Given the advances in reconstructive surgery especially in light of the near full face transplant recently performed, what is the progress being made with respect to plaque excision and implantation of regenerated tunica albuginea for correction of Peyronie’s disease?

This question has come up before and was addressed during another Q and A session. It certainly is timely to address it again. There has been discussion with leading researchers. in the field of tissue regeneration with respect to Peyronie’s disease. The concept would be using some kind of matrix tissue into which either tunica stem cells or a combination of fibroblasts which produce the collagen of the tunic with endothelial cells which are vascular cells which grow into the matrix. Another concept is to generate a complete piece of tunic in the laboratory which could then be directly implanted into the patient during penile reconstructive surgery. Although there is much progress being made with tissue regeneration, at this time we are not aware of an active research specifically for Peyronie’s disease. It is likely in time this will emerge. But frankly it appears that the current grafts, including vein, processed cadaveric pericardial tissue, and porcine small intestinal sub-mucosa (sis) are working well. The primary concern is not that the graft does not take adequately, but that the graft may be in part may be responsible for post operative erectile dysfunction. It is my opinion that the primary reason for the post-operative ED is patient selection issue having most to do with the underlying vascular health of the man and not the type of graft used.