PD48-10 MUST: MULTIPLE SLICE TECHNIQUE FOR PENILE LENGTHENING AND WIDENING WITHOUT GRAFTING DURING PENILE PROSTHESIS INSERTION

Abstract

You have accessJournal of UrologySexual Function/Dysfunction/Andrology: Peyronie's Disease1 Apr 2015PD48-10 MUST: MULTIPLE SLICE TECHNIQUE FOR PENILE LENGTHENING AND WIDENING WITHOUT GRAFTING DURING PENILE PROSTHESIS INSERTION Paulo Egydio, Franklin Kuehhas, and Robert Valenzuela Paulo EgydioPaulo Egydio More articles by this author , Franklin KuehhasFranklin Kuehhas More articles by this author , and Robert ValenzuelaRobert Valenzuela More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2767AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The resulting loss of penile length and girth due to Peyronie's disease (PD) is typically ignored, as the primary surgical focus is limited to the correction of the penile axis. In addition to PD, penile shortening may be caused by certain medical conditions and surgical procedures as well. Data show that reduction in penile length and girth as well as inability to have sexual intercourse lead to severe emotional problems, dissatisfaction, and decreased quality of life in a high percentage of men. Patients with severe ED and significant penile shortening with or without PD are candidates for more aggressive surgical procedures beyond routine penile prosthesis insertion. The purpose of this study is to present a modification of the so called “sliding technique” for the restoration of penile length and girth for patients suffering from penile shortening and erectile dysfunction. METHODS Between January 2013 and May 2014, 223 patients underwent our modified “sliding technique” for penile length and girth restoration with concomitant penile prosthesis implantation without any graft. Malleable penile prostheses were used in 207 patients and inflatable penile prostheses were inserted in 16 patients. All patients had severe ED associated with penile shortening with or without penile curvature. RESULTS • THE mean age at the time of surgery was 58 years (range, 40- 81). • The etiology of penile shortening and narrowing were: Peyronie's disease; post radical prostatectomy, post radiotherapy; post intracavernous injection therapy; post penile fracture; post redo-hypospadias repair and post priapism • Mean deviation of the penile axis was 50° (range, 0- 100). • Postoperative hematoma on the base of the penile shaft and laminar superficial hematoma on the pubic area were seen in 27% and in the majority of the cases respectively. However absorption was seen within 2 to 3 weeks without any additional drainage. • Temporary partial glans numbness was reported in 6%, however it vanished with the course of the follow-up. • Glans sensitivity, ability to achieve orgasm and ejaculation were preserved. • The penile axis was straightened in all cases. • Our approach led to a mean penile length gain of 3.1 cm (range, 2-7). • All patients resumed sexual intercourse and were able to perform satisfactory sexual intercourse. No penile prosthesis infection was observed. CONCLUSIONS The MUST technique is safe and effective and is associated with reduced operative times, less cost and low infection rate. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e969-e970 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Paulo Egydio More articles by this author Franklin Kuehhas More articles by this author Robert Valenzuela More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...