Abstract
Objective: To assess patient satisfaction with surgical outcome, body related self-perceptions, self-attitudes of sexuality, and health related quality of life after penile surgery with small intestinal submucosa (SIS) grafting for the treatment of severe Peyronie’s disease (PD). Material and methods: This retrospective study included 82 patients, who were treated with SIS grafting for severe PD between 2009 and 2013 at the University Medical Center Hamburg-Eppendorf. Patients were asked to complete standardized questionnaires including the International Index of Erectile Function Erectile Function domain (IIEF-EF), Short-Form (SF)-8 Health Survey, and Frankfurt Body Concept Scale-Sexuality (FKKS-SEX). Results: Follow-up was available in 58 (69.9%) patients. SIS grafting resulted in subjective straightening of the penis in 53 (91.3%) patients. After a mean follow-up of 28.9 ± 16.5 months, 24 (41.4%) patients were satisfied or very satisfied with surgical outcome. Postoperatively, the mean FKKS-SEX was 23.5 ± 5.9. In total, 36 (62.1%), 18 (31%), and four (6.9%) patients had FKKS-SEX scores corresponding to positive, neutral, and negative self-perception and self-attitude of sexuality, respectively. The mean postoperative SF-8 was 15.2 ± 6.4. Compared to the mean for German controls, patients achieved lower mean scores in the domains social functioning (50.4 ± 7.1), mental health (49.5 ± 9.2), and emotional roles (48.5 ± 6.8). Subjective shortening of the penis (Odds ratio (OR): 2.0), negative body related self-perceptions, and self-attitudes of sexuality (OR: 3.6) as well as IIEF-EF score (OR: 0.9) were risk factors for patient dissatisfaction (p-values ≤ 0.02). Conclusion: A relevant number of patients is not satisfied with surgical outcome after SIS grafting for the treatment of severe PD. Subjective shortening of the penis, negative body related self-perceptions, and self-attitudes of sexuality as well as IIEF-EF score were risk factors for patient dissatisfaction.
Highlights
Peyronie’s disease (PD) is a chronic connective tissue disorder of the tunica albuginea of the corpora cavernosa of the penis, and may cause relevant penile pain, penile plaque formation, and loss of penile length, as well as deformity and curvature of the penis [1]
There have been few published studies on small intestinal submucosa (SIS) grafting for PD, and these studies have primarily focused on surgical outcome and complications [8,9,10,11], whereas patient reported treatment satisfaction has been considered in the minority of studies [12,13,14,15,16]
We found that 41% of patients were satisfied, whereas almost 45% of patients were not satisfied with outcome following surgery, SIS grafting resulted in complete straightening of the penis in more than 90% of patients
Summary
Peyronie’s disease (PD) is a chronic connective tissue disorder of the tunica albuginea of the corpora cavernosa of the penis, and may cause relevant penile pain, penile plaque formation, and loss of penile length, as well as deformity and curvature of the penis [1]. Surgical treatment is performed to correct penile deformity and penile curvature, with the aim to enable patients to have sexual intercourse. This represents the standard therapy in the stable phase of severe PD [5]. There have been few published studies on SIS grafting for PD, and these studies have primarily focused on surgical outcome and complications [8,9,10,11], whereas patient reported treatment satisfaction has been considered in the minority of studies [12,13,14,15,16]. Patient self-perceptions and attitudes of sexuality following SIS grafting have not been investigated so far
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