exclusion criteria included congenital curvature, complex deformities (hourglass deformity or constriction bands), requirement for prosthetic implantation, or known bovine product allergies. Surgical Technique Following standard aseptic protocols, plaque incision was performed under regional anesthesia to correct the curvature. The defect was grafted with a bovine pericardial patch (Invengenx-CR® patch manufactured by Tisgenx Inc) tailored to the incision size and secured with interrupted absorbable sutures. All surgeries were performed by the same senior urological surgeon to ensure procedural consistency. ( Fig. 1 ) Data Collection Demographic data, intraoperative parameters (handling characteristics, operative time), hospital stay duration, postoperative complications, and adverse events were recorded. Patient satisfaction was assessed using a 5-point Likert scale. Follow-up Postoperative assessments were done immediately after surgery and at 1 month. Statistical Analysis Given the small sample size, data were analyzed descriptively. Continuous variables are presented as means and standard deviations, while categorical variables are expressed as frequencies and percentages. Graphs were generated using standard spreadsheet software. Results Baseline Characteristics A total of five patients diagnosed with Peyronie's disease were enrolled in the study. The baseline demographic details are presented in Table 1 . The mean age of the patients was 40.4 ± 4.8 years, and the mean weight was 71.6 ± 1.1 kg. All patients were male. Table 1 Baseline Characteristics of the Study Population Patient ID Age (years) Weight (kg) 1 32 76 2 46 76 3 29 68 4 47 66 5 48 72 6 39 91 Intraoperative Outcomes All surgeries were completed successfully following the standardized plaque incision and grafting procedure. No intraoperative complications were observed. The bovine pericardial patches demonstrated excellent handling characteristics across all cases. Surgical evaluations rated the grafts with perfect scores (10/10) for flexibility, elasticity, surgical seating, suture retention, and hemostasis. The grafts conformed well to the anatomical defects and maintained structural integrity throughout the procedures, without tearing or excessive bleeding. Postoperative Outcomes The mean duration of hospital stay was two days. None of the patients required admission to an intensive care unit. No postoperative complications were observed during the hospital stay or at follow-up assessments. Specifically, there were no instances of surgical site infections, necrosis, ischemia, hematoma, thrombus formation, calcification, pseudoaneurysm formation, graft dehiscence, or recurrent penile curvature. Wound healing was satisfactory in all cases, and there were no reports of fibrosis or loss of penile sensation. Patient Satisfaction Patient satisfaction was assessed using a 5-point Likert scale immediately at discharge and again at the one-month follow-up. At the time of discharge, all six patients (100%) rated their satisfaction as "very satisfied." At the one-month follow-up, the six patients who had completed evaluation continued to report "very satisfied" ratings. The patient satisfaction scores are summarized in Table 2 . Table 2 Patient Satisfaction Scores Timepoint Very Satisfied Satisfied Neutral Dissatisfied Very Dissatisfied Discharge 6 0 0 0 0 1 Month 6 0 0 0 0 Discussion This prospective study evaluated the clinical outcomes associated with the use of bovine pericardial tissue patches for plaque incision and grafting in patients with Peyronie’s disease. Our findings demonstrate that bovine pericardial grafts provide excellent surgical handling characteristics, facilitate satisfactory anatomical correction, and are associated with favorable short-term postoperative outcomes. Importantly, there were no intraoperative or postoperative complications, and patient satisfaction was uniformly high. The surgical management of Peyronie’s disease typically depends on the severity of penile curvature, the presence of deformities such as hourglass deformities, and the patient's sexual function. For patients with severe curvature, particularly those exceeding 60 degrees or with complex deformities, plaque incision and grafting (PIG) is the preferred approach [ 1 , 2 ]. In this context, the choice of graft material plays a critical role in influencing both short- and long-term outcomes. Bovine pericardium has several desirable properties as a graft material. It is characterized by high tensile strength, elasticity, biocompatibility, and resistance to infection [ 3 , 4 ]. Unlike synthetic grafts, bovine pericardium induces minimal inflammatory response and integrates well with host tissue [ 5 ]. Compared to autologous grafts, such as saphenous vein or tunica vaginalis, it avoids the morbidity associated with graft harvesting and reduces operative time [ 6 , 7 ]. Our study’s finding that the patch achieved perfect handling scores