Introduction and Objectives
Peyronie disease (PD) predominantly occurs in men aged 40–60 years. Exact etiology of PD is not clear. Usually, the penis hurts only during an erection. This pain occurs in one third of patients and is pathognomonic for PD. Penile curvature of varying degrees may be observed, only during an erection. Issues concerning surgical indication, patient selection, surgical techniques, and grafting are still discussed in literature. Aim: to evaluate outcomes of Peyronie's disease surgical treatment by venous grafting.
Material and Methods
A total 58 patients (surgery from 2003 to 2008 year) undergone lengthening procedures on the convex side of the penile curvature by means of vena saphena grafting. The mean age was 57 years (37–68 years). Onset of Peyronie's disease varies from 6 months to 2 years. The mean angle of curvature was 65.4±19.5 degree. Plaque was excised and vena saphena grafting was used to cover the defect. The mean follow-up time was 24.1±5.9 months (11–48 months). Patients were asked to contact surgeon by mail and answer questions concerning change of rection, straightness, pain when penis erected, glans penis hypoesthesia. 58 letters were sent and 44 answers were collected (response rate 75.9%).
Results
Increase of erection mentioned in 3 (6.8%) patients. The same erection observed in 29 (65.9%) patients. Worse erection reported in 12 (27.3%) cases. In 6 (13.6%) patients curvature apeared again, in 38 (86.4%) patients penis remains straight. Pain in erected penis remained in 3 (6.8%) patients, usually related with recurrence curvature. Glans penis hypoesthesia present in 13 (29.5%) patients.
Conclusions
PD surgery with v.saphena grafting is effective treatment of penile curvature. Glans penis hypoesthesia and erectile dysfunction are main long term complications of PD surgery.
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Copyright
© 2009 European Association of Urology. Published by Elsevier Inc. All rights reserved.
