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Inflatable Penile Prosthesis Placement, Scratch Technique and Postoperative Vacuum Therapy as a Combined Approach to Definitive Treatment of Peyronie’s Disease

2018; Lippincott Williams & Wilkins; Volume: 200; Issue: 3 Linguagem: Inglês

10.1016/j.juro.2018.04.060

1527-3792

Gabriele Antonini, Ettore De Berardinis, Francesco Del Giudice, Gian Maria Busetto, Stefano Lauretti, Ramiro Fragas, Benjamin I. Chung, Simon Conti, Diana Giannarelli, Isabella Sperduti, Martin Gross, Paul Perito,

Pelvic floor disorders treatments

No AccessJournal of UrologyAdult Urology1 Sep 2018Inflatable Penile Prosthesis Placement, Scratch Technique and Postoperative Vacuum Therapy as a Combined Approach to Definitive Treatment of Peyronie's Disease Gabriele Antonini, Ettore De Berardinis, Francesco Del Giudice, Gian Maria Busetto, Stefano Lauretti, Ramiro Fragas, Benjamin I. Chung, Simon L. Conti, Diana Giannarelli, Isabella Sperduti, Martin S. Gross, and Paul E. Perito Gabriele AntoniniGabriele Antonini Department of Urology, Sapienza Rome University, Policlinico Umberto I, Rome, Italy , Ettore De BerardinisEttore De Berardinis Department of Urology, Sapienza Rome University, Policlinico Umberto I, Rome, Italy , Francesco Del GiudiceFrancesco Del Giudice Department of Urology, Sapienza Rome University, Policlinico Umberto I, Rome, Italy , Gian Maria BusettoGian Maria Busetto Department of Urology, Sapienza Rome University, Policlinico Umberto I, Rome, Italy , Stefano LaurettiStefano Lauretti Department of Urology, Santa Caterina della Rosa Clinic ASL RM-C, Rome, Italy , Ramiro FragasRamiro Fragas Clinica Central Cira Garcia, La Havana, Cuba , Benjamin I. ChungBenjamin I. Chung Department of Urology, Stanford University Medical Center, Stanford, California , Simon L. ContiSimon L. Conti Department of Urology, Stanford University Medical Center, Stanford, California , Diana GiannarelliDiana Giannarelli Biostatistical Unit, Regina Elena National Cancer Institute, Rome, Italy , Isabella SperdutiIsabella Sperduti Biostatistical Unit, Regina Elena National Cancer Institute, Rome, Italy , Martin S. GrossMartin S. Gross Section of Urology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire , and Paul E. PeritoPaul E. Perito Department of Urology, Coral Gables Hospital, Coral Gables, Florida View All Author Informationhttps://doi.org/10.1016/j.juro.2018.04.060AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Peyronie's disease is a devastating condition resulting in penile malformation, erectile dysfunction, pain and emotional distress. In this prospective, 2 institution study we evaluated a multimodal surgical and mechanical combined approach to the definitive treatment of Peyronie's disease and concomitant erectile dysfunction. Materials and Methods: A total of 145 select patients underwent endocavernous disruption of Peyronie's disease plaques via the scratch technique, followed by inflatable penile prosthesis insertion. Postoperatively patients were assigned to vacuum device therapy for 3 minutes twice daily to continue penile curvature correction. Followup continued for 1 year after surgery. Anatomical and functional results were assessed. Results: Patients with plaques in the proximal third, middle third and subcoronal areas of the penis had a mean ± SD postoperative residual curvature of 21.5 ± 4.5, 17.3 ± 4.8 and 14.1 ± 3.1 degrees, respectively. After 24 weeks of vacuum therapy the mean penile curvature deviation decreased to 8.7 ± 2.5, 9.1 ± 2.9 and 7.7 ± 0.9 degrees, respectively. The mean IIEF-5 (International Index of Erectile Function) score was 9.8 ± 2.3 preoperatively, 18.9 ± 3.1 at 6 months (p <0.001) and 24.1 ± 3.6 at 1 year (p <0.001). The mean EDITS (Erectile Dysfunction Inventory of Treatment Satisfaction) score at the end of followup was 64.6 ± 11.8. Operative and postoperative complications were minimal. Conclusions: Our novel combination of intraoperative and postoperative therapies in the treatment of patients with Peyronie's disease and an inflatable penile prosthesis was safe and efficacious with excellent functional outcomes. Penile curvature corrections were statistically significant and complications were negligible. © 2018 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails References 1 : An analysis of the natural history of Peyronie's disease. J Urol2006; 175: 2115. Link, Google Scholar 2 : The prevalence of Peyronie's disease in the United States: a population-based study. 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Volume 200Issue 3September 2018Page: 642-647Supplementary Materials Advertisement Copyright & Permissions© 2018 by American Urological Association Education and Research, Inc.Keywordspatient reported outcome measurestissue expansion devicesmaleurologic surgical procedurespenile prosthesispenile indurationMetrics See more details Twitter (13) Facebook (1) Mendeley (20) Author Information Gabriele Antonini Department of Urology, Sapienza Rome University, Policlinico Umberto I, Rome, Italy More articles by this author … View all authors Expand All Advertisement PDF downloadLoading ...