Salvage penile curvature correction surgery.
It is commonly believed that coarser suture materials should be used to provide sufficient tenacity in surgery for penile curvature correction. We report our 15-year experience of fine sutures in a second operation in 31 patients who underwent prior curvature correction elsewhere with coarser sutures, resulting in recurrent penile curvature. Suture materials used in prior surgeries in these patients were either 2-0 or 3-0 nylon sutures. In this series, all 31 patients underwent a modified Nesbit procedure at the level of the collagen bundles using finer sutures. Prior to July 1998, 10 men underwent salvage surgery using 4-0 polyglactin sutures. Thereafter, we adapted 6-0 nylon sutures for another 21 patients. We categorized the patients into the polyglactin (n = 10) and nylon (n = 21) groups respectively. Overall, 29 patients were available for follow-up while using the abridged 5-item version of the International Index of Erectile Function (IIEF-5) scoring system, with 21 patients in the nylon group. We have found cavernosography a practical and reliable method to objectively assess penile morphology in these patients. The penile morphology both subjectively and objectively was excellent in all patients, except for 1 in each group. Erectile function restoration showed a trend of satisfaction in the polyglactin group and based on IIEF-5 was significantly improved in the nylon group (14.2 ± 3.6 vs 21.9 ± 2.1, n = 20, P < .001). These results suggest that in penile tunical surgery, fine sutures such as 6-0 nylon may result in better penile morphology and functional outcomes.
Hsieh
Cheng-Hsing
CH
Buddhist Tzu Chi General Hospital, Taipei Branch, Taipei, Taiwan.
Chen
Heng-Shuen
HS
Lee
Wen-Yuan
WY
Chen
Kuo-Liang
KL
Chang
Chao-Hsiang
CH
Hsu
Geng-Long
GL
D000328:Adult; D003094:Collagen / Q000648:ultrastructure; D005832:Genital Diseases, Male / Q000601:surgery; D006801:Humans; D008297:Male; D009757:Nylons; D010410:Penile Erection; D010413:Penis / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D011098:Polyglactin 910; D011859:Radiography; D013536:Suture Techniques; D013537:Sutures; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*
D009757:Nylons; D011098:Polyglactin 910; D003094:Collagen