To present the feasibility and safety of penile length and girth restoration based on a modified "sliding technique" for patients suffering from severe ED, significant penile shortening with or without Peyronie's disease.
MATERIALS AND METHODS: Between January 2013 and January 2014, 143 patients underwent our modified "sliding technique" for penile length and girth restoration and concomitant penile prosthesis implantation. It is based on three key elements: 1) the sliding maneuver for penile length restoration, 2) potential complementary longitudinal ventral and/or dorsal tunical incisions for girth restoration, and 3) closure of the newly created rectangular bow-shaped tunical defects with Buck's fascia only.
RESULTS: 143 patients underwent the procedure. The etiologies of penile shortening and narrowing were PD in 53.8%, severe ED with unsuccessful intracavernosal injection therapy in 21%, post-radical prostatectomy 14.7%, androgen deprivation therapy, with or without brachytherapy or external radiotherapy, for prostate cancer in 7%, post-penile fracture in 2.1%, post-redo-hypospadias repair 0.7%, and post-priapism in 0.7%. In cases of ED and PD, the mean deviation of the penile axis was 45° (range, 0-100°). The mean subjective penile shortening reported by patients was 3.4 cm (range, 1-7 cm), and shaft constriction was present in 53.8%. Malleable penile prostheses were used in 133 patients and inflatable penile prostheses were inserted in 10 patients. The median follow-up was 9.7 months (range, 6-18 months). The mean penile length gain was 3.1 cm (range, 2-7 cm). No penile prosthesis infection caused device explantation. The average IIEF score increased from 24 points at baseline to 60 points at the six-month follow-up.
CONCLUSION: Penile length and girth restoration based on our modified "sliding technique" is a safe and effective procedure. The elimination of grafting saves operative time and consequently, decreases infection risk and costs associated with surgery.
Written by:
Egydio PH, Kuehhas FE. Are you the author?
Centre for Peyronie's Disease Reconstruction, Sao Paulo, Brazil.
Reference: BJU Int. 2015 Jan 28. Epub ahead of print.
doi: 10.1111/bju.13065
PubMed Abstract
PMID: 25644141