The combination of penile revascularization surgery with penile corrective techniques as an alternative to prosthesis implantation in patients with Peyronie's disease having ED: preliminary results.

The aim of this study was to investigate for the first time the surgical results of combining complex corrective techniques with penile revascularization in patients with Peyronie's disease having ED and consider the technique as an alternative to penile prosthesis implantation. Between 2008 and 2011 penile revascularization surgery along with penile corrective techniques was performed in nine patients with Peyronie's disease having ED. A preoperative urological evaluation was performed with penile color doppler ultrasonography, electromyography of the corpus cavernosum and cavernosometry. The degree of penile angulation was >40° in all patients. All the patients were asked to answer a 15-item questionnaire-the 'International Index of Erectile Function' (IIEF-15)-and a 5-item version of the IIEF (IIEF-5) preoperatively and during the postoperative follow-up. The operation was deemed an improvement or a failure according to the scores on the IIEF-5. The mean age of the patients was 51.4±4.2 years. The mean follow-up period was 18 months. None of the patients reported complications after surgery. Complete penile straightening was achieved in all patients. However, two (22.2%) patients reported penile shortening but did not express any dissatisfaction in this regard. All patients were satisfied with the final surgical results. The mean IIEF-5 score was 9.8±3.1 before the operation and it was reported to be 22.03±2.4 at the end of the follow-up period (P<0.05). The mean erectile function domain score was 12.6±3.7 preoperatively and 24.09±3.9 at the end of the follow-up period (P<0.05). We achieved statistically significant improvements on the IIEF scores, and with this satisfactory preliminary results we suggest that this combination could be an alternative to penile prosthesis implantation in highly selected patients with Peyronie's disease having ED; however, further studies are needed to validate this conclusion.