A novel modification of tunical plication by plaque thinning: long-term results in treating penile curvature of Peyronie's disease

Abstract

Objective: To investigate the efficacy of a novel modified tunical plication procedure in correcting penile curvature of patients with Peyronie's disease.

Methods: Penile tunical plication was performed, combined with plaque thinning with carbide burs, and 18 patients were available for a long-term follow-up. Preoperative deformity and erectile capacity were accessed, and postoperative cosmetic and functional results were evaluated by physical examination, subjective satisfaction rate, and International Index of Erectile Function-5 questionnaire (IIEF-5).

Results: During the initial assessment after 6 months since surgery, complete straightening was achieved in 83.3% patients, and the residual curvatures in the three patients were within 20°. Satisfaction rate was 94.4% while one patient was partly dissatisfied with penile shortening, although the penile shortening occurred in 66.7% patients. No de novo erectile dysfunction was observed, and sexual function was significantly improved with the IIEF-5 scores increasing from 17.3 ± 4.1 to 20.9 ± 3.3 (P = 0.008). After a mean of 50.5-month follow-up (range from 29 to 72 months), although 22.2% patients reported curvature recurrence, neither the recurrence nor the penile shortening affected coitus, and 100% patients were satisfied with the results of the operation.

Conclusions: The plication procedure modified by plaque thinning with carbide burs is safe and effective in treating penile deformity due to Peyronie's disease, which characterized in improving the life quality of patients.