during surgery is consistent with previous reports from cardiovascular and urological surgeries where bovine pericardial patches were used [ 8 , 9 ]. Ease of cutting, suturing, and tissue conformity are critical attributes that directly influence operative success, especially in delicate procedures such as penile reconstruction. Furthermore, the structural integrity of the patch remained uncompromised throughout the procedures, and there were no incidents of intraoperative tearing, which reflects its mechanical reliability. In the postoperative period, none of the patients developed infections, hematomas, graft-related necrosis, residual leaks, or calcifications. These outcomes compare favorably to results reported with other graft materials. Studies using dermal grafts, for example, have demonstrated postoperative complication rates ranging from 5–20%, including infections, fibrosis, and loss of penile sensation [ 10 , 11 ]. The absence of any adverse events in our cohort supports the hypothesis that bovine pericardial patches offer a safer alternative. Patient satisfaction, assessed via a Likert scale, was uniformly high. Satisfaction in Peyronie's surgery is influenced by multiple factors, including correction of curvature, preservation of penile length, sexual function, and absence of complications [ 12 ]. All patients in our study reported being “very satisfied” both at discharge and at one-month follow-up, suggesting that the surgical and functional outcomes met or exceeded patient expectations. The study has limitations, notably the small sample size and the relatively short follow-up period. Peyronie’s disease is a chronic condition, and long-term follow-up is necessary to assess for delayed complications such as curvature recurrence, graft contracture, or erectile dysfunction [ 13 , 14 , 15 ]. Future studies with larger sample sizes and longer follow-up durations are warranted to confirm the durability of these favorable outcomes and to validate the findings in more diverse populations. Another limitation is the absence of a control group using an alternative graft material. Comparative studies would help establish whether bovine pericardial tissue confers superior outcomes relative to other biological or synthetic grafts. Randomized controlled trials comparing bovine pericardial patches with commonly used autologous and synthetic materials could provide more definitive evidence regarding its efficacy. In conclusion, this study provides preliminary evidence supporting the use of bovine pericardial tissue patches for tunical grafting in Peyronie’s disease. The material exhibited excellent intraoperative handling, a strong safety profile, and high short-term patient satisfaction. Given these promising results, bovine pericardial tissue appears to be a highly suitable option for plaque incision and grafting procedures in patients with Peyronie’s disease. Nonetheless, ongoing evaluation through larger and longer-term studies is essential to confirm these findings and to establish bovine pericardium as a standard graft material in urological reconstructive surgery. Declarations Author Contributions P Joshi : Protocol/project development, Surgical procedures, Manuscript writing P Kandhari : Data collection, Patient management, Manuscript editing M Costa : Data analysis, Literature review, Manuscript writing S Thakkar : Data collection, Manuscript editing E Oyibo : Literature review, Manuscript writing S Bhadranawar : Data management, Figures/tables preparation S Kulkarni : Project supervision, Final manuscript approval Funding: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. Competing Interests: The authors declare that they have no financial or non-financial competing interests related to the content of this manuscript. Ethics approval This study received approval from the Royal Pune Independent Ethics Committee Office No. 13, Srv. No.-81/A, Anupam Arcade, Opposite Snake Park, Katraj, Pune, Maharashtra - 411046 India (Reg. No. ECR/45/Indt/MH/2013/RR-19). The study adhered to the guidelines outlined in the Declaration of Helsinki. Consent to participate Informed consent was obtained from all individual participants included in the study. References Mulhall JP, Schiff J, Guhring P (2006) An analysis of the natural history of Peyronie's disease. J Urol 175:2115–2118. https://doi.org/10.1016/S0022-5347(06)00270-9 Dibenedetti DB, Nguyen D, Zografos L, Ziemiecki R, Zhou X (2011) A population-based study of Peyronie's disease: prevalence and treatment patterns in the United States. Adv Urol 2011:282503. https://doi.org/10.1155/2011/282503 Schwarzer U, Sommer F, Klotz T, Braun M, Engelmann U (2001) The prevalence of Peyronie's disease: results of a large survey. BJU Int 88:727–730. https://doi.org/10.1046/j.1464-4096.2001.02436.x Ralph D, Gonzalez-Cadavid N, Mirone V, Perovic S, Sohn M, Usta M, Levine, L. (2010). The management of Peyronie's disease: evidence-based 2010 guidelines. The