Corporoplasty for advanced Peyronie's disease using venous and/or dermis patch grafting: new surgical technique and long-term patient satisfaction

PURPOSE: We evaluated long-term results and patient satisfaction after corporoplasty using saphenous vein and/or dermis patch grafting in patients with advanced Peyronie's disease. MATERIALS AND METHODS: A total of 20 patients who underwent venous and/or dermis patch corporoplasty were followed a mean of 19 months. Postoperatively patients satisfaction was assessed using the International Index of Erectile Function questionnaire. The mean preoperative grade of deviation in this collective was 86 degrees, frequently associated with additional malrotation. RESULTS: Intraoperatively the deviation was straightened in all cases. Postoperatively 20% of patients complained of 1 or 2 cm. penile shortening and in 25% there was a slight deviation relapse of 5 to 15 degrees. Only 2 patients had recurrence (30 and 70 degrees, respectively. In 3 cases (15%) postoperative erectile dysfunction was treated successfully with sildenafil or prostaglandin E. Overall postoperative sexual satisfaction score on the International Index of Erectile Function was 2.76 of a possible 5, although erection and cohabitation status were rated higher with at 3 and 2.94, respectively. CONCLUSIONS: Saphenous vein interposition is safe and effective for high grade Peyronie's disease. In cases of insufficient vein anatomy additional dermis patch interposition is a good alternative. The limited median postoperative patient satisfaction score even for minor procedures with good objective results indicates only moderate overall satisfaction at a mean of 19 months postoperatively, which was likely due to high preoperative patient expectation of surgical correction.