The outcomes of pics technique for the management of end-stage peyronie's disease

Abstract

To present the surgical, the functional and patients’ reported outcomes (PROs) of PICS technique in multicentric series of patients affected by end-stage PD. Patients underwent an IPP implantation followed by PICS technique were recruited in two European tertiary referral center. The primary endpoint of the study was the achievement of a complete straightening of the penis. The secondary endpoints were surgical, functional and PROs. The International Index of Erectile Function (IIEF-5), the Sexual Encounter profile questions 2 and 3 (SEP 2 and SEP 3) and the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) were used to assess patients’ erectile function. The PICS technique was used in 37 patients. Median patient age was 62 years (IQR 57-70 years). Residual curvature after IPP was 60° (IQR 50–70°). Operative time was 100 minutes (IQR 90–120). Median follow-up resulted of 14 months (IQR 12–17). 27 of 37 patients (72.9%) achieved a totally straight penis. 6 patients (16.2 %) experienced a residual penile curvature: of 10° in 3 patients, 15° in 1 patient and 20° in 2 patients. The residual curvature did not interfere with sexual intercourse in any of the cases. No intraoperative complications were detected. 9 of 37 patients (24.3%) developed an early postoperative complications: 3 (8.1%) manifested a transient fever and 6 (16.2%) experienced a genital hematoma. We detected a single case (2.7%) of acute infection requiring a removal of the IPP. No cases of IPP mechanical failure were described. Median IIEF-5 score increased from 10 (8-12) in postoperative settings to 23.5 (22.2-25) at 12 months follow-up. SEP 2-3 increased from 5 (13.5%) and 0 (0%) to 34 (91.9) in both domains. EDITS scored 25 (21.2-29.5) at 12 months follow-up. The PICS technique represents a safe and effective approach to manage residual penile curvature during IPP placement in patients with end-stage PD. None