Surgical correction of Peyronie's disease via tunica albuginea plication or partial plaque excision with pericardial graft: long-term follow up.
BACKGROUND
Limited publications exist regarding long-term outcomes of surgical correction for Peyronie's Disease (PD).


OBJECTIVE
To report on long-term postoperative parameters including rigidity, curvature, length, sensation, function, and patient satisfaction in men with PD treated surgically via Tunica Albuginea Plication (TAP) or Partial Plaque Excision with Tutoplast Human Pericardial Grafting (PEG).


METHODS
Objective and subjective data regarding patients who underwent either TAP or PEG.


METHODS
We report on 142 patients (61 TAP and 81 PEG) with both objective data and subjective patient reports on their postoperative experience. Patients underwent either TAP or PEG following our previously published algorithm. Data was collected via chart review and an internally generated survey, in which patients were asked about their rigidity, straightness, penile length, sensation, sexual function and satisfaction.


RESULTS
Average follow up for TAP patients was 72 months (range 8-147) and 58 months (range 6-185) for PEG patients. At survey time, 93% of TAP and 91% of PEG patients reported curvatures of less than 30o. Rigidity was reportedly as good as or better than preoperative in 81% of TAP and 68% of PEG patients, and was adequate for coitus in 90% of TAP and 79% of PEG patients with or without the use of PDE5i. Objective flaccid stretched penile length measurements obtained pre and postoperatively show an average overall length gain of 0.6 cm (range -3.5-3.5) for TAP and 0.2 cm (range -1.5-2.0) for PEG patients. Sensation was reportedly as good as or better than preoperative in 69% of both TAP and PEG patients; 98% of TAP patients and 90% of PEG are able to achieve orgasm. 82% of TAP patients and 75% of PEG patients were either very satisfied or satisfied.


CONCLUSIONS
Our long-term results support both TAP and PEG as durable surgical therapy for men with clinically significant PD.
Taylor
Frederick L
FL
Department of Urology, Rush University Medical Center, Chicago, IL, USA. Frederick_Taylor@rush.edu
Levine
Laurence A
LA
D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010410:Penile Erection / Q000502:physiology; D010411:Penile Induration / Q000000981:diagnostic imaging / Q000601:surgery*; D010413:Penis / Q000000981:diagnostic imaging / Q000601:surgery*; D010496:Pericardium / Q000637:transplantation; D011183:Postoperative Complications / Q000209:etiology; D013536:Suture Techniques; D018616:Ultrasonography, Doppler, Duplex