MP67-17 PLICATION FOR SEVERE PEYRONIE'S DEFORMITIES HAS SIMILAR OUTCOMES TO MILD CASES

Abstract

You have accessJournal of UrologySexual Function/Dysfunction: Peyronie's Disease I1 Apr 2018MP67-17 PLICATION FOR SEVERE PEYRONIE'S DEFORMITIES HAS SIMILAR OUTCOMES TO MILD CASES Rohit Reddy, Maxim McKibben, Nabeel Shakir, Joceline Fuchs, Jeremy Scott, and Allen Morey Rohit ReddyRohit Reddy More articles by this author , Maxim McKibbenMaxim McKibben More articles by this author , Nabeel ShakirNabeel Shakir More articles by this author , Joceline FuchsJoceline Fuchs More articles by this author , Jeremy ScottJeremy Scott More articles by this author , and Allen MoreyAllen Morey More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2201AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Although penile plication (PP) is an effective and common treatment for mild to moderate Peyronie′s Disease (PD), scant data exists on outcomes of PP for severe or complex deformities. We compared long-term PP outcomes among severe and mild PD patients in our large single surgeon experience. METHODS We performed a retrospective review of patients who underwent PP for PD between 2009-2017. All patients had multiple parallel tunical plication without degloving via a longitudinal penile incision regardless of curvature severity. Severe PD was defined as either ≥60°, biplanar curvature, or hourglass deformity. Patient demographics and surgical outcomes were analyzed. A modified Peyronie′s Disease Questionnaire (PDQ) and International Index of Erectile Function (IIEF-5) were administered by phone. Success was defined as improvement in sexual function. Additionally, 30 PP patients with mild to moderate curvature were contacted as a comparator group. RESULTS Of 379 PP patients, 225 (59‰) had severe/bidirectional curvature, 54 (24‰) of whom responded to phone survey at a median follow-up of 38 months. Mean preoperative curvature was 68.3°, which was corrected to a mean of 9.5°, using an average of 9.4 plication sutures (range 4-25). Comparing severe PD to the mild PD group (mean curve 40°), similar proportions of patients reported improvement of penile curvature (77.8‰ v 73.3‰, p=0.7), improvement in sexual function (50‰ v 46.7‰, p=0.9), and penile shortening (55.6‰ v 76.7‰, p=0.16), though only two severe patients (3.7‰) had decreased stretched penile length measured intraoperatively. IIEF-5 was similar between the groups preoperatively (19.5 v 18.7, p=0.5), and slightly decreased in the mild group postoperatively (19.7 v 16.0, p=0.015). PDQ metrics including difficulty inserting penis and pain with erections and intercourse were the same between severe and mild patients (p>0.1). On multivariate logistic regression, independent predictors of improved sexual function were younger age (OR 0.85, IQR 0.75-0.96, p=0.003), and greater angle of correction (OR 1.09, IQR 1.01-1.17, p=0.007). CONCLUSIONS PP for surgical correction of severe PD is effective, with similar PROs compared to patients with milder disease. Similarities in PDQ and IIEF between simple and complex groups suggests broader application of PP beyond mild cases. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e913-e914 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Rohit Reddy More articles by this author Maxim McKibben More articles by this author Nabeel Shakir More articles by this author Joceline Fuchs More articles by this author Jeremy Scott More articles by this author Allen Morey More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...