Penile prosthesis (PP) is the mainstay of treatment in Peyronie's disease (PD) with co-existent refractory erectile dysfunction (ED). This study aimed to assess the clinical outcomes of patients who underwent PP as the first-line surgical treatment in PD without ED. A total of 636 patients underwent PP for PD from 2012 to 2022, but only 168 patients who underwent PP as first-line surgical management for PD with or without ED were included in the study. The mean (SD) age of 168 patients was 56.3 years (12.4). The mean curvature of the "PD with ED" group and the "PD without ED" group were 38.2 (5.6) degrees and 42.2 (5.9) degrees. The median (IQR) follow-up was 56.0 months (34.5- 61.4). Most (86.9%) patients underwent 3-piece inflatable PP. An important finding is that 33 patients (19.6%) without ED had undergone PP. Mechanical failure requiring revision surgery was less common in the 'without ED' group than in the ED group (6.8% vs. 10.2%, p 0.04). Most PD patients without ED (87.9%, 29/33) and with ED (88.9%, 120/135) were "satisfied" after PP implantation at six months, as defined by a score of ≥4 on a 5-point Likert scale. If surgery is offered in PD, PP may be considered a safe and effective first-line surgical treatment regardless of the ED, given the acceptable complications and high satisfaction rates. However, this new concept warrants further research.
International journal of impotence research. 2024 Jun 22 [Epub ahead of print]
Ignacio Moncada, Pramod Krishnappa, Claudia Zaccaro, Augustin Fraile, Javier Romero-Otero, Juan Ignacio Martinez-Salamanca, Enrique Lledó-Garcia
Department of Urology and Robotic Surgery, Hospital Universitario Sanitas la Zarzuela, 28023, Madrid, Spain., Department of Urology and Robotic Surgery, Hospital Universitario Sanitas la Zarzuela, 28023, Madrid, Spain. ., Department of Urology, Hospital Universitario Ramon y Cajal, 28034, Madrid, Spain., Department of Urology, HM Hospitals, 28660, Madrid, Spain., Lyx Institute of Urology, Universidad Francisco de Victoria, Hospital Universitario Puerta De Hierro-Majadahonda, 28222, Madrid, Spain., Department of Urology, Hospital General Universitario Gregorio Marañón, 28007, Madrid, Spain.