The comparison of success status and complications in peyronie disease patients: penile plication versus plaque incision and grating techniques

Year 2023, Volume: 6 Issue: 4, 780 - 784, 30.07.2023

Çağrı Doğan , Murat Akgül , Cenk Murat Yazıcı , Serkan Şeramet , Hulusi Dayısoylu , Erdem Can Topkaç

https://doi.org/10.32322/jhsm.1310131

Abstract

Aims: This study aimed to evaluate and compare the outcomes of tunical lengthening and shortening techniques for the surgical management of Peyronie's disease (PD) in terms of penile length, patient satisfaction, and complications.
Methods: A retrospective analysis was conducted on PD patients who underwent surgical procedures between January 2017 and May 2023 at a single institute. Patient demographics, comorbidities, penile curvature, penile length, and surgical techniques were evaluated. The surgical procedures included plaque incision and grafting, and tunical plication. Post-operative data, including penile length, residual curvature, patient satisfaction, adverse events, and erectile function, were collected at 1-12 months of surgery.
Results: A total of 36 patients (mean follow-up period: 432.25±121.14 days) underwent surgical procedures for PD. Penile length in the tunical lengthening group (13.04±1.62 cm) was significantly longer than in the tunical shortening group (10.85±1.24 cm, p=0.001). Tunical shortening procedures were associated with a higher rate of penile shortening (57.1% vs. 6.7%, p=0.001) and suture-related discomfort (38.1% vs. 6.7%, p=0.031) compared to tunical lengthening procedures. Patient satisfaction was higher in the tunical lengthening group (80% vs. 66.7%, p=0.378). There was no significant difference in painful erection during penetrations or incapability of intercourse between the groups. The average length of hospital stay was longer for tunical shortening surgery compared to tunical lengthening surgery (1.27±0.27 vs. 1.79±0.39, p=0.023).
Conclusion: Tunical lengthening procedures demonstrated superior outcomes in terms of penile length and suture-related discomfort compared to tunical shortening procedures for the surgical management of PD. Patient satisfaction was also higher in the tunical lengthening group. Clinicians should consider various factors when selecting the appropriate surgical technique for PD, including penile length, the degree of penile curvature, and surgeon experience. Prospective randomized studies are needed to further validate these findings and assess long-term outcomes.

Keywords

Peyronie, plicatation, grafting, penile length, satisfaction

References

• Salonia A, Bettocchi C, Boeri L, et al. European Association of Urology Guidelines on Sexual and Reproductive Health-2021 Update: Male Sexual Dysfunction. Eur Urol. 2021;80(3):333-357. doi:10.1016/j.eururo.2021.06.007
• de la Peyronie F: Sur quelques obstacles qui s’opposent à l’éjaculation naturelle de la semence. Mem Acad Roy Chir. 1743:1:425.
• Rosen R, Catania J, Lue T, et al. Impact of Peyronie's disease on sexual and psychosocial functioning: qualitative findings in patients and controls. J Sex Med. 2008;5(8):1977-1984. doi:10.1111/j.1743-6109.2008.00883.x
• Ziegelmann MJ, Trost LW, Russo GI, Levine LA. Peyronie's disease intervention studies: an exploration of modern-era challenges in study design and evaluating treatment outcomes. J Sex Med. 2020;17(3):364-377. doi:10.1016/j.jsxm.2019.11.271
• Smith JF, Walsh TJ, Conti SL, Turek P, Lue T. Risk factors for emotional and relationship problems in Peyronie's disease. J Sex Med. 2008;5(9):2179-2184. doi:10.1111/j.1743-6109.2008.00949.x
• Akkus E, Kadioglu A, Esen A, et al. Prevalence and correlates of erectile dysfunction in Turkey: a population-based study. Eur Urol. 2002;41(3):298-304. doi:10.1016/s0302-2838(02)00027-1
• Levine LA, Lenting EL. A surgical algorithm for the treatment of Peyronie's disease. J Urol. 1997;158(6):2149-2152. doi:10.1016/s0022-5347(01)68184-9
• Levine LA, Larsen SM. Surgery for Peyronie's disease. Asian J Androl. 2013;15(1):27-34. doi:10.1038/aja.2012.92
• Akkus E, Ozkara H, Alici B, et al. Incision and venous patch graft in the surgical treatment of penile curvature in Peyronie's disease. Eur Urol. 2001;40(5):531-537. doi:10.1159/000049831
• Ainayev Y, Zhanbyrbekuly U, Gaipov A, et al. Comparison of Technical Success and Adverse Events of Plaque Incision and grafting methods in patients with peyronie's disease: tunica vaginalis versus buccal mucosa. Urology. 2022;170:226-233. doi:10.1016/j.urology.2022.07.063
• Ainayev Y, Zhanbyrbekuly U, Gaipov A, et al. Surgical reconstruction of penile curvature due to Peyronie's disease by plaque incision and buccal mucosa graft. J Sex Med. 2021;18(7):1308-1316. doi:10.1016/j.jsxm.2021.04.009
• Cormio L, Mancini V, Massenio P, et al. Combined plaque incision, buccal mucosa grafting, and additional tunica albuginea plication for peyronie's disease. Sex Med. 2019;7(1):48-53. doi:10.1016/j.esxm.2018.11.002
• Chow AK, Sidelsky SA, Levine LA. Surgical outcomes of plaque excision and grafting and supplemental tunica albuginea plication for treatment of peyronie's disease with severe compound curvature. J Sex Med. 2018;15(7):1021-1029. doi:10.1016/j.jsxm.2018.04.642
• Barrett-Harlow B, Clavell-Hernandez J, Wang R. New Developments in surgical treatment for penile size preservation in Peyronie's disease. Sex Med Rev. 2019;7(1):156-166. doi:10.1016/j.sxmr.2018.07.001
• .Egydio PH, Kuehhas FE, Sansalone S. Penile length and girth restoration in severe Peyronie's disease using circular and longitudinal grafting. BJU Int. 2013;111(4 Pt B):E213-E219. doi:10.1111/j.1464-410X.2012.11582.x
• Tahra A, Küçük EV, İnkaya A. Peyroni hastalığının hafif ve orta şiddetli kurvatür tedavisinde plikasyon ve greftleme cerrahisi ile sonuçlarımız. Androl Bul. 2017;19:6-9. https://doi.org/10.24898/ tandro.2017.46547.
• Başer A, Çelen S, Bütün S, et al. Peyroni cerrahisinde hasta memnuniyetine etki eden faktörler. Pam Tıp Derg. 2020;13(3):705-713.