A new mini-invasive surgical treatment for Peyronie’s disease: mechanically processed lipoaspirates as regenerative therapy

Abstract

Peyronie’s disease (PD) is an acquired penile disorder characterized by pain, penile deformities, and erectile dysfunction (ED). The prevailing hypothesis suggests repetitive microtraumas in genetically predisposed individuals lead to tunica albuginea inflammation and fibrous tissue formation. Peyronie’s disease progresses through acute and chronic phases. The chronic phase is commonly associated with the presence of scar tissue, penile deformities, and ED, although these features may also be present to varying degrees during the acute phase. Peyronie’s disease can cause significant emotional, social, and psychological distress, including impaired sexual relationships, reduced intimacy, social withdrawal, and feelings of stigmatization.1 Autologous fat grafting, introduced by Neuber in 1893, was initially used for tissue loss treatment, with its regenerative potential highlighted in 2001.2 Adipose tissue consists of 20% adipocytes and 80% stromal vascular fraction (SVF), the core of regeneration. Lipoaspirate from liposuction can be processed into microfat (MF) and nanofat (NF). These Mechanically Processed Lipoaspirates (MPLs) maintain the SVF (tSVF), a heterogeneous cell population, including adipose-derived stem cells and other key cells known for their anti-inflammatory, anti-fibrotic, and regenerative properties. MPLs have shown promise in treating scars and atrophic conditions, potentially addressing chronic tunica albuginea lesions in PD’s chronic phase.