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Published on: March 15, 2024
Favorable patient reported outcomes after penile plication for wide array of peyronie disease abnormalities
Steven J Hudak1, Allen F Morey, Mehrad Adibi
1Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas 75390-9110, USA.
Purpose:
We present patient reported outcomes from our 5-year experience using penile plication to correct a wide variety of Peyronie disease malformations.
Materials And Methods:
We reviewed the records of all men who underwent penile plication for Peyronie disease, as performed by one of us (AFM). All patients were treated with tunical plication without penile degloving via a 2 cm longitudinal penile incision regardless of curvature severity or erectile function. A concomitant inflatable penile prosthesis was placed in men with refractory erectile dysfunction. A questionnaire was administered to assess the patient perception of postoperative penile curvature, length, rigidity and adequacy for intercourse.
Results:
Of 154 treated patients 78 (51%) and 65 (42%) had simple (less than 60 degrees) and complex (biplanar curvature, or curvature 60 degrees or greater) malformation, respectively, while 11 (7%) underwent plication plus inflatable penile prosthesis placement. A total of 132 patients responded to the questionnaire a mean 14 months after surgery. Overall, 96% of patients reported curvature improvement after penile plication, 93% reported erection adequate for sexual intercourse and 95% considered that the overall condition improved after surgery. Despite a significant difference in the number of plication sutures (mean 10 vs 7) and curvature angle correction (mean 57 vs 30 degrees, each p <0.005), self-reported outcomes of complex cases were equivalent to those of simple cases. While 84% of patients had no measureable decrease in stretched penile length, 103 of 154 (78%) reported a perceived penile length reduction after surgery.
Conclusions:
Penile plication without degloving is effective for correcting a wide variety of Peyronie disease malformations. It can be safely combined with inflatable penile prosthesis placement.
Insights
Penile plication surgery effectively corrects Peyronie disease deformities, with high patient satisfaction regarding curvature and sexual function. This technique can be safely combined with penile prosthesis implantation when needed.
Area of Science:
- Urology
- Andrology
- Reconstructive Surgery
Background:
- Peyronie disease involves penile curvature and can impact sexual function.
- Surgical correction aims to restore penile straightness and function.
Purpose of the Study:
- To evaluate patient-reported outcomes of penile plication for Peyronie disease over a 5-year period.
- To assess the effectiveness of penile plication in correcting various penile malformations.
Main Methods:
- A retrospective review of 154 patients undergoing penile plication for Peyronie disease.
- Patients received tunical plication via a small incision, with optional inflatable penile prosthesis placement.
- Postoperative outcomes were assessed via questionnaire regarding curvature, length, rigidity, and intercourse adequacy.
Main Results:
- 96% of patients reported improved penile curvature and 93% adequate erection for intercourse.
- Outcomes for complex Peyronie disease cases were similar to simple cases.
- 78% of patients reported a perceived decrease in penile length, though most had no measurable reduction.
Conclusions:
- Penile plication without degloving is an effective treatment for diverse Peyronie disease malformations.
- The procedure can be safely combined with inflatable penile prosthesis placement for men with erectile dysfunction.
