Patient and partner satisfaction and long-term results after surgical treatment for Peyronie’s disease

Usta, Mustafa F.; Bivalacqua, Trinity J.; Sanabria, Jose; Koksal, Ismail Turker; Moparty, Krishnarao

doi:10.1016/s0090-4295(03)00244-9

Cited by 91 publications

(76 citation statements)

References 24 publications

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“…[46][47][48] The reported patient satisfaction Larsen 29 rate with these procedures ranges from 41% to 96%, partner satisfaction has been reported at 77% and rigidity adequate for coitus reported from 79% to 100%. 22,46,[48][49][50][51] ED is reported in 0%-35% with a trend toward increased risk of ED in men over the age of 60 years, as well as a higher risk of ED when grafting is performed to correct ventral curvature. 22,48 Depending on the graft material used, recurrence of greater than 30u curvature can be seen from 0% to 16% with plaque incision/excision and grafting procedures.…”

Section: Tunical Lengthening Procedures (Incision or Partial Excisionmentioning

confidence: 99%

“…22,48 Depending on the graft material used, recurrence of greater than 30u curvature can be seen from 0% to 16% with plaque incision/excision and grafting procedures. 48,51 Graft materials The concept of the ideal graft has been debated. At this time, no graft has been identified as the ultimate one.…”

Section: Tunical Lengthening Procedures (Incision or Partial Excisionmentioning

confidence: 99%

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Surgery for Peyronie's disease

Levine¹,

Larsen²

2012

Asian J Androl

110

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Peyronie's disease (PD) is most simply referred to as a fibrotic wound-healing disorder of the tunica albuginea. It is both a physically and psychologically devastating disorder that causes penile deformity, curvature, hinging, narrowing and shortening, which may compromise sexual function. Although a variety of non-surgical treatments have been suggested, none to date offer a reliable and effective correction of the penile deformity. As a result, surgery remains the gold standard treatment option, offering the most rapid and reliable treatment which will be the focus of this article. We review the preoperative evaluation, surgical algorithm, graft materials and postoperative management of PD. Outcomes for tunical shortening, tunical lengthening and penile prosthesis placement for penile straightening are reviewed. Tunica albuginea plication is the preferred method of straightening for men with adequate rigidity and less severe disease defined as curvature less than 706 without narrowing/hinging. Men who have more severe, complex deformity, but maintain strong preoperative erectile function should be considered candidates for straightening with plaque incision or partial excision and grafting. Finally, for those men who have inadequate rigidity and PD, penile prosthesis placement with straightening is the best approach to address both problems. Keywords: penile prosthesis; Peyronie's disease, penile reconstruction; plaque excision and grafting; plaque incision; tunica albuginea plication INTRODUCTION Peyronie's disease (PD) is most simply referred to as a fibrotic woundhealing disorder of the tunica albuginea. It is both a physically and psychologically devastating disorder that causes penile deformity, curvature, hinging, narrowing, shortening and painful erections. 1 The perceived loss of length and girth is often more disturbing than the curvature itself, all of which can lead to moderate to severe depressive symptoms, emotional, and relationship problems. 2,3 Despite a myriad of treatment options, PD remains a considerable therapeutic dilemma due to several factors including an incomplete understanding of its etiopathophysiology and the relative paucity of randomized, placebo-controlled trials. A general explanation of this disorder, which has gained acceptance, is that PD is a disorder in which genetically susceptible individuals experience a localized response to endogenous factors such as tumor growth factor-b, which are released in response to microtrauma. This can lead to biological transformation of cells within the tunica albuginea, cell cycle dysregulation, genotypic changes and increased expression of cytokines and free radicals. This inflammatory response leads to unregulated extracellular matrix deposition including fibronectin and collagen, and ultimately plaque scar formation, which does not appear to undergo proper scar remodeling, leaving an inelastic segment in the involved tunica albuginea. [4][5][6][7][8][9] Although a variety of non-surgical treatments have been suggested, none offer a r...

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Section: Tunical Lengthening Procedures (Incision or Partial Excisionmentioning

confidence: 99%

Section: Tunical Lengthening Procedures (Incision or Partial Excisionmentioning

confidence: 99%

Surgery for Peyronie's disease

Levine¹,

Larsen²

2012

Asian J Androl

110

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“…7,14,15 Recently, it has been suggested that, due to anatomical specificities of the tunica albuginea, Nesbit's operation is a more suitable procedure for correction of lateral curvatures when compared to patch methods, especially in deviations of o601. [16][17][18] In this study, three patients presented with lateral curvature but also with deviation of o601. They underwent Nesbit's operation, complete curvature correction was achieved, and no postoperative erectile dysfunction was observed.…”

Section: Discussionmentioning

confidence: 67%

“…24 Several groups of authors are using successfully the cadaveric pericardium as a patch. 16,22 The good side of this material is a smaller risk of allergic reaction and infection, when compared to synthetic materials. However, significant 30 and 63% of erectile dysfunction have been observed when this graft is used after incision and plaque excision, respectively.…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment of Peyronie's disease based on penile length and degree of curvature

et al. 2004

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The aim of the study was to present the selection criteria for surgical techniques for the treatment of patients with Peyronie's disease. A total of 55 men with Peyronie's disease were surgically treated. We created specific criteria for selection of the appropriate surgical technique. All patients had a stable disease for 6 months and impossible vaginal intromission. All patients had subjective (as reported by the patient) and/or objective normal penile rigidity (as observed after intracavernous administration of alprostadil). Also, they all underwent drug therapy, which was unsuccessful. Among them, 40 patients with penile curvature of o601 and erect penile length of 413 cm underwent Nesbit's operation, whereas plaque excision and grafting with polytetrafluoroethylene patch was performed in 15 patients with penile curvature of Z601 and/or erect penile length of r13 cm. At a mean (7s.d.) follow-up of 81.1733.8 and 78.7732.8 months, respectively, straightening of the penis was achieved in 35 out of 40 (87.5%) and 12 out of 15 (80%) patients, respectively, whereas erectile dysfunction developed in two out of 40 (5%) and one out of 15 (6%), respectively. Shortening of the penis occurred in all 40 patients undergoing Nesbit's operation, and in none of the patients undergoing plaque excision. Six out of 40 (15%) patients undergoing Nesbit's operation reported subjective perception of penis shortening, whereas none of the patients undergoing plaque excision complained of this discomfort. In conclusion, we recommend the selection of surgical technique based on penile length and degree of curvature. Nesbit's operation is an appropriate surgical technique for the treatment of patients with erect penile length of 413 and deviation of o601, whereas the plaque excision and grafting with polytetraflouroethylene patch is a technique of choice in the treatment of patients with erect penile length of r13 and/or deviation of Z601.

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“…[ [12][13][14][15][16][17][18][19] Ven grefti, bilinen ve en çok kullanılan bu çalışmada da tercih ettiğimiz greft materyalidir. Ven grefti ile %60-95'ler oranında penil düzelme ve %88-92 oranında tatmin sağlanabilmektedir.…”

Section: [11]unclassified