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Predicting erectile dysfunction following surgical correction of Peyronie's disease without inflatable penile prosthesis placement: vascular assessment and preoperative risk factors.

Publication ,  Journal Article
Taylor, FL; Abern, MR; Levine, LA
Published in: J Sex Med
January 2012

INTRODUCTION: Surgical therapy remains the gold standard treatment for Peyronie's Disease (PD). Surgical options include plication, grafting, and placement of inflatable penile prosthesis (IPP). Postoperative erectile dysfunction (ED) is a potential complication for PD surgery without IPP. We present our large series follow-up to evaluate preoperative risk factors for postoperative ED. AIMS: The aim of this study is to evaluate preoperative risk factors for the development of ED following surgical correction of PD taking into account the degree of curvature, graft size, surgical approach, hypertension, hyperlipidemia, diabetes, smoking history, preoperative use of phosphodiesterase 5 inhibitors (PDE5), and preoperative duplex ultrasound findings including peak systolic and end diastolic velocities and resistive index. METHODS: We identified 218 men undergoing either tunica albuginea plication (TAP) or partial plaque excision with pericardial grafting for PD following a previously published algorithm between November 1992 and April 2007. Preoperative and postoperative erectile function, curvature characteristics, presence of vascular risk factors, and duplex ultrasound findings were available on 109 patients. MAIN OUTCOME MEASURES: Our primary outcome measure is the development of ED after surgery for PD. RESULTS: Ten percent of TAP and 21% of plaque excision with grafting patients developed postoperative ED. Neither curve direction (P = 0.76), graft area (P = 0.78), surgical approach (P = 0.12), chronic hypertension (P = 0.51), hyperlipidemia (P = 0.87), diabetes (P = 0.69), nor smoking history (P = 0.99) were significant predictors of postoperative ED. No combination of risk factors was found to be predictive of postoperative ED. Preoperative use of PDE5 was not a significant predictor of postoperative ED (P = 0.33). Neither peak systolic, end diastolic, nor resistive index were significant predictors of ED (P = 0.28, 0.28, and 0.25, respectively). CONCLUSION: This long-term follow-up of a large published series suggests that neither preoperative risk factors nor preoperative duplex ultrasound findings are predictive of postoperative ED, thus reinforcing the use of previously published preoperative treatment algorithms.

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Published In

J Sex Med

DOI

EISSN

1743-6109

Publication Date

January 2012

Volume

9

Issue

1

Start / End Page

296 / 301

Location

Netherlands

Related Subject Headings

  • Ultrasonography
  • Risk Factors
  • Postoperative Complications
  • Penis
  • Penile Induration
  • Penile Erection
  • Obstetrics & Reproductive Medicine
  • Middle Aged
  • Male
  • Humans
 

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ICMJE
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Journal cover image

Published In

J Sex Med

DOI

EISSN

1743-6109

Publication Date

January 2012

Volume

9

Issue

1

Start / End Page

296 / 301

Location

Netherlands

Related Subject Headings

  • Ultrasonography
  • Risk Factors
  • Postoperative Complications
  • Penis
  • Penile Induration
  • Penile Erection
  • Obstetrics & Reproductive Medicine
  • Middle Aged
  • Male
  • Humans