The psychosocial impact of penile reconstructive surgery for congenital penile deviation.
BACKGROUND
A variety of surgical techniques to correct congenital penile deviation (CPD) have been described. Although surgical outcomes have been reported, the impact of this treatment on sexual relationship, confidence, self-esteem, and sexual function has never been established.


OBJECTIVE
To assess the impact of surgical treatment for CPD on sexual relationship, confidence, self-esteem, and sexual function, employing validated instruments.


METHODS
The Self-Esteem and Relationship (SEAR) and International Index of Erectile Function (IIEF) questionnaires.


METHODS
Prospective, longitudinal, uncontrolled study of 32 men undergoing penile reconstructive surgery for CPD. Assessment of change in sexual relationship, confidence, self-esteem, and sexual function scores.


RESULTS
Twenty (37.5%) patients had ventral and 12 (62.5%) had lateral curvature, mean magnitude was 37 +/- 12 degrees . Significant improvement in SEAR domains scores was observed in sexual relationship (82 vs. 40, P < 0.01), overall relationship (86 vs. 62, P < 0.01), and confidence (88 vs. 58, P < 0.001). While mean IIEF erectile function domain score was unchanged: 24 +/- 3.6 and 25 +/- 2.5, before and after surgery, respectively (P = 0.85), significant improvements were observed in the libido (8 vs. 5, P = 0.02) and satisfaction (22 vs. 15, P < 0.01) domains of the IIEF. Predictors of improvement in SEAR and IIEF scores were perceived complete straightening and penile length preservation.


CONCLUSIONS
Penile reconstructive surgery for CPD is associated with significant improvements in overall relationship, sexual relationship, confidence, libido, and satisfaction, as reflected by higher scores in three of the four domains of the SEAR questionnaire and improvements in two of the four domains of the IIEF.
Tal
Raanan
R
Department of Surgery, Male Sexual & Reproductive Medicine Program, Urology Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
Nabulsi
Omar
O
Nelson
Christian J
CJ
Mulhall
John P
JP
D000293:Adolescent; D005783:Gender Identity; D006801:Humans; D007398:Interpersonal Relations; D007989:Libido; D008137:Longitudinal Studies; D008297:Male; D010410:Penile Erection / Q000523:psychology; D010411:Penile Induration / Q000151:congenital / Q000523:psychology* / Q000601:surgery*; D010413:Penis / Q000002:abnormalities* / Q000601:surgery*; D010549:Personal Satisfaction; D010555:Personality Inventory; D011446:Prospective Studies; D012649:Self Concept; D012725:Sexual Behavior; D055815:Young Adult