{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T15:52:18Z","timestamp":1772121138289,"version":"3.50.1"},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2022,2,23]],"date-time":"2022-02-23T00:00:00Z","timestamp":1645574400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"},{"start":{"date-parts":[[2022,2,23]],"date-time":"2022-02-23T00:00:00Z","timestamp":1645574400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":["jsm.jsexmed.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,4,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The use of plaque incision and graft techniques (PIG) for the treatment of severe Peyronie\u2019s disease (PD), may lead to erectile dysfunction (ED); graft size is 1 of the contributing factors for post-PIG ED. Recently the iGrafter software APP was introduced using a mathematical algorithm to distribute the incisions along the penile length resulting in a smaller grafting area.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Compare 2 PIG techniques, the Double-Y(DY) and iGrafter, in 3 main aspects: (i) Total grafting area; (ii) The variation in calculating the grafting to be used; (iii) time to perform the PIG.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Six urologists with expertise in sexual medicine performed both techniques twice using four 3-D validated training models for PD with a standard 60\u00b0 uniplanar dorsal curvature.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcomes<\/jats:title>\n                    <jats:p>The graft areas and operative partial and total time for each step of the operation were recorded for each procedure. Unpaired t-test and the coefficient of variation for graft area across surgeons was calculated comparing both techniques.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>For all surgeons, the use of iGrafter resulted in 2 grafts, for the DY technique in 1 graft. Overall, TT for the iGrafter was significantly longer than for DY technique (49.4 \u00b1 11 vs 40.7 \u00b1 5.7 minute; P = .02), The iGrafter grafting area was significantly smaller (11.6 \u00b1 1.2 vs 23.3 \u00b1 5.4 cm2; P: .01), representing a 50.2% area reduction when compared to the DY. The variation of graft area, using the iGrafter also yielded a more consistent graft across all surgeons (CV = 10.56% vs 23.28%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Significance<\/jats:title>\n                    <jats:p>The iGrafter, when compared to DY technique, reduced the graft area by 50%, which potentially means less erectile dysfunction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Strengths and Limitations<\/jats:title>\n                    <jats:p>Our study eliminates anatomical variations found in a real clinical case making it possible to compare surgical techniques with the same penile anatomy. However, the 3D-printed model cannot replicate the living human tissue property preventing a simulation close to actual surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The use of the iGrafter software for PIG surgery has shown to be a promising technique for severe PD management resulting in smaller graft size (about 50% smaller when compared to the DY), although it might be more time-consuming.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.jsxm.2022.01.010","type":"journal-article","created":{"date-parts":[[2022,2,23]],"date-time":"2022-02-23T08:30:42Z","timestamp":1645605042000},"page":"669-675","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":1,"title":["Grafting Area Reduction in Peyronie\u2019s Disease Surgery: Comparative Assessment Between Double Y Vs iGrafter APP Using 3D-Printed Penile Models"],"prefix":"10.1093","volume":"19","author":[{"given":"Ali","family":"Tourchi","sequence":"first","affiliation":[{"name":"Department of Urology, University of Arkansas for Medical Sciences , Little Rock, AR , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruno","family":"Nascimento","sequence":"additional","affiliation":[{"name":"Department of Urology, Universidade de S\u00e3o Paulo , S\u00e3o Paulo, S\u00e3o Paulo , Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandre","family":"de Freitas Miranda","sequence":"additional","affiliation":[{"name":"Department of Urology, Hospital Federal de Ipanema , Rio de Janeiro, RJ , Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eduardo","family":"Miranda","sequence":"additional","affiliation":[{"name":"Department of Surgery, Urology Division, Universidade Federal do Cear\u00e1 , Fortaleza, Cear\u00e1 , Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9","family":"Bessa","sequence":"additional","affiliation":[{"name":"Department of Urology, Universidade de S\u00e3o Paulo , S\u00e3o Paulo, S\u00e3o Paulo , Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William C.","family":"Nahas","sequence":"additional","affiliation":[{"name":"Department of Urology, Universidade de S\u00e3o Paulo , S\u00e3o Paulo, S\u00e3o Paulo , Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rog\u00e9rio Say\u00e3o","family":"Filho","sequence":"additional","affiliation":[{"name":"Department of Urology, Universidade de S\u00e3o Paulo , S\u00e3o Paulo, S\u00e3o Paulo , Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miguel","family":"Srougi","sequence":"additional","affiliation":[{"name":"Department of Urology, Universidade de S\u00e3o Paulo , S\u00e3o Paulo, S\u00e3o Paulo , 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