journal of sexual medicine , 7 (7), 2359–2374. https://doi.org/10.1111/j.1743-6109.2010.01850.x Garcia-Gomez B, Ralph D, Levine L, Moncada-Iribarren I, Djinovic R, Albersen M, Garcia-Cruz E, Romero-Otero J. (2018). Grafts for Peyronie's disease: a comprehensive review. Andrology , 6 (1), 117–126. https://doi.org/10.1111/andr.12421 Moreland RB (1999) Pathophysiology of Peyronie's disease. Int J Impot Res 11:119–132. https://doi.org/10.1038/sj.ijir.3900875 Carson C C. (1998). Penile prosthesis implantation in the treatment of Peyronie's disease. International journal of impotence research, 10(2), 125–128. https://doi.org/10.1038/sj.ijir.3900330 Zhu X.D, Guo J Q, Chen YC, Tang C J, Xue G X. (1988). Ten-year experience with pericardial xenograft valves. The Journal of thoracic and cardiovascular surgery , 95 (4), 572–576. Crawford FA Jr, Sade RM, Spinale F (1986) Bovine pericardium for correction of congenital heart defects. Ann Thorac Surg 41:602–605. https://doi.org/10.1016/S0003-4975(10)63068-8 Kadioglu A, Sanli O, Akman T, Ersay A, Guven S, Mammadov F (2007) Graft materials in Peyronie's disease surgery: a comprehensive review. J Sex Med 4:581–595. https://doi.org/10.1111/j.1743-6109.2007.00461.x Garcia Aroz S, Spaggiari M, Jeon H, Oberholzer J, Benedetti E, Tzvetanov I (2017) The use of bovine pericardial patch for vascular reconstruction in infected fields for transplant recipients. J Vasc Surg Cases Innov Tech 3:47–49. https://doi.org/10.1016/j.jvscit.2016.10.006 Cormio L, Zucchi A, Lorusso F, Selvaggio O, Fioretti F, Porena M, Carrieri G (2009) Surgical treatment of Peyronie’s disease by plaque incision and grafting with buccal mucosa. Eur Urol 55:1469–1475. https://doi.org/10.1016/j.eururo.2008.11.041 Cordon BH, Osmonov D, Hatzichristodoulou G, Morey AF (2017) Peyronie's penile plication. Transl Androl Urol 6:639–644. https://doi.org/10.21037/tau.2017.07.18 Morell VO, Wearden PA (2007) Experience with bovine pericardium for the reconstruction of the aortic arch in patients undergoing a Norwood procedure. Ann Thorac Surg 84:1312–1315. https://doi.org/10.1016/j.athoracsur.2007.05.036 Natsos A, Tatanis V, Kontogiannis S, Waisbrod S, Gkeka K, Obaidad M, Peteinaris A, Pagonis K, Papadopoulos C, Kallidonis P, Liatsikos E, Drettas P (2024) Grafts in Peyronie’s surgery without the use of prostheses: a systematic review and meta-analysis. Asian J Androl 26:250–259. https://doi.org/10.4103/aja202358 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 21 Jan, 2026 Read the published version in Basic and Clinical Andrology → Version 1 posted Editorial decision: Revision requested 02 Oct, 2025 Reviews received at journal 01 Oct, 2025 Reviews received at journal 01 Oct, 2025 Reviewers agreed at journal 16 Sep, 2025 Reviewers agreed at journal 08 Sep, 2025 Reviewers invited by journal 04 Sep, 2025 Editor assigned by journal 03 Sep, 2025 Submission checks completed at journal 03 Sep, 2025 First submitted to journal 31 Aug, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7499415","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":512427202,"identity":"ad3ffd61-3ba5-47fe-84da-392390f20e5e","order_by":0,"name":"Pankaj 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08:53:09","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7499415/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7499415/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12610-025-00298-7","type":"published","date":"2026-01-21T15:58:50+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":91078173,"identity":"bc0821e2-aa95-4a16-ad42-62583e9c3ca7","added_by":"auto","created_at":"2025-09-11 11:18:15","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":438098,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eSurgical steps of correction\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eA-B:\u003c/strong\u003e Artificial erection to assess degree and site of curvature.\u003cbr\u003e\n \u003cstrong\u003eC.\u003c/strong\u003e Subcoronal circumferential incision and complete penile degloving.\u003cbr\u003e\n \u003cstrong\u003eD.\u003c/strong\u003e Identification and marking of the point of maximal curvature.\u003cbr\u003e\n \u003cstrong\u003eE.\u003c/strong\u003e Dissection and mobilization of the neurovascular bundle for dorsal plaques.\u003cbr\u003e\n \u003cstrong\u003eF-H.\u003c/strong\u003e Longitudinal incision of the tunica albuginea over the fibrotic plaque.\u003cbr\u003e\n \u0026nbsp;\u003cstrong\u003eI.\u003c/strong\u003e Measurement of tunical defect created by plaque incision.\u003cbr\u003e\n \u003cstrong\u003eJ.\u003c/strong\u003e Tailoring of bovine pericardial graft to fit the tunical defect.\u003cbr\u003e\n \u003cstrong\u003eK.\u003c/strong\u003e Suturing of graft to tunical edges with interrupted or running absorbable sutures.\u003cbr\u003e\n \u003cstrong\u003eL.\u003c/strong\u003e Repositioning of neurovascular bundle and verification of hemostasis.