The Plication Procedure for Penile Curvature: Surgical Outcome and Postoperative Sexual Functioning

Abstract

Objective: This study evaluates the patients’ judgement of the surgical outcome of the plication procedure, as described by Schröder and Essed, and the postoperative sexual functioning of patients with congenital curvatures and Peyronie’s disease. Patients and Methods: Of 98 patients treated for penile curvatures between 1985 and 1996, 85 patients received postoperatively a ‘Questionnaire Assessing the Outcome of Surgery’ and a short version of the ‘Questionnaire for Screening Sexual Dysfunctions’. Results: 28 patients with congenital curvatures and 31 with Peyronie’s disease were evaluated. 75% of the patients with congenital curvatures and 58% of the patients with Peyronie’s disease were satisfied with the result. Patients treated for Peyronie’s disease reported diminished penile length and inability to have sexual intercourse more often than patients with congenital curvatures (90 vs. 64%, and 29 vs. 0%). After correction for age, patients with Peyronie’s disease were less satisfied with their present sex life, had more frequent erectile problems and more trouble with considerable sexual desire than a group of 42 controls. For patients with Peyronie’s disease satisfaction with the result was positively correlated with satisfaction with their present sex life and negatively correlated with the frequency of erectile problems. For patients with congenital curvatures satisfaction with the result was negatively correlated with both a postoperative curvature and a repeat operation. Conclusions: Some patients with Peyronie’s disease may not benefit from surgical correction (alone). Because of the occurrence of sexual problems, future evaluation of the role of pre- and postoperative sexological counselling in achieving better results is recommended.

Corporal plication for penile curvature caused by Peyronie's disease: the patients' perspective

“…Penile shortening is well described after surgery for Peyronie's disease [20,21]; in the present series, 90% of the patients noted a perceptible shortening of the penis and over half regarded this as significant. Shortening of the penis was reported in over half the patients assessed by Nooter et al.…”

Maladie de La Peyronie: connaissances validées et hypothèses en physiopathologie, épidémiologie, diagnostic et thérapeutique

“…La technique est très simple et efficace (57 à 93 % de patients satisfaits), avec de rares troubles de l'érection, mais avec un taux important de récidives (15 à 47 %) [44,45]. Le taux de récidive vient peut-être du type de fil utilisé : résorbable ou non.…”

Surgical alternatives for treating Peyronie's disease

“…Plication of the tunica albuginea of an erect penis is less invasive than other procedures and may be completed under local anaesthesia. Reported results vary widely with ‘straightening’ rates of 57–85%[17–22]. A recent study by Gholami and Lue [18] on the use of plication reported that the recurrence rate of penile curvature at a mean follow‐up of 2.6 years was only 15%, and 96% of patients were satisfied with their erection.…”

“…A recent study by Gholami and Lue [18] on the use of plication reported that the recurrence rate of penile curvature at a mean follow‐up of 2.6 years was only 15%, and 96% of patients were satisfied with their erection. Others have not found this surgery nearly as successful, with frequent complaints of bothersome sutures, shortening and ED [17,19]. Chahal et al [19] reported that 57% of patients in their study had a deterioration in their quality of life after the procedure, with 90% having a shortened penis (55%‘significantly shorter’), 36% with impaired erections, 32% with glans hypoesthesia, and 34% complaining of bothersome suture knots.…”

“…Gholami and Lue [18] used this procedure in patients with large or complex curvatures, although both the UNC and Lenting/Levine algorithm [6] support grafting techniques in these cases. Complications after surgery can include ED (6–38%), curve recurrence (15–20.7%), penile narrowing (0–9%), haematoma (0–4%), penile or glans hypoesthesia (3–48%), wound infection (0–3%), and bothersome knots (0–34%) [17–22].…”