Simultaneous penile prosthesis placement and collagen fleece (TachoSil) grafting. Where do we stand in 2024?

Surgical therapy of Peyronie's disease is the gold standard for correction of the associated penile curvature. In patients with co-existing erectile dysfunction, not responding to medical/conservative treatment, penile prosthesis implantation is indicated and recommended. Severe residual curvature in these cases can be addressed by plaque incision and grafting. The novel collagen fleece TachoSil (Corza Medical, MA, USA) has emerged as a reliable and robust graft for this purpose, with favorable results. Hatzichristodoulou was the first to publish his new technique of plaque incision and grafting with TachoSil for residual curvature correction during penile prosthesis implantation in 2018 (PICS Technique). Since then, this technique was adopted and used by various surgeons. In the current narrative review all publications using this novel graft after plaque incision for residual curvature correction will be presented and respective results discussed. Moreover, the surgical technique will be highlighted in detail. The TachoSil has self-adhesive properties which make it unique and the ideal graft for this indication. Results of the studies on this topic, that are available so far, are excellent. The technique is safe. However, data from more patients and even more long-term follow-up results of patients treated with this technique and graft are requested.