\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7499415/v1/3418c3ee0a914cc7454946b0.png"},{"id":101151797,"identity":"0bb9218a-7a8f-42f7-8fcd-7640358a9733","added_by":"auto","created_at":"2026-01-26 16:05:42","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1024337,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7499415/v1/4063f021-8b71-40ab-b25a-941433d1d8a6.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Clinical Outcomes of Bovine Pericardial Tissue Patch Grafting for Surgical Correction of Peyronie’s Disease: A Prospective Single-Center Case Series","fulltext":[{"header":"Introduction","content":"\u003cp\u003ePeyronie's disease (PD) is a localized connective tissue disorder of the penile tunica albuginea, characterized by the development of fibrous plaques, which can lead to penile curvature, pain, and sexual dysfunction [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. The prevalence of PD is estimated to range from 3\u0026ndash;9% in the general male population, although it may be underreported due to patient reluctance [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Surgical correction remains the gold standard for patients with severe deformities, failed medical management, or significant functional impairment [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eSeveral surgical techniques exist for PD, including plication, plaque incision/excision with grafting, and implantation of penile prostheses [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Grafting is preferred in patients with significant curvature (\u0026gt;\u0026thinsp;60 degrees) or complex deformities where plication would result in unacceptable penile shortening [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. The ideal graft material must be durable, flexible, biocompatible, non-immunogenic, and easy to handle intraoperatively [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eBovine pericardium has emerged as an attractive graft material due to its favorable biomechanical properties, high tensile strength, pliability, and ease of integration into host tissues [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. It has been widely used in cardiovascular and reconstructive surgeries, demonstrating excellent outcomes and minimal adverse events [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Its application in penile surgery, although less extensively studied, has shown promising results.\u003c/p\u003e\u003cp\u003eThe choice of graft material critically impacts long-term outcomes, including recurrence of curvature, erectile dysfunction, graft contracture, and patient satisfaction [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Previous studies have evaluated autologous, synthetic, and xenogeneic grafts, but consensus regarding the optimal material remains elusive [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Bovine pericardium offers potential advantages over synthetic and some autologous options, including reduced surgical time, absence of donor site morbidity, and superior handling characteristics [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eHowever, comprehensive prospective data evaluating the use of bovine pericardial patches specifically for tunical grafting in PD patients remain limited. This study aims to systematically assess the clinical performance, safety, and surgeon-reported handling characteristics of a bovine pericardial tissue patch in patients undergoing surgical correction for Peyronie's disease. The primary outcomes included intraoperative and postoperative complication rates, postoperative penile function, and patient satisfaction.\u003c/p\u003e\u003cp\u003eWe hypothesized that the bovine pericardial patch would demonstrate excellent integration, low complication rates, and high satisfaction among both surgeons and patients.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003e\u003cstrong\u003eStudy Design and Population\u003c/strong\u003e\u003cp\u003eA prospective, single-center study was conducted enrolling six patients diagnosed with Peyronie's disease, who required surgical correction using plaque incision and grafting techniques. Inclusion criteria included men aged 18 years and above with disabling penile curvature secondary to PD and willingness to participate and provide informed consent. Exclusion criteria included congenital curvature, complex deformities (hourglass deformity or constriction bands), requirement for prosthetic implantation, or known bovine product allergies.\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eSurgical Technique\u003c/strong\u003e\u003cp\u003eFollowing standard aseptic protocols, plaque incision was performed under regional anesthesia to correct the curvature. The defect was grafted with a bovine pericardial patch (Invengenx-CR\u0026reg; patch manufactured by Tisgenx Inc) tailored to the incision size and secured with interrupted absorbable sutures. All surgeries were performed by the same senior urological surgeon to ensure procedural consistency. ( Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eData Collection\u003c/strong\u003e\u003cp\u003eDemographic data, intraoperative parameters (handling characteristics, operative time), hospital stay duration, postoperative complications, and adverse events were recorded. Patient satisfaction was assessed using a 5-point Likert scale.