The combination of penile revascularization surgery with penile corrective techniques as an alternative to prosthesis implantation in patients with peyronie’s disease accompanied by erectile dysfunction: Long-term results

Abstract

This study aimed to investigate the long-term outcomes of the surgical combination of revascularization and penile corrective techniques after having obtained promising preliminary results from a previous study. Between 2008 and 2015, the combined treatment was undertaken for 60 patients with Peyronie's disease and erectile dysfunction. A preoperative urological evaluation was performed with penile color Doppler ultrasonography, electromyography of the corpus cavernosum and cavernosometry. All the patients completed 15-item and 5-item IIEFs preoperatively and at postoperative follow-up. The mean age of the patients was 53.78 ± 6.48 years ranging from 47 to 63. The mean follow-up period was 48 (14-68) months. The degree of penile angulation was >40 in all the patients. Urethra dissection was required in five patients. Penile disassembly was performed on one patient due to distal complex corporeal deformity. None of the patients reported complications after surgery. The mean total IIEF score was reported to be 25.4 ± 2.8 before the operation and 52.23 ± 1.2 at the end of the follow-up (p < 0.05). The mean IIEF-5 score was 7.3 ± 1.3 preoperatively and 20.9 ± 1.9 at the end of follow-up (p < 0.05). The results of IIEF-15 for erectile function demonstrated that 32 patients had a cutoff value of >26, indicating no ED. Although all patients had complete penile straightening, 7 (11.66%) reported shortening of the penis but was not dissatisfied with the treatment. The number of patients satisfied with the outcomes of the operation was 53. The statistically significant improvement and satisfactory results achieved with the IIEF questionnaires suggest that the proposed combined treatment could be an alternative to penile prosthesis in highly selected patients with Peyronie's disease, particularly those with erectile dysfunction; however, more studies are needed to confirm these results.

Utilization of Epigastric Vessels in Combined Penile Straightening and Revascularization Surgery

“…However, a non-negligible part of patients has less severe deformity or mild vasculogenic erectile dysfunction, yet a group of patients simply questioning the physician for another option. We have already reported both the preliminary results and the longterm results of our penile revascularization case series combined with complex penile correction surgery [1,3]. Herein, we describe a novel surgical technique during the combination of Peyronie's surgery and penile revascularization that could be defined as harvesting epigastric vein for cavernous patch; instead of using saphenous vein.…”

“…Also, the most comprehensive case series of the combination surgery comprises a very-selected patient cohort by a single surgeon, which brings an evidence that is inferior to the multi-center results of prosthesis implantation. However, the total success of the procedure is not negligible [1,3].…”

Long-term results of corporoplasty in Peyronie’s disease

“…Опубликованы отдельные сообщения об успешной хирургической реваскуляризации полового члена с одновременной пликацией белочной оболочки у пациентов с БП и сопутствующей ЭД [16]. Однако имплантация фаллопротеза, благодаря своей относительной простоте и надежности, остается методом выбора для лечения пациентов с БП и ЭД, не отвечающей на консервативную терапию [15].…”