Long‐Term Results of Reconstructive Surgery for Peyronie's Disease

Garaffa, Giulio; Kuehhas, Franklin E.; Luca, Francesco De; Ralph, David

doi:10.1002/smrj.42

Cited by 15 publications

(10 citation statements)

References 85 publications

(183 reference statements)

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“…Traditionally, the management of patients with PD and refractory ED consisted of the placement of a PP, with additional straightening manoeuvers to guarantee adequate rigidity and curvature correction [15][16][17][20][21][22][23]. Although the current guidelines suggest that the aim of surgery is to guarantee a penis straight and hard enough for penetrative sexual intercourse, the recent evidence suggests that most patients with PD are bothered by the loss of length associated with the disease and that further loss in length due to the surgical correction leads to additional bother, irrespective of the magnitude of the loss [4][5][6]. Furthermore, patients with PD undergoing PP implantation report the lowest satisfaction scores among the PP implant population, mainly because of the shortening and the change of shape of their penis [6].…”

Section: Discussionmentioning

confidence: 99%

“…Diffuse cardiovascular disease, as well as the change in interface between the corpus cavernosum and the tunica albuginea caused by the formation of the plaque, may explain the progressive worsening of the quality of the erection, which is a common finding in this group of patients . Therefore, the quality of life of sexually active patients with PD and their partners is often severely affected, and this may cause depression, low self‐esteem, and difficulty in the relationship with the partner .…”

Section: Introductionmentioning

confidence: 99%

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A prospective multicentric international study on the surgical outcomes and patients’ satisfaction rates of the ‘sliding’ technique for end‐stage Peyronie's disease with severe shortening of the penis and erectile dysfunction

et al. 2015

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Objectives To report the results from a prospective multicentric study of patients with Peyronie's disease (PD) treated with the ‘sliding’ technique (ST). Patients and Methods From June 2010 to January 2014, 28 consecutive patients affected by stable PD with severe penile shortening and end‐stage erectile dysfunction (ED) were enrolled in three European PD tertiary referral centres. The validated International Index of Erectile Function (IIEF) questionnaire, the Sexual Encounter Profile (SEP) Questions 2 and 3, and the Peyronie's disease questionnaire (PDQ) were completed preoperatively by all patients. At the follow‐up visits (at 3, 6 and 12 months), the IIEF, the SEP Questions 2 and 3, the PDQ, and the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) were completed. The outcome analysis was focused on penile length restoration, and intra‐ and postoperative complications classified according the Clavien–Dindo Classification. Results The mean (range) follow‐up was 37 (9–60) months. A malleable penile prosthesis (PP) was implanted in seven patients, while an inflatable three‐pieces PP was placed in the remainder. In the case of inflatable PP implantation, porcine small intestinal submucosa and acellular porcine dermal matrix were used to cover the tunical defects. While in patients undergoing malleable PP implantation, collagen‐fibrin sponge was used. The mean operative time was 145 min in the inflatable PP group and 115 min in the malleable PP group. There were no intraoperative complications. Postoperative complications included profuse bleeding requiring a blood transfusion in one patient (3.5%) on anticoagulation therapy for a mechanical heart valve (Grade II) and PP infection requiring the removal of the device (7%) (Grade III). There were no late recurrences of the shaft deformation. The postoperative functional data showed a progressive improvement in the score of all questionnaires, peaking at 12 months postoperatively. The mean (range) penile lengthening was 3.2 (2.5–4) cm and no patient reported recurrence of the curvature. Conclusions The present series suggests that, in the hands of experienced high‐volume surgeons, penile length restoration with the use of the ST represents an effective option for end‐stage PD associated with ED and severe shortening of the shaft. Larger series and longer follow‐up will be required to fully establish the efficacy of this procedure.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A prospective multicentric international study on the surgical outcomes and patients’ satisfaction rates of the ‘sliding’ technique for end‐stage Peyronie's disease with severe shortening of the penis and erectile dysfunction

et al. 2015

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“…The grafts needed were harvested as described by Eppley et al (16). The corporoplasty procedures were done essentially the same way as for all others grafting techniques (17). Circumcisions were made by a "sleeve technique" or a "forceps-guided method".…”

Section: Methodsmentioning

confidence: 99%

Buccal mucosa is a promising graft in Peyronie’s disease surgery. Our experience and a brief literature review on autologous grafting materials

Fabiani

Servi

Fioretti

et al. 2016

Arch Ital Urol Androl

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“…Grafting surgery becomes essential when penile deformities become handicapping to the patient both cosmetically and functionally, as having an acute angle of curvature beyond 60°, a pathologically short penis, a hinging penis due to an hourglass deformity, or a penis incapable of penetrative sexual intercourse 4,5 . However, due to the progressive nature of the disease, surgical correction must never be conducted before the plaque has stabilized for over not less than 12 to 18 months and becomes painless 6 . A typical preoperative erectile rigidity is a mandatory prerequisite for grafting to be the only treatment.…”

Section: Preoperative Considerations: (Patient Selection/patient Pre‐mentioning

confidence: 99%

A decade of grafting techniques as a sole treatment for Peyronie’s disease

2020

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Background Peyronie's disease (PD) can be a cosmetically and functionally devastating condition. Surgical approaches have been proposed in the chronic stages of PD as plication or plaque incision/excision with grafting to preserve penile size in complex cases. Although several surgeons nowadays are inclined toward the utilization of non‐autologous grafts owing to the ease of their preparation and availability, synthetic graft procedures still await more technical improvements and supporting evidence before their consideration for standard care. Objectives In this review, our goal is to facilitate an insight into the most promising grafting materials used for the management of PD and techniques associated. Materials and methods A PubMed review was conducted for all the studies on our topic within the past ten years (January 2009 until December 2019). The outcome parameters we documented and compared comprised of operative time, follow‐up time, postoperative penile cosmesis and function, and, finally, overall patient satisfaction related to each technique. Results Our search yielded 23 English‐written original study articles in addition to a single case report on the various grafting techniques utilized as the sole treatment for PD, each demonstrating different outcomes and points of comparison. Conclusion A successful grafting procedure for PD requires an appropriately tailored surgical modality and an experienced surgeon. Nevertheless, proper preoperative patient counseling on all aspects of his condition and opted treatment modality while setting clear and realistic expectations remains key for overall patient satisfaction.

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Long‐Term Results of Reconstructive Surgery for Peyronie's Disease

Cited by 15 publications

References 85 publications

A prospective multicentric international study on the surgical outcomes and patients’ satisfaction rates of the ‘sliding’ technique for end‐stage Peyronie's disease with severe shortening of the penis and erectile dysfunction

A prospective multicentric international study on the surgical outcomes and patients’ satisfaction rates of the ‘sliding’ technique for end‐stage Peyronie's disease with severe shortening of the penis and erectile dysfunction

Buccal mucosa is a promising graft in Peyronie’s disease surgery. Our experience and a brief literature review on autologous grafting materials

A decade of grafting techniques as a sole treatment for Peyronie’s disease

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