\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eFollow-up\u003c/strong\u003e\u003cp\u003ePostoperative assessments were done immediately after surgery and at 1 month.\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eStatistical Analysis\u003c/strong\u003e\u003cp\u003eGiven the small sample size, data were analyzed descriptively. Continuous variables are presented as means and standard deviations, while categorical variables are expressed as frequencies and percentages. Graphs were generated using standard spreadsheet software.\u003c/p\u003e\u003c/p\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\u003ch2\u003eBaseline Characteristics\u003c/h2\u003e\u003cp\u003eA total of five patients diagnosed with Peyronie's disease were enrolled in the study. The baseline demographic details are presented in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. The mean age of the patients was 40.4\u0026thinsp;\u0026plusmn;\u0026thinsp;4.8 years, and the mean weight was 71.6\u0026thinsp;\u0026plusmn;\u0026thinsp;1.1 kg. All patients were male.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eBaseline Characteristics of the Study Population\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePatient ID\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAge (years)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eWeight (kg)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e32\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e68\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e47\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e66\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e72\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e91\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eIntraoperative Outcomes\u003c/h3\u003e\n\u003cp\u003eAll surgeries were completed successfully following the standardized plaque incision and grafting procedure. No intraoperative complications were observed. The bovine pericardial patches demonstrated excellent handling characteristics across all cases. Surgical evaluations rated the grafts with perfect scores (10/10) for flexibility, elasticity, surgical seating, suture retention, and hemostasis. The grafts conformed well to the anatomical defects and maintained structural integrity throughout the procedures, without tearing or excessive bleeding.\u003c/p\u003e\n\u003ch3\u003ePostoperative Outcomes\u003c/h3\u003e\n\u003cp\u003eThe mean duration of hospital stay was two days. None of the patients required admission to an intensive care unit. No postoperative complications were observed during the hospital stay or at follow-up assessments. Specifically, there were no instances of surgical site infections, necrosis, ischemia, hematoma, thrombus formation, calcification, pseudoaneurysm formation, graft dehiscence, or recurrent penile curvature. Wound healing was satisfactory in all cases, and there were no reports of fibrosis or loss of penile sensation.\u003c/p\u003e\n\u003ch3\u003ePatient Satisfaction\u003c/h3\u003e\n\u003cp\u003ePatient satisfaction was assessed using a 5-point Likert scale immediately at discharge and again at the one-month follow-up. At the time of discharge, all six patients (100%) rated their satisfaction as \"very satisfied.\" At the one-month follow-up, the six patients who had completed evaluation continued to report \"very satisfied\" ratings. The patient satisfaction scores are summarized in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003ePatient Satisfaction Scores\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTimepoint\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eVery Satisfied\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eSatisfied\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eNeutral\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eDissatisfied\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eVery Dissatisfied\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDischarge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1 Month\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis prospective study evaluated the clinical outcomes associated with the use of bovine pericardial tissue patches for plaque incision and grafting in patients with Peyronie\u0026rsquo;s disease. Our findings demonstrate that bovine pericardial grafts provide excellent surgical handling characteristics, facilitate satisfactory anatomical correction, and are associated with favorable short-term postoperative outcomes. Importantly, there were no intraoperative or postoperative complications, and patient satisfaction was uniformly high.