The use of skin graft is no longer the best solution for penile reconstruction. One of the many benefits of the Egydio Technique, which has evolved over the last 20 years, is that it is no longer necessary to insert the penile graft. The graft is a tissue used in urology for penile reconstruction. It is usually removed from other parts of the patient's body or from animal’s tissues, such as the submucosa of pigs or bovine pericardium.
Because it comes from avascular tissue with no blood circulating, the use of the graft for penile reconstruction has become obsolete.
It is essential that the patient, who wants to do a penile reconstruction in order to recover his sexual life, get to know the risks of using a penile graft. For this reason, you will find below a list of issues regarding the use of this technique.
PROBABLE NEGATIVE FACTORS ON THE USE OF GRAFT FOR PENILE RECONSTRUCTION
Long suture lines
The skin graft requires many suture lines that can be palpable, even after the total healing.
Different sizes and thicknesses
The skin grafts have different sizes and thicknesses. This means that besides causing the "lump" effect due to the variation in thickness, the penis also suffers from the "patchwork quilt" effect due to the unevenness of sizes. Both problems can be easily felt with palpation.
As well as the different sizes and thicknesses, the graft can also have different levels of resistance. Therefore, if the penile prosthesis is required, there is the risk of bulging and possible rupture of the graft.
The need to adapt to the deformity
When there is an asymmetrical deformity in the penis, it is necessary to use a skin graft to cover it. As it is not possible to use a skin graft with the exact size of the penile deformity, it is necessary to make adjustments between several skin grafts to cover a certain area. This "patchwork quilt" effect can break apart due to the sutures that mend the pieces of the graft.
Avascular and unhealed tissue
As it is a tissue transferred from one place to another, the graft is avascular, which means there is no blood supply. The lack of irrigation may result in a process of scarring retraction, that is, the tissue may shrink in size. Another issue that must be taken into account for the use of the graft is that the lack of blood circulation increases the chances of infection and can hinder the healing process.
The expansion is limited by the graft
Penile elasticity can be negatively affected by the use of skin graft. This is because the tissue acts as an expansion limiter, hindering the penis from being stretched to the maximum possible size.
EGYDIO TECHNIQUE: HOW TO DO A PENILE RECONSTRUCTION WITHOUT USING GRAFT
The Egydio Technique for penile reconstruction aims to achieve maximum elongation and thickness up to the limit of the nerves and urethra. This is possible due to a tissue expansion, which consists in a process of stretching the tissues of the patient's penis without using grafts. The correction is performed directly on the albuginea tunic of the penis with multiple and small cuts, mathematically dimensioned and strategically located, which allows a greater lengthening and increase of the caliber of the penis.
In the penile reconstruction with the expansion technique, the incisions are made in vascular tissues that contains blood circulation, which minimizes possible infections and allows the healing process.
The directions of the incisions are calculated according to the needs of expansion of the penis. If the intention is to correct the size, horizontal incisions are made to allow reaching the maximum size of the penis, respecting the limit of the nerves. If the caliber is the main issue, vertical incisions are made to allow penile expansion.
With the Egydio Technique, it is also possible to minimize the risks of infections by using the No-TouchProcedure. The goal of this procedure and the reason why it was developed is to have no contact between the surgeon's hands and the skin of the penis and scrotum, minimizing the risk of infections and postoperative complications.
For safe sexual intercourse with penetration that does not cause complications for the man, it is important that the size and caliber of the penis be in balance, preventing the penis to escape or bend during the sexual relation. Penile reconstruction with the Egydio Technique aims to maintain harmony between these two factors, always taking into account the limits of the penile nerves.
Watch the video where Dr. Paulo explains the disadvantages of using a penile graft:
I understand this is a technical issue and it may raise questions. I am here to listen to you and provide the necessary medical guidance, with confidentiality and discretion.
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Dr. Paulo Egydio
MD, PhD, Dedicado no Tratamento da Doença de Peyronie, Pênis Curvo e Implante de Próteses Penianas. Doutor em Urologia pela USP, CRM 67482, RQE 19514. - Vencedor do Debate do Sobrevivente da AUA em 2019.