Penile curvature after Peyronie's disease surgery: What are the risk factors?

Abstract

Surgery is the golden standard for the treatment of patients with Peyronie's disease in chronic phase (12-18 months). Learning risk factors for post-surgical curvature (>20 degrees) would aid both surgeon and patient in their decision-making process. The aim of this study was to investigate the risk factors for residual/recurrent curvatures. The clinical data of the patients, who underwent reconstructive surgery for PD between 1997 and 2016, were retrospectively reviewed. Follow-ups were performed via physical examination, surveys and phone calls. For shortening surgery (Nesbit/plication), initial bi-planar curvature was proved to be a predictor of post-operative curvature (p = .05). Lateral and ventral curvatures were associated with higher recurrence rates in patients who underwent grafting surgery (p = .01). In terms of baseline comorbidities, only diabetes mellitus had an association with curvature nonrecurrence for both shortening and lengthening surgeries (p < .05). Grafting surgery may be suggested to patients who had bi-planar curvatures instead of Nesbit surgery. Nesbit plication surgery may be preferred for patients with lateral and ventral curvatures instead of grafting surgery. Higher cavernosal blood pressures and more nocturnal erections of nondiabetic young patients might impede plication sutures and grafts and therefore increase penile curvature recurrence.