(748) Mechanically Processed Lipoaspirates as Regenerative Therapy for Peyronie’s Disease: A Prospective Comparative Study

Introduction Peyronie’s disease (PD) is an acquired fibrotic disorder characterized by tunical plaque formation leading to penile deformity, pain, and erectile dysfunction (ED). Current treatments are often unsatisfactory or invasive. Mechanically processed lipoaspirates (MPLs), rich in stromal vascular fraction (SVF) and adipose-derived stem cells, exhibit anti-fibrotic and regenerative properties that may benefit PD’s chronic lesions. Objective To assess the safety and efficacy of microfat (MF) and nanofat (NF) MPL injections as single-session regenerative therapies in stable-phase PD. Methods A prospective comparative study was conducted on men with stable PD (≥6 months) treated between 2018 and 2024. Participants underwent intraplaque and tunical MPL injections using MF (2022–2024) or NF (2018–2022). Preoperative evaluation included medical history, penile ultrasound, autophotography, and International Index of Erectile Function (IIEF-5). Postoperative assessments at 3 months evaluated penile curvature, plaque characteristics, pain, IIEF-5, and satisfaction (0–10 scale). Data were analyzed with Wilcoxon, Mann–Whitney, and chi-squared tests (p<0.05). Results Fifty-nine men were analyzed (median age 59 years; NF group n=26, MF group n=33). Baseline median curvature was 30° (IQR 25–40). Both groups showed significant postoperative improvement in curvature, pain, and IIEF-5 scores (median +2 to +3 points). Curvature reduction was greater with MF (–15° vs –10°, p=0.04), and satisfaction was significantly higher (median 7 vs 4, p<0.001). No perioperative complications occurred; minor ecchymoses resolved spontaneously. Median follow-up was 11.8 months. MF use independently predicted high satisfaction. Conclusions Mechanically processed lipoaspirates are a safe, minimally invasive, one-session regenerative option for stable-phase PD. MF provided superior curvature correction and patient satisfaction compared with NF, supporting its potential role as an effective alternative to traditional reconstructive surgery. Disclosure No