Tunical plication in the management of penile curvature due La Peyronie’s disease. Our experience on 47 cases

Abstract

BackgroundPeyronie’s disease is an acquired connective tissue disorder of the penile tunica albuginea with fibrosis and inflammation. The disease produces palpable plaques, penile curvature and pain during erections. Patients report negative effects in four major domains: physical appearance and self-image, sexual function and performance. These changes damage sexual life and compromise the quality of life. Our objective is to review the patient's sexual life after penile tunical plicature using the International Index of Erectile Function (IIEF) and the Sexual Encounter Profile (SEP) questionnaires.MethodsA total of 47 patients with Peyronie's disease (PD) were enrolled at our urology department and they underwent correction of penile deviation between February 2009 and March 2010. Mean patient age was 56 years and mean follow-up was 24 months. Patients with painless PD plaque with no progression in angulation for at least 12 months were chosen for surgery. They underwent a penile tunical plication.IIEF and SEP questionnaire were administered to all patients.ResultsOf all treated patients, 94% were able to insert their penis in the partner's vagina (p<0.01; SEP question 2), compared with 62% preoperatively and 90% of them was satisfied overall with the sexual intercourse (p<0.01; SEP question 5) .Patients had a significantly higher endpoint and a greater change from baseline for the remaining SEP questions related to achievement of an erection, satisfaction of erection hardness (SEP questions 1 and 4; p < 0:001).We reported a significant improvement in the IIEF scores (from a baseline total score of 25.2 +/- 3.2 to a final score of 38.3 +/- 5.2; P<0.01). It resulted in significantly higher endpoint IIEF scores across all five IIEF domains: Erectile Function, Intercourse Satisfaction, Orgasmic Function, Sexual Desire and Overall Satisfaction. The main complaint was penile shortening (28 patients, 60%), feeling of the suture during flaccidity and tumescence (37 patients, 80%).ConclusionPatient quality of life improved after surgery thanks to the improvement of their sexual life. The complications are unimportant and few bother symptoms are reported. The significant improvement in erectile function was also supported by IIEF and SEP questionnaire data. Nowadays tunical plication is a safe, advantageous and useful technique to treat patients suffering of Peyronie’s disease.

Surgical correction of Peyronie's disease via tunica albuginea plication: long‐term follow‐up

“…Penile prosthesis implantation is considered for patients with PD and concurrent ED who are not responding to medical treatment. (Hatzimouratidis et al ., ); on the other hand, the optimal surgical treatment for PD patients with conserved erectile function is still controversial (Langston & Carson, ; Iacono et al ., ).…”

Peyronie’s disease may negatively impact the sexual experience of a couple and female sexual function: a single center study

“…This procedure consists of the transverse excision of an ellipse of albugineous tunic of approximately 1 mm every 10° of curvature (22). For this study, we enrolled patients undergoing a Nesbit modified corporoplasty according to our technique (23). The procedure consisted of making single or multiple longitudinal incisions on the convex side of the curvature and then closing them horizontally (24).…”

Long-term results of corporoplasty in Peyronie’s disease

“…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]. Выбор способа коррекции пенильной деформации при БП у пациентов с сохранной эректильной функцией не так однозначен [17,18]. Процедуры по увеличению площади белочной оболочки позволяют избежать сокращения длины пениса, но являются более инвазивными из-за необходимости в рассечении или иссечении бляшки.…”