\u003c/p\u003e\u003cp\u003eThe surgical management of Peyronie\u0026rsquo;s disease typically depends on the severity of penile curvature, the presence of deformities such as hourglass deformities, and the patient's sexual function. For patients with severe curvature, particularly those exceeding 60 degrees or with complex deformities, plaque incision and grafting (PIG) is the preferred approach [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. In this context, the choice of graft material plays a critical role in influencing both short- and long-term outcomes.\u003c/p\u003e\u003cp\u003eBovine pericardium has several desirable properties as a graft material. It is characterized by high tensile strength, elasticity, biocompatibility, and resistance to infection [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Unlike synthetic grafts, bovine pericardium induces minimal inflammatory response and integrates well with host tissue [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Compared to autologous grafts, such as saphenous vein or tunica vaginalis, it avoids the morbidity associated with graft harvesting and reduces operative time [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eOur study\u0026rsquo;s finding that the patch achieved perfect handling scores during surgery is consistent with previous reports from cardiovascular and urological surgeries where bovine pericardial patches were used [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Ease of cutting, suturing, and tissue conformity are critical attributes that directly influence operative success, especially in delicate procedures such as penile reconstruction. Furthermore, the structural integrity of the patch remained uncompromised throughout the procedures, and there were no incidents of intraoperative tearing, which reflects its mechanical reliability.\u003c/p\u003e\u003cp\u003eIn the postoperative period, none of the patients developed infections, hematomas, graft-related necrosis, residual leaks, or calcifications. These outcomes compare favorably to results reported with other graft materials. Studies using dermal grafts, for example, have demonstrated postoperative complication rates ranging from 5\u0026ndash;20%, including infections, fibrosis, and loss of penile sensation [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. The absence of any adverse events in our cohort supports the hypothesis that bovine pericardial patches offer a safer alternative.\u003c/p\u003e\u003cp\u003ePatient satisfaction, assessed via a Likert scale, was uniformly high. Satisfaction in Peyronie's surgery is influenced by multiple factors, including correction of curvature, preservation of penile length, sexual function, and absence of complications [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. All patients in our study reported being \u0026ldquo;very satisfied\u0026rdquo; both at discharge and at one-month follow-up, suggesting that the surgical and functional outcomes met or exceeded patient expectations.\u003c/p\u003e\u003cp\u003eThe study has limitations, notably the small sample size and the relatively short follow-up period. Peyronie\u0026rsquo;s disease is a chronic condition, and long-term follow-up is necessary to assess for delayed complications such as curvature recurrence, graft contracture, or erectile dysfunction [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Future studies with larger sample sizes and longer follow-up durations are warranted to confirm the durability of these favorable outcomes and to validate the findings in more diverse populations.\u003c/p\u003e\u003cp\u003eAnother limitation is the absence of a control group using an alternative graft material. Comparative studies would help establish whether bovine pericardial tissue confers superior outcomes relative to other biological or synthetic grafts. Randomized controlled trials comparing bovine pericardial patches with commonly used autologous and synthetic materials could provide more definitive evidence regarding its efficacy.\u003c/p\u003e\u003cp\u003eIn conclusion, this study provides preliminary evidence supporting the use of bovine pericardial tissue patches for tunical grafting in Peyronie\u0026rsquo;s disease. The material exhibited excellent intraoperative handling, a strong safety profile, and high short-term patient satisfaction. Given these promising results, bovine pericardial tissue appears to be a highly suitable option for plaque incision and grafting procedures in patients with Peyronie\u0026rsquo;s disease. Nonetheless, ongoing evaluation through larger and longer-term studies is essential to confirm these findings and to establish bovine pericardium as a standard graft material in urological reconstructive surgery.