Intraoperative Decision-making for Precise Penile Straightening During Inflatable Penile Prosthesis Surgery - 19/11/15

Abstract |
Objective |
To present a novel algorithm for definitive reconstruction of penile curvature in men undergoing inflatable penile prosthesis (IPP) surgery as an alternative to manual penile modeling and grafting procedures.
Methods |
Patients with erectile dysfunction and concomitant penile curvature undergoing IPP placement were divided into 2 treatment groups: (1) group 1, penile deformity known preoperatively, and (2) group 2, penile curvature recognized intraoperatively after IPP placement. Group 1 patients underwent penile plication after artificial erection and immediately before IPP insertion via the same penoscrotal incision, whereas group 2 patients were treated with a Yachia (Heineke-Mikulicz) corporoplasty over the intact cylinders. Patients completed postoperative Patient Global Impression of Improvement (PGI-I) questionnaires assessing overall satisfaction.
Results |
Among 405 men receiving IPP at our institution from 2007 to 2014, 30 patients received synchronous correction of penile curvature (7%). Group 1 included 23 of 30 (77%) patients, and 7 of 30 (23%) were in group 2. Overall mean initial curvature was 36°, and all patients were corrected to <10°. Average operative times were 18 minutes longer compared with patients who underwent IPP placement alone (82 vs 64 minutes, P <.05). At an average follow-up of 13 months (range 7-32), 19 of 20 (95%) group 1 and 6 of 7 (86%) group 2 patients who completed surveys reported an improved overall condition. No patient reported chronic pain, recurrent deformity, or device malfunction.
Conclusion |
Penile curvature can be safely and reliably corrected at the time of IPP placement, regardless of whether the deformity was identified preoperatively.
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| Financial Disclosure: Timothy J. Tausch is a consultant to American Medical Systems and Coloplast Corp. Jordan A. Siegel is a consultant to American Medical Systems. Allen F. Morey is a consultant to and a meeting participant and lecturer for American Medical Systems and Coloplast Corp. The remaining authors declare that they have no relevant financial interests. |
Vol 86 - N° 5
P. 1048-1052 - novembre 2015 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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