Inflatable Penile Prosthesis Placement, Scratch Technique and Postoperative Vacuum Therapy as a Combined Approach to Definitive Treatment of Peyronie's Disease

Gabriele Antonini, Ettore De Berardinis, Francesco Del Giudice, Gian Maria Busetto, Stefano Lauretti, Ramiro Fragas, Benjamin I. Chung, Simon L. Conti, Diana Giannarelli, Isabella Sperduti, Martin S. Gross, Paul E. Perito

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Peyronie's disease is a devastating condition resulting in penile malformation, erectile dysfunction, pain and emotional distress. In this prospective, 2 institution study we evaluated a multimodal surgical and mechanical combined approach to the definitive treatment of Peyronie's disease and concomitant erectile dysfunction. Materials and Methods: A total of 145 select patients underwent endocavernous disruption of Peyronie's disease plaques via the scratch technique, followed by inflatable penile prosthesis insertion. Postoperatively patients were assigned to vacuum device therapy for 3 minutes twice daily to continue penile curvature correction. Followup continued for 1 year after surgery. Anatomical and functional results were assessed. Results: Patients with plaques in the proximal third, middle third and subcoronal areas of the penis had a mean ± SD postoperative residual curvature of 21.5 ± 4.5, 17.3 ± 4.8 and 14.1 ± 3.1 degrees, respectively. After 24 weeks of vacuum therapy the mean penile curvature deviation decreased to 8.7 ± 2.5, 9.1 ± 2.9 and 7.7 ± 0.9 degrees, respectively. The mean IIEF-5 (International Index of Erectile Function) score was 9.8 ± 2.3 preoperatively, 18.9 ± 3.1 at 6 months (p <0.001) and 24.1 ± 3.6 at 1 year (p <0.001). The mean EDITS (Erectile Dysfunction Inventory of Treatment Satisfaction) score at the end of followup was 64.6 ± 11.8. Operative and postoperative complications were minimal. Conclusions: Our novel combination of intraoperative and postoperative therapies in the treatment of patients with Peyronie's disease and an inflatable penile prosthesis was safe and efficacious with excellent functional outcomes. Penile curvature corrections were statistically significant and complications were negligible.

Original languageEnglish
Pages (from-to)642-647
Number of pages6
JournalJournal of Urology
Volume200
Issue number3
DOIs
Publication statusPublished - Sep 1 2018

Keywords

  • male
  • patient reported outcome measures
  • penile induration
  • penile prosthesis
  • tissue expansion devices
  • urologic surgical procedures

ASJC Scopus subject areas

  • Urology

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