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAuthor Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eP Joshi\u003c/strong\u003e: Protocol/project development, Surgical procedures, Manuscript writing\u003cbr\u003e\u003cstrong\u003eP Kandhari\u003c/strong\u003e: Data collection, Patient management, Manuscript editing\u003cbr\u003e\u003cstrong\u003eM Costa\u003c/strong\u003e: Data analysis, Literature review, Manuscript writing\u003cbr\u003e\u003cstrong\u003eS Thakkar\u003c/strong\u003e: Data collection, Manuscript editing\u003cbr\u003e\u003cstrong\u003eE Oyibo\u003c/strong\u003e: Literature review, Manuscript writing\u003cbr\u003e\u003cstrong\u003eS Bhadranawar\u003c/strong\u003e: Data management, Figures/tables preparation\u003cbr\u003e\u003cstrong\u003eS Kulkarni\u003c/strong\u003e: Project supervision, Final manuscript approval\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e\u003cbr\u003eThis research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests:\u003c/strong\u003e\u003cbr\u003eThe authors declare that they have no financial or non-financial competing interests related to the content of this manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study received approval from the Royal Pune Independent Ethics Committee Office No. 13, Srv. No.-81/A, Anupam Arcade, Opposite Snake Park, Katraj, Pune, Maharashtra - 411046 India (Reg. No. ECR/45/Indt/MH/2013/RR-19). The study adhered to the guidelines outlined in the Declaration of Helsinki.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInformed consent was obtained from all individual participants included in the study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eMulhall JP, Schiff J, Guhring P (2006) An analysis of the natural history of Peyronie\u0026apos;s disease. J Urol 175:2115\u0026ndash;2118. https://doi.org/10.1016/S0022-5347(06)00270-9\u003c/li\u003e\n\u003cli\u003eDibenedetti DB, Nguyen D, Zografos L, Ziemiecki R, Zhou X (2011) A population-based study of Peyronie\u0026apos;s disease: prevalence and treatment patterns in the United States. Adv Urol 2011:282503. https://doi.org/10.1155/2011/282503\u003c/li\u003e\n\u003cli\u003eSchwarzer U, Sommer F, Klotz T, Braun M, Engelmann U (2001) The prevalence of Peyronie\u0026apos;s disease: results of a large survey. BJU Int 88:727\u0026ndash;730. https://doi.org/10.1046/j.1464-4096.2001.02436.x\u003c/li\u003e\n\u003cli\u003eRalph D, Gonzalez-Cadavid N, Mirone V, Perovic S, Sohn M, Usta M, Levine, L. (2010). The management of Peyronie\u0026apos;s disease: evidence-based 2010 guidelines. \u003cem\u003eThe journal of sexual medicine\u003c/em\u003e, \u003cem\u003e7\u003c/em\u003e(7), 2359\u0026ndash;2374. https://doi.org/10.1111/j.1743-6109.2010.01850.x\u003c/li\u003e\n\u003cli\u003eGarcia-Gomez B, Ralph D, Levine L, Moncada-Iribarren I, Djinovic R, Albersen M, Garcia-Cruz E, Romero-Otero J. (2018). Grafts for Peyronie\u0026apos;s disease: a comprehensive review. \u003cem\u003eAndrology\u003c/em\u003e, \u003cem\u003e6\u003c/em\u003e(1), 117\u0026ndash;126. https://doi.org/10.1111/andr.12421\u003c/li\u003e\n\u003cli\u003eMoreland RB (1999) Pathophysiology of Peyronie\u0026apos;s disease. Int J Impot Res 11:119\u0026ndash;132. https://doi.org/10.1038/sj.ijir.3900875\u003c/li\u003e\n\u003cli\u003eCarson C C. (1998). Penile prosthesis implantation in the treatment of Peyronie\u0026apos;s disease. International journal of impotence research, 10(2), 125\u0026ndash;128. https://doi.org/10.1038/sj.ijir.3900330\u003c/li\u003e\n\u003cli\u003eZhu X.D, Guo J Q, Chen YC, Tang C J, Xue G X. (1988). Ten-year experience with pericardial xenograft valves. \u003cem\u003eThe Journal of thoracic and cardiovascular surgery\u003c/em\u003e, \u003cem\u003e95\u003c/em\u003e(4), 572\u0026ndash;576.\u003c/li\u003e\n\u003cli\u003eCrawford FA Jr, Sade RM, Spinale F (1986) Bovine pericardium for correction of congenital heart defects. \u003cem\u003eAnn Thorac Surg\u003c/em\u003e 41:602\u0026ndash;605. https://doi.org/10.1016/S0003-4975(10)63068-8\u003c/li\u003e\n\u003cli\u003eKadioglu A, Sanli O, Akman T, Ersay A, Guven S, Mammadov F (2007) Graft materials in Peyronie\u0026apos;s disease surgery: a comprehensive review. \u003cem\u003eJ Sex Med\u003c/em\u003e 4:581\u0026ndash;595. https://doi.org/10.1111/j.1743-6109.2007.00461.x\u003c/li\u003e\n\u003cli\u003eGarcia Aroz S, Spaggiari M, Jeon H, Oberholzer J, Benedetti E, Tzvetanov I (2017) The use of bovine pericardial patch for vascular reconstruction in infected fields for transplant recipients. \u003cem\u003eJ Vasc Surg Cases Innov Tech\u003c/em\u003e 3:47\u0026ndash;49. https://doi.org/10.1016/j.jvscit.2016.10.006 \u003c/li\u003e\n\u003cli\u003eCormio L, Zucchi A, Lorusso F, Selvaggio O, Fioretti F, Porena M, Carrieri G (2009) Surgical treatment of Peyronie\u0026rsquo;s disease by plaque incision and grafting with buccal mucosa. \u003cem\u003eEur Urol\u003c/em\u003e 55:1469\u0026ndash;1475. https://doi.org/10.1016/j.eururo.2008.11.041\u003c/li\u003e\n\u003cli\u003eCordon BH, Osmonov D, Hatzichristodoulou G, Morey AF (2017) Peyronie\u0026apos;s penile