Intraoperative Decision-making for Precise Penile Straightening During Inflatable Penile Prosthesis Surgery

Timothy J. Tausch, Paul H. Chung, Jordan A. Siegel, Louise Gliga, Alexandra K. Klein, Allen F. Morey

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

OBJECTIVE: To present a novel algorithm for definitive reconstruction of penile curvature in men undergoing inflatable penile prosthesis (IPP) surgery as an alternative to manual penile modeling and grafting procedures.

METHODS: Patients with erectile dysfunction and concomitant penile curvature undergoing IPP placement were divided into 2 treatment groups: (1) group 1, penile deformity known preoperatively, and (2) group 2, penile curvature recognized intraoperatively after IPP placement. Group 1 patients underwent penile plication after artificial erection and immediately before IPP insertion via the same penoscrotal incision, whereas group 2 patients were treated with a Yachia (Heineke-Mikulicz) corporoplasty over the intact cylinders. Patients completed postoperative Patient Global Impression of Improvement (PGI-I) questionnaires assessing overall satisfaction.

RESULTS: Among 405 men receiving IPP at our institution from 2007 to 2014, 30 patients received synchronous correction of penile curvature (7%). Group 1 included 23 of 30 (77%) patients, and 7 of 30 (23%) were in group 2. Overall mean initial curvature was 36°, and all patients were corrected to < 10°. Average operative times were 18 minutes longer compared with patients who underwent IPP placement alone (82 vs 64 minutes, P <.05). At an average follow-up of 13 months (range 7-32), 19 of 20 (95%) group 1 and 6 of 7 (86%) group 2 patients who completed surveys reported an improved overall condition. No patient reported chronic pain, recurrent deformity, or device malfunction.

CONCLUSION: Penile curvature can be safely and reliably corrected at the time of IPP placement, regardless of whether the deformity was identified preoperatively.

Original languageEnglish (US)
Pages (from-to)1048-1052
Number of pages5
JournalUrology
Volume86
Issue number5
DOIs
StatePublished - Nov 1 2015

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Penile Prosthesis
Decision Making
Erectile Dysfunction
Operative Time
Chronic Pain

ASJC Scopus subject areas

  • Urology

Cite this

Intraoperative Decision-making for Precise Penile Straightening During Inflatable Penile Prosthesis Surgery. / Tausch, Timothy J.; Chung, Paul H.; Siegel, Jordan A.; Gliga, Louise; Klein, Alexandra K.; Morey, Allen F.

In: Urology, Vol. 86, No. 5, 01.11.2015, p. 1048-1052.

Research output: Contribution to journalArticle

Tausch, Timothy J. ; Chung, Paul H. ; Siegel, Jordan A. ; Gliga, Louise ; Klein, Alexandra K. ; Morey, Allen F. / Intraoperative Decision-making for Precise Penile Straightening During Inflatable Penile Prosthesis Surgery. In: Urology. 2015 ; Vol. 86, No. 5. pp. 1048-1052.
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abstract = "OBJECTIVE: To present a novel algorithm for definitive reconstruction of penile curvature in men undergoing inflatable penile prosthesis (IPP) surgery as an alternative to manual penile modeling and grafting procedures.METHODS: Patients with erectile dysfunction and concomitant penile curvature undergoing IPP placement were divided into 2 treatment groups: (1) group 1, penile deformity known preoperatively, and (2) group 2, penile curvature recognized intraoperatively after IPP placement. Group 1 patients underwent penile plication after artificial erection and immediately before IPP insertion via the same penoscrotal incision, whereas group 2 patients were treated with a Yachia (Heineke-Mikulicz) corporoplasty over the intact cylinders. Patients completed postoperative Patient Global Impression of Improvement (PGI-I) questionnaires assessing overall satisfaction.RESULTS: Among 405 men receiving IPP at our institution from 2007 to 2014, 30 patients received synchronous correction of penile curvature (7{\%}). Group 1 included 23 of 30 (77{\%}) patients, and 7 of 30 (23{\%}) were in group 2. Overall mean initial curvature was 36°, and all patients were corrected to < 10°. Average operative times were 18 minutes longer compared with patients who underwent IPP placement alone (82 vs 64 minutes, P <.05). At an average follow-up of 13 months (range 7-32), 19 of 20 (95{\%}) group 1 and 6 of 7 (86{\%}) group 2 patients who completed surveys reported an improved overall condition. No patient reported chronic pain, recurrent deformity, or device malfunction.CONCLUSION: Penile curvature can be safely and reliably corrected at the time of IPP placement, regardless of whether the deformity was identified preoperatively.",
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