Jie Yang1, Jing Chen2, Xin-feng Wu3, Ning-jing Song4, Xiao-yun Xu5, Quan Li1, Di Qiao6, Jia-yi Zhang1, Wei Wang1, Huang Su1, Zeng-jun Wang1, Jian-tang Su1, Ning-hong Song7. 1. Department of Urology, First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China. 2. Department of General Surgery, First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China. 3. Institute of Dermatology Surgery, China Academy of Medical Sciences and Peking Union Medical College, Nanjing, People's Republic of China. 4. Department of Dermatology, Shanghai Skin Diseases Hospital, Shanghai, People's Republic of China. 5. Department of Dermatology, Jiangsu Province Official Hospital, Nanjing, People's Republic of China. 6. Department of Urology, Jiangsu Province Official Hospital, Nanjing, People's Republic of China. 7. Department of Urology, First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China. Electronic address: yj197912@163.com.
Abstract
PURPOSE: We evaluated whether glans preserving surgery would be more helpful for patients to regain satisfactory sexual competency postoperatively than conventional partial amputation. MATERIALS AND METHODS: From 2004 to 2012 at 4 centers a total of 135 men treated with glans preserving surgery and 36 treated with partial amputation were selected for evaluation from a total of 273 consecutive patients with penile cancer. Subjective evaluation for patient sexual performance was investigated using the IIEF-15. Objective evaluation was done using the audiovisual sexual stimulation test with the RigiScan® Plus. The degree of satisfaction with penile appearance, and patient confidence and partner acceptability for intercourse were evaluated by 5-point scales. RESULTS: Patients treated with glans preserving surgery had better performance in 4 IIEF-15 domains (erectile function, orgasmic function, intercourse satisfaction and overall satisfaction) and 1 RigiScan parameter (tip rigidity) (each p <0.01). They also had significantly higher appearance satisfaction (64.4% vs 13.9%) and intercourse confidence (55.6% vs 5.6%) than men who underwent partial amputation. Sexual partners in the glans preserving group also showed significantly higher appearance satisfaction (51.1% vs 5.6%) and intercourse acceptability (37.8% vs 16.7%) than in the partial amputation group. CONCLUSIONS: Glans preserving surgery effectively preserves the functional anatomy and cosmetic appearance of the glans penis. Glans preservation contributes to minimizing postoperative erectile dysfunction and negative psychological impediments, and promotes return to satisfactory sexual performance. Patients treated with glans preservation have more advantages in obtaining sexual acceptance from their partners than those who undergo amputation.
PURPOSE: We evaluated whether glans preserving surgery would be more helpful for patients to regain satisfactory sexual competency postoperatively than conventional partial amputation. MATERIALS AND METHODS: From 2004 to 2012 at 4 centers a total of 135 men treated with glans preserving surgery and 36 treated with partial amputation were selected for evaluation from a total of 273 consecutive patients with penile cancer. Subjective evaluation for patient sexual performance was investigated using the IIEF-15. Objective evaluation was done using the audiovisual sexual stimulation test with the RigiScan® Plus. The degree of satisfaction with penile appearance, and patient confidence and partner acceptability for intercourse were evaluated by 5-point scales. RESULTS:Patients treated with glans preserving surgery had better performance in 4 IIEF-15 domains (erectile function, orgasmic function, intercourse satisfaction and overall satisfaction) and 1 RigiScan parameter (tip rigidity) (each p <0.01). They also had significantly higher appearance satisfaction (64.4% vs 13.9%) and intercourse confidence (55.6% vs 5.6%) than men who underwent partial amputation. Sexual partners in the glans preserving group also showed significantly higher appearance satisfaction (51.1% vs 5.6%) and intercourse acceptability (37.8% vs 16.7%) than in the partial amputation group. CONCLUSIONS:Glans preserving surgery effectively preserves the functional anatomy and cosmetic appearance of the glans penis. Glans preservation contributes to minimizing postoperative erectile dysfunction and negative psychological impediments, and promotes return to satisfactory sexual performance. Patients treated with glans preservation have more advantages in obtaining sexual acceptance from their partners than those who undergo amputation.
Authors: Vasileios I Sakalis; Riccardo Campi; Lenka Barreto; Herney Garcia Perdomo; Isabella Greco; Łukasz Zapala; Mithun Kailavasan; Tiago Antunes-Lopes; Jack David Marcus; Kenneth Manzie; John Osborne; Benjamin Ayres; Luc M F Moonen; Andrea Necchi; Juanita Crook; Pedro Oliveira; Lance C Pagliaro; Chris Protzel; Arie S Parnham; Maarten Albersen; Curtis A Pettaway; Philippe E Spiess; Scott T Tagawa; R Bryan Rumble; Oscar R Brouwer Journal: Eur Urol Open Sci Date: 2022-05-02
Authors: Roman Sosnowski; Marta Kulpa; Mariola Kosowicz; Jan Karol Wolski; Olga Kuczkiewicz; Katarzyna Moskal; Michał Szymański; Tomasz Kalinowski; Tomasz Demkow Journal: Cent European J Urol Date: 2016-06-20