Intraoperative Decision-making for Precise Penile Straightening During Inflatable Penile Prosthesis Surgery.
Urology
; 86(5): 1048-52, 2015 Nov.
Article
em En
| MEDLINE
| ID: mdl-26190086
ABSTRACT
OBJECTIVE:
To present a novel algorithm for definitive reconstruction of penile curvature in men undergoing inflatable penile prosthesis (IPP) surgery as an alternative to manual penile modeling and grafting procedures.METHODS:
Patients with erectile dysfunction and concomitant penile curvature undergoing IPP placement were divided into 2 treatment groups (1) group 1, penile deformity known preoperatively, and (2) group 2, penile curvature recognized intraoperatively after IPP placement. Group 1 patients underwent penile plication after artificial erection and immediately before IPP insertion via the same penoscrotal incision, whereas group 2 patients were treated with a Yachia (Heineke-Mikulicz) corporoplasty over the intact cylinders. Patients completed postoperative Patient Global Impression of Improvement (PGI-I) questionnaires assessing overall satisfaction.RESULTS:
Among 405 men receiving IPP at our institution from 2007 to 2014, 30 patients received synchronous correction of penile curvature (7%). Group 1 included 23 of 30 (77%) patients, and 7 of 30 (23%) were in group 2. Overall mean initial curvature was 36°, and all patients were corrected to < 10°. Average operative times were 18 minutes longer compared with patients who underwent IPP placement alone (82 vs 64 minutes, P <.05). At an average follow-up of 13 months (range 7-32), 19 of 20 (95%) group 1 and 6 of 7 (86%) group 2 patients who completed surveys reported an improved overall condition. No patient reported chronic pain, recurrent deformity, or device malfunction.CONCLUSION:
Penile curvature can be safely and reliably corrected at the time of IPP placement, regardless of whether the deformity was identified preoperatively.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pênis
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Prótese de Pênis
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Procedimentos de Cirurgia Plástica
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Disfunção Erétil
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Cuidados Intraoperatórios
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
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Guideline
/
Incidence_studies
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Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Urology
Ano de publicação:
2015
Tipo de documento:
Article