Penile Sensory Changes After Plaque Incision and Grafting Surgery for Peyronie’s Disease

摘要

IntroductionPlaque incision and grafting (PIG) for Peyronie’s disease (PD) is not devoid of complications such as erectile dysfunction and penile sensory changes. AimTo define the rate and chronology of penile sensation loss after PIG surgery and to define predictors of such. MethodsThe study population consisted of patients with PD-associated penile curvature who underwent PIG surgery with at least 6 months of follow-up. Demographics and PD factors were recorded. Patient had preoperative assessment of penile sensation and deformity. Postoperative follow-up occurred at 1 week, 1 month, 6 months, and 1 year after surgery. Neurovascular bundle elevation was conducted with loupe magnification. Main Outcome MeasurePenile sensation was evaluated with a biothesiometer and graded on a patient-reported visual analog scale (0–10) in which 0 defined a completely numb area and 10 defined perfect sensation. The degree of sensation loss was defined as extensive (any 1 area >5 cm), major (2–5 cm), and minor (≤2 cm). The penile sensation loss distribution was defined as focal (1 site) or diffuse (>1 site). Results63 patients were analyzed. Mean age was 56 ± 10 years. Mean duration of PD at the time of PIG was 15 ± 7 (12–38) months. 75% had curvature alone, and 25% had hourglass/indentation deformities. Mean primary curvature was 64? ± 28?. The mean operation duration was 3.5 ± 1.8 hours. 21% had some degree of sensation loss at 1 week, 21% at 1 month, 8% at 6 months, and 3% at 12 months. Only 1 patient (1.5%) at 2 years continued to have extensive sensation loss on the glans and distal shaft with a very elevated sensitivity threshold. Using multivariable analysis, the only predictor of penile sensation loss ≥6 months was a duration of operation >4 hours (odds ratio?= 2.1; 95% confidence interval?= 1.2–3.0;P 12 months. Longer operations appeared to be more likely associated with sensation loss.Terrier JE, Tal R, Nelson CJ. Penile sensory changes after plaque incision and grafting surgery for Peyronie’s disease. J Sex Med 2018;15:1491–1497.