plication. \u003cem\u003eTransl Androl Urol\u003c/em\u003e6:639\u0026ndash;644. https://doi.org/10.21037/tau.2017.07.18 \u003c/li\u003e\n\u003cli\u003eMorell VO, Wearden PA (2007) Experience with bovine pericardium for the reconstruction of the aortic arch in patients undergoing a Norwood procedure. \u003cem\u003eAnn Thorac Surg\u003c/em\u003e 84:1312\u0026ndash;1315. https://doi.org/10.1016/j.athoracsur.2007.05.036\u003c/li\u003e\n\u003cli\u003eNatsos A, Tatanis V, Kontogiannis S, Waisbrod S, Gkeka K, Obaidad M, Peteinaris A, Pagonis K, Papadopoulos C, Kallidonis P, Liatsikos E, Drettas P (2024) Grafts in Peyronie\u0026rsquo;s surgery without the use of prostheses: a systematic review and meta-analysis. \u003cem\u003eAsian J Androl\u003c/em\u003e 26:250\u0026ndash;259. https://doi.org/10.4103/aja202358\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"basic-and-clinical-andrology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"andr","sideBox":"Learn more about [Basic and Clinical Andrology](https://bacandrology.biomedcentral.com/)","snPcode":"12610","submissionUrl":"https://submission.nature.com/new-submission/12610/3","title":"Basic and Clinical Andrology","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Peyronie's disease, Bovine pericardium, Graft, Penile curvature, Surgical outcomes","lastPublishedDoi":"10.21203/rs.3.rs-7499415/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7499415/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eSurgical correction of Peyronie's disease often requires grafting techniques to restore penile anatomy and function. The bovine pericardial patch is a promising biomaterial due to its strength, elasticity, and biocompatibility. This study evaluates the safety, handling, and clinical outcomes associated with its use.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eA prospective, single-center clinical study enrolled six patients with Peyronie's disease requiring plaque incision and grafting. Data on surgical handling, postoperative outcomes, complications, and patient satisfaction were collected and analyzed descriptively.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eAll surgeries were completed without intraoperative complications. Patch handling characteristics were rated as excellent. No adverse events, graft-related complications, or loss of penile function were observed. Patient satisfaction was rated as very high at follow-up.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eBovine pericardial tissue patch grafting demonstrated excellent safety, efficacy, and satisfaction rates for correction of Peyronie's disease deformities, supporting its wider clinical use.\u003c/p\u003e","manuscriptTitle":"Clinical Outcomes of Bovine Pericardial Tissue Patch Grafting for Surgical Correction of Peyronie’s Disease: A Prospective Single-Center Case Series","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-11 11:10:10","doi":"10.21203/rs.3.rs-7499415/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-10-02T12:46:04+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-10-01T23:55:25+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-10-01T11:10:02+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"113538023265111661543281787836076757968","date":"2025-09-16T19:09:06+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"122403370058874089804251748692100091557","date":"2025-09-08T22:09:45+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-09-04T10:15:56+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-09-03T13:17:40+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-09-03T13:17:33+00:00","index":"","fulltext":""},{"type":"submitted","content":"Basic and Clinical Andrology","date":"2025-08-31T08:41:43+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"basic-and-clinical-andrology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"andr","sideBox":"Learn more about [Basic and Clinical Andrology](https://bacandrology.biomedcentral.com/)","snPcode":"12610","submissionUrl":"https://submission.nature.com/new-submission/12610/3","title":"Basic and Clinical Andrology","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"ea7831e4-11ac-47fc-b34d-89384e168f41","owner":[],"postedDate":"September 11th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-01-26T16:02:08+00:00","versionOfRecord":{"articleIdentity":"rs-7499415","link":"https://doi.org/10.1186/s12610-025-00298-7","journal":{"identity":"basic-and-clinical-andrology","isVorOnly":false,"title":"Basic and Clinical Andrology"},"publishedOn":"2026-01-21 15:58:50","publishedOnDateReadable":"January 21st, 2026"},"versionCreatedAt":"2025-09-11 11:10:10","video":"","vorDoi":"10.1186/s12610-025-00298-7","vorDoiUrl":"https://doi.org/10.1186/s12610-025-00298-7","workflowStages":[]},"version":"v1","identity":"rs-7499415","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7499415","identity":"rs-7499415","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}