COMPARISON OF PATIENT'S SATISFACTION AND LONG TERM RESULTS OF TWO PLICATION TECHNIQUES: LESSONS LEARNED FROM 387 PATIENTS WITH PENILE CURVATURE
The aim of the study was to compare the patient&[prime]s satisfaction and long-term results of two plication techniques in patients with penile curvature.
The study included 387 patients who underwent surgical correction of penile curvature with penile plication in three tertiary university hospitals. Of the patients, 260 had congenital penile curvature, and 127 had Peyronie&[prime]s disease. Related to the surgical procedure, 202 patients underwent plication of tunica albuginea with Lue&[prime]s sixteen-dot technique, while 185 patients underwent tunica albuginea excision with traditional Nesbit technique. Surgical outcomes and patient&[prime]s satisfaction were compared between the two techniques in all patients.
The mean age and follow-up period of the patients were 34 years (range 16 to 81) and 41 months (range 6 to 144), respectively. The mean angle of deformity was 42 degrees (range 30 to 80). The rates of early complications, including superficial wound infection, hematoma and urethral injury were similar and very low in the both techniques. Mean duration of surgery was significantly shorter in the 16-dot plication technique (48 minutes), compared with the Nesbit technique (63 minutes) (p=0.001). Outcomes of the two surgical procedures are shown in the table, regardless of their etiology of penile curvature. The rates of penile sensory loss and de-novo erectile dysfunction were significantly higher in the Nesbit technique than in the 16-dot plication technique, but rate of palpable bumps or knots under the penile skin was significantly higher in the 16-dot plication technique than in the Nesbit technique. Regardless of the surgical techniques, the patients with congenital penile curvature had significantly less postoperative de-novo erectile dysfunction than Peyronie&[prime]s disease patients.
Overall, both surgical techniques have very high success and satisfaction rates with very low complication rates. However, the types of complications are significantly different between the two surgical procedures. Therefore, patients with penile curvature should be informed about surgical outcomes, and surgical method for penile curvature should be preferred based on surgeon&[prime]s experience and patient&[prime]s preference.